I am registered nurse with trainings in music, sports, and psychology. Currently a PhD student at The Hong Kong Polytechnics University, dedicated to promote the use of music in rehabilitation.
EDUCATION
MSc (Psychology), MA (Psychology of Music), BNur
RESEARCH, TEACHING, or OTHER INTERESTS
Physical Therapy, Sports Therapy and Rehabilitation, Psychology, Multidisciplinary, Music
10
Scopus Publications
Scopus Publications
Patients’ perspectives and experiences on physiotherapy care for knee osteoarthritis: A qualitative study Fadi M Al Zoubi, Arnold YL Wong, Mandy MP Kan, Aliki Thomas, André E Bussières Clinical Rehabilitation, 2025 Objective To explore the perspectives and experiences of patients with knee osteoarthritis regarding physiotherapy care management in Hong Kong. Design Qualitative study using semi-structured, individual interviews. Setting Community. Participants Patients age 50 years or older with knee osteoarthritis, purposively recruited. Intervention Face-to-face semi-structured interviews were conducted with patients who had completed a physiotherapy rehabilitation programme in the past six months. Main Measures A 21-question interview guide encouraged participants to discuss their physiotherapy management, experiences, and recommended interventions, covering all non-pharmacological treatments outlined in local clinical guidelines. Questions also explored factors influencing adherence to care during and after physiotherapy. Interviews were audio-recorded, transcribed verbatim, and analysed thematically. Results Fourteen patients participated. Five key themes emerged: (a) navigating pain and management strategies; (b) adapting daily life and the impact of knee osteoarthritis on activities; (c) complexities of treatment and the need for personalised care; (d) the role of exercise and mobility; and (e) barriers to access and resources. While patients reported receiving various physiotherapy interventions, gaps were noted in aquatic therapy, neuromuscular training, weight management, and assistive devices. Barriers included limited access, financial constraints, and lack of home exercise equipment. Although participants valued physical activity, maintaining an exercise routine was challenging. Conclusions A comprehensive, patient-centred approach is essential for effective physiotherapy care for knee osteoarthritis in Hong Kong. Addressing practical barriers and integrating patient feedback can enhance the accessibility and impact of evidence-based interventions.
The structure, process and outcomes of interprofessional care among knee osteoarthritis patients: a scoping review Jessica Hiu Toon Lee, Mandy Ming Pui Kan, Arkers Kwan Ching Wong Efort Open Reviews, 2025 Knee osteoarthritis (OA) is a common chronic condition that leads to joint pain and disability among older adults. An interprofessional collaborative approach has nowadays been widely advocated in knee OA management although little is known about the characteristics of care, roles and responsibilities of healthcare providers and how they collaborate as a team to optimise treatment outcomes.The Donabedian structure–process–outcome framework was used in the review. Six databases were searched from February 2013 to March 2023.A total of 26 articles that met our inclusion criteria were reported. All studies (n = 26) identified the physiotherapist as a critical member of the interprofessional team. Several studies (n = 5) have offered training to healthcare providers in the management of knee OA. The intervention components in most studies included disease-based education (n = 21) and exercise therapy (n = 16).A comprehensive understanding of the existing interprofessional knee OA care in this review could potentially assist the government and healthcare organisations in developing interprofessional practice guidelines and designing intervention programmes that maximise their benefits.
Organ pedalboard as a rehabilitation tool: A qualitative exploratory study of healthcare providers’ perceptions and recommendations Mandy M. P. Kan, Wai Hang Kwok, Eric C. Fan, Fadi M. Al Zoubi Plos One, 2024 Objective This qualitative study explored healthcare providers’ perceptions and attitudes regarding the use of organ pedalboards as a rehabilitation tool, particularly for lower extremity conditions. The study also sought to identify the perceived barriers and facilitators to adopting organ pedalboards within rehabilitation settings, as well as gather healthcare providers’ recommendations for integrating this tool into clinical practice. Method Healthcare providers, including physiotherapists, occupational therapists, music therapists, and sports therapists, were recruited for focus group interviews using purposive and snowball sampling. At the outset of the interview, participants watched an organist playing musical notes on a pedalboard and had the opportunity to try on the pedalboard. A researcher then modulated the group discussion with the organist and asked questions following a semi-structured interview guide. The guided questions concern the perceptions of using organ pedal training for patients, as well as participants’ attitudes and perceived barriers towards it. Verbatim transcription and content analysis were performed on qualitative data. Findings Seventeen healthcare providers were interviewed in four focus groups. Healthcare providers perceive music as a motivator in rehabilitation, aiding in natural movement through rhythm and beats. Music intervention, particularly training on the pedalboard, is seen as beneficial for lower extremity rehabilitation, improving range of motion, balance, and coordination. It also offers cognitive benefits and enhances patient engagement and psychosocial well-being. Its safety concerns were addressed and discussed. Conclusion Our study is the first to explore the feasibility of using a pedalboard as a rehabilitation tool. Healthcare providers identify the circumstances and potential therapeutic benefits of the use of organ pedal training in the management of lower extremity problems. This will assist in the development of a lower extremity training protocol that can accommodate all the physiological hip, knee, ankle, and foot movements in the future.
