Authors (including presenting author) :
Chiu HN(1), Cheung WT (1), Cassandra Ho WH (1), Joey Ng CM (1), Leo Cheung CT (1)
Affiliation :
(1) Physiotherapy Department, Tai Po Hospital
Keyword 1: :
Physiotherapy
Keyword 2: :
Geriatric psychiatry
Keyword 3: :
Immobilization
Introduction :
Prolonged physical restraint in psychogeriatric patients is associated with immobilization, muscle atrophy, and decline in mobility. Current evidence regarding frequency of treatment varies, which in turn affects rehabilitation outcomes. A structured ambulatory program can minimize the effects of immobilization and reduce adverse outcome.
Objectives :
The objective of the project was to investigate the effect of increased physiotherapy intervention frequency on mobility status in psychogeriatric patients subjected to prolonged physical restraint.
Methodology :
This was a pilot study conducted over nine months in a male psychogeriatric ward. Forty patients under physical restraint were assigned to two groups: an Intervention Group (n=20) receiving a standardized mobilization program 5 times per week and a Control Group (n=20) receiving the standard frequency of 3 times per week. Baseline and post-intervention measurements were taken using the Modified Functional Ambulation Category (MFAC), Elderly Mobility Scale (EMS), and Walking Distance. Paired and unpaired t-tests were used for within-group and between-group comparisons, respectively.
Result & Outcome :
The groups were comparable at baseline (p > 0.05 for all demographics and outcome measures). The Intervention Group showed a statistically significant improvement in Walking Distance post-intervention (mean difference +44.0 m; p = 0.006), while the Control Group's improvement was non-significant (mean difference +8.9 m; p = 0.142). The between-group comparison revealed a highly significant difference in the mean gain of Walking Distance, favoring the Intervention Group (t = 3.852, p = 0.0005). For outcomes in MFAC and EMS, the intervention group showed greater improvement when compared with the control group. However, the differences were small and did not reach statistical significance (p > 0.05),the statistically insignificant improvements may be explained by the small sample size and same gender. Increasing physiotherapy sessions from three to five times per week significantly reduces decline in walking endurance in physically restrained psychogeriatric patients. This approach is vital for countering immobilization-induced deconditioning, particularly in cardiovascular and muscular endurance. The study supports high-frequency mobilization protocols to enhance rehabilitation outcomes in psychiatric settings. Further research is warranted to determine the optimal intervention frequency and to explore effects on broader functional scales.
