Hong Kong health care and hospitals

How barcodes are helping elderly patients exercise correctly in Hong Kong

The QR code programme is a pilot project designed to pave the way for long-range medical consultations using electronic devices

PUBLISHED : Tuesday, 02 January, 2018, 7:01am
UPDATED : Tuesday, 02 January, 2018, 3:06pm

With the help of a few barcodes, elderly patients in Hong Kong who had their worn-out knee joints replaced at Pamela Youde Nethersole Eastern Hospital could exercise at home before and after surgery using their smartphones to watch their physiotherapists demonstrating the correct movements.

Launched in February and extended to serve patients recovering from breast cancer in October, the QR code programme was a pilot project designed to pave the way for long-range medical consultations using electronic devices.

“We are trying to learn about how well the elderly patients can utilise the technology and devices such as smartphones and tablet computers through the pilot project,” said Sambo Wan Shuk-ying, manager of the hospital’s physiotherapy department.

“In the long run, we would like to develop tele-consultations, so that patients – especially the elderly – don’t have to come to the hospital so often.”

Around 170 patients received knee arthroplasty, or replacement, surgery in 2016 at Eastern Hospital in Chai Wan, of which 86.5 per cent were aged 65 and above.

“We chose to produce motion graphics of preparatory and rehabilitative exercises for them because the majority of the group consists of senior patients. For them, the movements involved are relatively complicated and proper exercises are vital for their recovery,” level-two physiotherapist Thomas Chan Yee-on said.

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Before their surgery, a patient would have to exercise their knee and thigh muscles every day for a month. After the first week of therapy in hospital following surgery, the patient would have to complete the other two stages of rehabilitation by exercising at home. The 40 to 60 minutes of exercises each day included stretching their toes and ankles, straightening the knee and practising to walk with a stick.

The first stage of domestic therapies could last for two to three months, during which the patient would visit the doctor once every one or two weeks. The length of the second stage would depend on how well the patient could walk and balance.

“Improper exercise – too little, too much or in the wrong positions – could leave the patients with stiff knees and chronic pain,” level-one physiotherapist Man Chun-bong said.

To demonstrate the correct movements, the therapists spent five months developing a total of 19 motion graphics for the four stages of exercises.

QR codes were generated for each of the motions and affixed to the corresponding pages of four exercise pamphlets, in which still photos of positions, written descriptions and advice from therapists were also provided.

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From March to May, 35 patients who had knees replaced at Eastern Hospital were given the new pamphlets with QR codes. Of the 24 family members of patients who were interviewed by the hospital for feedback, 71 per cent agreed that the QR codes and motion graphics were effective in helping them to make sure that the patients exercised adequately and properly at home.

“Without the QR codes and the motion graphics, I wouldn’t know that my knees were not straightened enough at home,” said Rose Chiu, 69, who had both her knees replaced last year.

It took Chiu three weeks to get rid of the walking frame after her first surgery in June and only one week after the second operation in November.

“Watching the motion graphics made me more confident in overcoming the pain to exercise so I progressed better,” Chiu said.

Chiu’s husband, Fung Bing-yiu, a 75-year-old smartphone user, said he mastered the use of the QR codes after the therapists taught him once.

“It’s very handy. We watched the graphics together when I supervised her exercising,” Fung said.