The COVID-19 pandemic has led to a surge in medical service demand.Physiotherapists are important in facilitating the acute management and rehabilitation of patients with COVID-19.In this case series, we outline the major roles of outreach physiotherapy and tele-physiotherapy in managing patients with COVID-19.Among 121 patients referred for outreach physiotherapy services from February to April 2022, 25 had COVID-19.We identified four themes concerning physiotherapeutic management of patients with COVID-19: urgent onsite chest physiotherapy, oxygen therapy management, home-based rehabilitation, and tele-physiotherapy.Outreach physiotherapy services can reduce strain on public hospital services during the COVID-19 pandemic by preventing AED or hospital admissions, rehabilitating frail patients, and close monitoring of patient conditions during home isolation periods.

In Hong Kong, more than 1.8 million people had ever been tested positive for SARS-CoV-2 during the COVID-19 pandemic. 1In 2022, 9287 deaths from COVID-19 infections were reported, of which 96.9% occurred in those aged >60 years and 69.9% were never vaccinated.Vaccines for COVID-19 have been proved to be effective in reducing mortality in older adults.However, vaccine hesitancy remains major barriers, with a prevalence of 27.7%. 2 In the current issue, Wong 3 reviewed clinical efficacies of influenza, pneumococcal, and herpes zoster vaccines, and proposed strategies to improve their uptakes to better protect older adults.It is hope that with concerted efforts of multiple sectors, mortality from these common viruses can be curtailed.Despite social isolation measures during the pandemic, patient care and healthcare services still needed to be maintained.Suitable patients might better be managed at their own residence, whether it was at residential care homes for the elderly (RCHEs) or their own homes.Mo et al 4 shared their experiences of outreach physiotherapy for geriatric patients with COVID-19.These care experiences are valuable for planning future outreach pulmonary services.Comprehensive geriatric assessment, followed by appropriate interventions, is effective in improving functional outcomes and decreasing acute hospital stays and discharges to RCHE. 5 This requires medicosocial collaboration, particularly in ageing populations in which the proportion of older people attending accident and emergency departments is expected to rise.Cheung and Lee, 6 in a qualitative study, highlighted concerns from frontline emergency department workers on the limitations in provision of direct services, medical-social collaboration, hospital-community interface, and environment conducive to elder care.Additionally, Wong et al 7 used two case reports to illustrate the need for hospital/RCHE and medico-social collaborative models for care of dying patients.It is hope that directors of healthcare services take deep thoughts on the issues and plan ahead to meet the challenging demands.

Sarcopenia is a diagnosis included in the International Classification of Diseases, but there is no consensus on its diagnostic criteria.We reviewed studies from the past 5 years to identify associations of individual sarcopenia components with adverse outcomes.Most studies follow guidelines established by either the European Working Group on Sarcopenia in Older People or the Asian Working Group on Sarcopenia.However, no method for measuring muscle mass can accurately predict adverse outcomes, except for the creatine dilution method.Cut-off values for muscle mass and strength also differ among studies.Standardised measurements and appropriate cut-off values for muscle mass and strength may help to develop preventive strategies and treatments.

Homes for the aged; Hospice care cerebrovascular disease, hypertension, and diabetes mellitus, who was non-communicable, bedbound, and receiving nasogastric tube feeding, was diagnosed with carcinoma of the rectum with multiple liver metastases.Her family opted for conservative management.An end-of-life (EOL) programme was introduced by the CGAT.After a thorough discussion with the family regarding the care plan, a nonhospitalised Do-Not-Attempt Cardiopulmonary Resuscitation (DNACPR) order and an advance care plan (ACP) were established.The JCECC team including the designated community doctor (ie, visiting medical officer of the RCHE), together with the RCHE, held a meeting with the patient's family to discuss EOL care including the preferred place of death.After the patient had been hospitalised for sepsis and hyperglycaemia in September 2024, the family expressed a preference for the patient to receive care and die in the RCHE, rather than undergo further hospitalisation.Communication among CGAT, community doctor, RCHE, and family was initiated.The family's wish was supported, and assistance in logistics of funeral services was provided by the RCHE and JCECC.In October 2024, the patient's condition deteriorated, with high haemoglucostix readings.She was assessed by the CGAT doctor and prescribed insulin injections.However, after discussion with the community doctor and the family, a decision was made to discontinue insulin injections and haemoglucostix monitoring.The patient's condition continued to decline; she was transferred to the EOL room, a specially decorated accommodation designed to allow terminally ill residents to remain with their

Background.Osteoarthritis (OA) of the knee affects daily activities and quality of life among older adults.Tele-rehabilitation minimises barriers of distance, time, and cost.This study aimed to compare the effects of tele-rehabilitation and supervised rehabilitation on balance, physical function, and disability among patients with knee OA.Methods: Patients aged 40 years with grade 2 or 3 knee OA and impaired balance and moderate knee pain were recruited from Dr DY Patil College of Physiotherapy, Pimpri Pune, India.Patients were randomly assigned to either a tele-rehabilitation (via Zoom) group or a supervised rehabilitation group; both groups received three rehabilitation sessions per week for 4 weeks.The exercise protocol consisted of mobility, stretching, and strengthening exercises for the affected lower limb, along with balance training.Patients were assessed before and after the intervention using the timed-up-and-go test (TUG) for balance, one-leg standing test for static balance, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for pain, stiffness, and physical function. Results:Of 86 patients screened for eligibility, 30 were enrolled and randomly assigned to receive either tele-rehabilitation (n=15) or supervised rehabilitation (n=15).Finally, 28 participants completed the intervention (one dropout in each group).The two groups were comparable in terms of age, body mass index, pain intensity, and baseline outcomes in the TUG test, one-leg standing test, and WOMAC.After the intervention, both groups demonstrated significant improvements in all outcome measures, with the exception of the left-side one-leg standing test in the tele-rehabilitation group (p=0.483).Both groups had similar improvements in TUG test for balance (p=0.640),one-leg standing test for static balance (p=0.541 for right leg, p=0.764 for leftleg), and WOMAC for disability (p=0.837).Conclusions: Tele-rehabilitation and supervised rehabilitation have similar effects on improving balance, physical function, and disability in patients with knee OA.