Research Report Abstracts - Gesundheit

WPT2011, Research Report Abstracts eS1355
Participants: Consecutive patients (n = 2423) referred to the
RJAP with hip or knee osteoarthritis were evaluated from
2007 to 2010.
Methods: After consenting to an interprofessional examination,
physical characteristics (age, height, weight, body mass
index), clinical examination and radiographic findings were
evaluated. Physical function was assessed by self-report in
patients with osteoarthritis (OA) of the hip using the Oxford
Hip Score, Lower Extremity Functional Scale (LEFS) and the
Harris Hip Score (HHS) while patients with OA of the knee
completed the Oxford Knee Score, the LEFS and the Knee
Society Score (KSS). Actual performance measures included
the 6 minute walk test (6MWT) and Timed Up and Go (TUG)
for patients with hip OA; the 6MWT and stair test for patients
with knee OA.
Analysis: Patient characteristics were examined using univariate
analyses. Time to surgery was measured as the number
of days from initial review to surgery. Independent t-tests
were used to examine between-group differences in patients
who accessed surgery via the RJAP versus surgeons’ offices.
Differences were deemed significant at p < 0.05.
Results: 2423 patients were evaluated in the RJAP between
2007 and 2010. Of those, only 673 (28%) required surgical
review. Wait times and function were compared in a subset
of 678 patients (63% females, 65% knees) with mean ± sd
age of 66 ± 13 years and BMI of 31 ± 7 kg/m 2 who accessed
surgery through RJAP vs. surgeon’s offices from 2007 to
2009. Both self report (Oxford, Harris Hip, LEFS scores)
and performance (6MWT, stair) measures were significantly
worse (p < 0.001) in patients who required surgical review.
No significant difference existed in KSS (p = 0.57) or TUG
times (p = 0.74) for patients with knee or hip OA, respectively.
Wait time for surgery was significantly less (p < 0.001) when
accessed via the RJAP (THA: 139 days, TKA: 115 days) compared
to the provincial target (182 days) and via surgeons’
offices (THA: 194 days, TKA: 206 days).
Conclusions: These data suggest that the use of APPs in
multidisciplinary triage clinics streamlines care, reduces surgical
wait times, and establishes priority for surgical review
of patients with hip or knee OA that is based on function.
Implications: Despite multidisciplinary consensus panels
suggesting indications for THA or TKA should be increased
pain and reduced function, studies reveal that radiographic
findings influence surgeon’s decision in daily practice. Conversely,
APPs appear to base their decisions on function.
Keywords: Triage; Osteoarthritis; Total joint arthroplasty
Funding acknowledgements: This work received funding
from the following agencies: Ontario Ministry of Health and
Long Term Care.
Ethics approval: Ethics approval for evaluation of the RJAP
is through Hamilton Health Science/McMaster University
Faculty of Health Sciences REB.
Research Report Poster Display
Number: RR-PO-209-3-Thu Thursday 23 June 12:00
RAI: Exhibit Halls2&3
A COMPREHENSIVE HEALTHY LIFESTYLE
PROGRAM FOR CHILDREN RECEIVING
TREATMENT FOR ACUTE LYMPHOBLASTIC
LEUKEMIA: FEASIBILITY AND EFFICACY
Wright M. 1,2 , Nathan P. 3 , Collins L. 1 , Birken C. 3 , Johnston
K. 3
1McMaster Children’s Hospital, Hamilton, Canada,
2McMaster University, Hamilton, Canada, 3Hospital for
Sick Children, Toronto, Canada
Purpose: This study was undertaken to evaluate the feasibility
and efficacy of a comprehensive healthy lifestyle program
to promote physical activity and optimal nutrition for children
receiving treatment for acute lymphoblastic leukemia
(ALL).
Relevance: Children receiving treatment for ALL may experience
reduced habitual physical activity, weight gain, and
motor function deficits. Survivors are at risk for numerous
long-term treatment sequelae including obesity, cardiac dysfunction,
metabolic syndrome, and restricted participation
and limitations in physical activities. It is important to promote
optimal activity and nutrition practices, however service
delivery can be challenging.
Participants: A convenience sample of 13 eligible children
in the maintenance phase of treatment for standard risk ALL,
ages 4–8 years (mean 5.5), 77% male, enrolled in the study.
Methods: A tailored lifestyle program involving a series
of 7 monthly individual education sessions was provided
for parents and children by a physiotherapist, oncologist,
dietician, and behavioural therapist. The content focused on
evidence based approaches to facilitate participation in physical
activity and encourage healthy eating habits. Behavioural
techniques to promote the activity and nutrition recommendations
were suggested. Sessions were complemented
with comprehensive written materials. Measures included
indicators of feasibility, the 6-minute walk test (6MWT),
Gross Motor Function Measure-ALL (GMFM-ALL), Pediatric
Orthopedic Society of North America transfers and
basic mobility (POSNA-TM) and sports and physical function
(POSNA-SP) scales, Habitual Activity Estimation Scale
(HAES), dorsiflexion range of motion, and Body Mass Index
percentiles for age (BMI%).
Analysis: Analyses included descriptive documentation of
feasibility factors and paired t-test of pre/post data to determine
efficacy.
Results: The accrual rate was 52%. Twelve (92%) of the families
completed the program with an attendance rate of 100%
for the physiotherapy components and an overall program
attendance rate of 94%. Time for physiotherapy sessions was
not considered a burden to staff or families and all were delivered
face-to-face. However, 12% of the other sessions were
delivered by phone due to scheduling difficulties. Parents’