Authors (including presenting author) :
Poon A (1), Won SW (1), Yuan WS(1) , Wan CN(1), Tam SH(1), Chang LM(1), Chan SY(1), Ip WM(1), Lau M(1)
Affiliation :
(1) Occupational Therapy Department, Shatin Hospital
Keyword 1: :
Action Observation Therapy
Keyword 2: :
ADL Training
Introduction :
Over the next five years, the development of smart care will be a key focus for occupational therapy. Action Observation Therapy (AOT) is a dynamic approach where patients observe and then imitate purposeful actions, allowing them to safely rehearse and practice functional tasks. To align with the strategic direction of smart care, the Occupational Therapy (OT) Department at Shatin Hospital has developed and implemented an AOT intervention protocol for Activities of Daily Living (ADL) training.
Objectives :
The primary goal is to integrate AOT and intervention protocols into ADL training and interventions to enhance patient engagement, compliance, and the clinical effectiveness and standardization of OT practices.
Methodology :
The initiative was structured into three main phases: I.Development and Standardization (December 2024)
Conducted a needs assessment to identify current practices and service gaps in ADL training.
Developed AOT training videos and protocols based on activity analysis and stratified levels of assistance.
Created 23 instructional AOT training videos covering various domains, including upper and lower garment dressing, toileting, and showering, with step-by-step processes for both observation and execution phases.
Uploaded all standardized training protocols and AOT training videos to the department's electronic platform, enabling remote training for patients via electronic devices.
II.Staff Training and Engagement (February and March 2025)
Implemented specialized training for Occupational Therapists (OTs) and Patient Care Assistants (PCAs) focusing on the principles of AOT in ADL training, training protocols, assistance stratification, preparation, procedures, safety, and precautions.
III.Clinical Application and Outcome Evaluation (March to November 2025)
Applied AOT training videos and protocols according to the stratified levels of assistance.
Evaluated the effectiveness of AOT training using the Modified Barthel Index.
Assessed the feasibility and satisfaction of OTs, PCAs, and patients through a quantitative questionnaire using a 5-point Likert scale (1 = not helpful/insufficient to 5 = very helpful/best) for helpfulness, acceptability, ease of setup, reasonableness, and adherence to AOT training.
Result & Outcome :
Patient Practice: From March to November 2025, 3,129 patients practiced AOT in ADL training, with cognitive functions ranging from less than the 2nd percentile to more than the 16th percentile on the HK MoCA 5.
Application Scope: The program covered various patient specialties, including geriatric day patients (10.9%), general medical and geriatric in-patients (69.6%), surgical in-patients (10.9%), neurological in-patients (4.3%), and palliative care in-patients (4.3%).
Satisfaction:
Patient satisfaction scores were high, with helpfulness (mean = 3.98), acceptability (mean = 4.2), and training adherence (mean = 4.0); therapists found the training highly feasible and satisfactory, with helpfulness (mean = 4.3), acceptability (mean = 4.4), and reasonableness and logic (mean = 4.4); and PCAs reported good ease of setup (mean = 3.88) and moderate acceptability (mean = 3.56).
Effectiveness of AOT:
Evaluated 196 patients who received AOT training for at least one week (mean attendance = 25.3 sessions).
Mean age: 79.1 years; 52.5% female.
Paired sample t-test showed significant improvement in the Modified Barthel Index (t = -12.8, P = 0.00). Conclusion
AOT has been proven to be an effective tool for ADL training, enhancing the positive effects of action observation and execution. It allows patients to safely practice ADL tasks, increases patient engagement and compliance, and improves the clinical effectiveness of occupational therapists in ADL training and intervention.