Effects of Peer- or Professional-Led Support in Enhancing Adherence to Wearable Monitoring Devices Among Community-Dwelling Older Adults: Systematic Review of Randomized Controlled Trials Colette Sze Wing Chan, Mandy Ming Pui Kan, Arkers Kwan Ching Wong Journal of Medical Internet Research, 2024 Background Despite the well-documented health benefits associated with wearable monitoring devices (WMDs), adherence among community-dwelling older adults remains low. By providing guidance on the purpose and benefits of using WMDs, facilitating goal-setting aligned with the device’s features, promoting comprehension of the health data captured by the device, and assisting in overcoming technological challenges, peers and health care professionals can potentially enhance older adults’ adherence to WMDs. However, the effectiveness of such support mechanisms in promoting adherence to WMDs among older adults remains poorly understood. Objective The aims of this systematic review were to examine the effects of peer- or professional-led intervention programs designed to improve adherence to WMDs among community-dwelling older adults and to identify the intervention components that may positively influence the effects of the intervention. Methods We conducted a comprehensive search across 7 electronic databases (Cochrane Central Register of Controlled Trials [CENTRAL], PubMed, EMBASE, PsycINFO, British Nursing Index, Web of Science, and CINAHL) to identify articles published between January 1, 2010, and June 26, 2023. We specifically targeted randomized controlled trials that examined the impact of peer- or professional-led interventions on enhancing adherence to WMDs among individuals aged 60 years and older residing in the community. Two independent reviewers extracted data from the included studies and assessed the potential risk of bias in accordance with the Cochrane Risk of Bias tool for randomized trials, version 2. Results A total of 10,511 studies were identified through the database search. Eventually, we included 3 randomized controlled trials involving 154 community-dwelling older adults. The participants had a mean age of 65 years. Our review revealed that increasing awareness of being monitored and implementing the SystemCHANGE approach, a habit change tool focusing on personal goals and feedback, were effective strategies for enhancing adherence to WMDs among older adults. All of the included studies exhibited a low risk of bias. Conclusions By collaboratively designing specific goals related to WMDs with health care professionals, including nurses and physicians, older adults exhibited a higher likelihood of adhering to the prescribed use of WMDs. These goal-setting tools provided a framework for structure and motivation, facilitating the seamless integration of WMDs into their daily routines. Researchers should prioritize interventions that target awareness and goal-setting as effective approaches to enhance adherence to WMDs among older adults, thereby maximizing the realization of associated health benefits.
A cognitive intervention to correct a maladaptive technique in organists due to prior music learning: A randomized controlled trial Mandy MP Kan, Nicola Dibben, Arnold YL Wong Psychology of Music, 2024 Organists who start as skilled pianists may later maladapt their keyboard technique to play the organ. This randomized controlled study investigated the feasibility of using an audio cognitive intervention to correct organists’ playing technique. Forty participants played a music excerpt with two dynamics (soft/loud) on two musical instruments (organ/piano) at baseline, while their corresponding forearm muscle activities were measured by surface electromyography (sEMG). They also rated their playing force. Participants were then randomized to receive either a 5-min audio cognitive intervention (learning to use self-talk phrases “organists—stops/ expression pedals—minimal force” to reduce their tension in playing the organ; n = 21) or a control audio recording (instructing them to rest for 5 min; n = 19). All participants then repeated the two dynamics on the two musical instruments. The intervention group displayed significantly lower forearm sEMG muscle activity during organ playing, whereas the controls’ playing was unchanged. Our study shows that organists use unnecessary muscle tension to produce dynamics and that our intervention was effective and could improve motor control in playing the organ. Self-talk is therefore a viable way for music educators to help learners correct habitual but maladaptive techniques arising from prior learning.
Effects of Using a Shoulder/Scapular Brace on the Posture and Muscle Activity of Healthy University Students during Prolonged Typing—A Randomized Controlled Cross-Over Trial Melissa Leung, Mandy M. P. Kan, Hugo M. H. Cheng, Diana E. De Carvalho, Shahnawaz Anwer, Heng Li, Arnold Y. L. Wong Healthcare Switzerland, 2023 Laptop use appears to contribute to poor working postures and neck pain among university students. Postural braces have the potential to improve upper back/neck posture and therefore might have a role as an ergonomic aid for this population. Therefore, the purpose of this study was to assess the short-term effects of scapular bracing on pain, fatigue, cervicothoracic posture, and the activity of the neck and upper-back muscles in healthy college students. A randomized controlled crossover trial was conducted to evaluate the self-reported pain and fatigue, the amplitude and median frequency of surface electromyography in neck extensors, upper trapezius, and lower trapezius, as well as the neck and shoulder sagittal alignment (measured by inertial sensors and digital photographs) during a 30-min typing task in a sample of young, healthy university students with or without a scapular brace. The brace condition resulted in significantly smaller levels of bilateral trapezius muscle activity (p < 0.01). Rounded shoulder posture was slightly better in the brace condition, but these differences were not significant (p > 0.05). There were no significant immediate differences in pain or fatigue scores, neck alignment, or the electromyographic activity of the other muscles tested between brace and non-brace conditions (all p > 0.05). However, bracing appears to immediately reduce the electromyographic activity of the lower trapezius muscles (p < 0.05). These findings shed some light on the possible advantages of scapular bracing for enhancing laptop ergonomics in this group of individuals. Future studies are warranted to evaluate the effects of different types of braces, the importance of matching the brace to the user, and the short- and long-term effects of brace use on computer posture and muscle activity.
Challenges, Concerns, and Experiences of Community-Dwelling Older Women with Chronic Low Back Pain—A Qualitative Study in Hong Kong, China Tiffany H. T. Wong, Kaden S. K. Lee, Sharon M. C. Lo, Mandy M. P. Kan, Crystal Kwan, Emmanuelle Opsommer, Shahnawaz Anwer, Heng Li, Arnold Y. L. Wong, Veronika Schoeb Healthcare Switzerland, 2023 Background and Objectives: Although chronic low back pain (CLBP) is known to negatively affect multiple aspects of the lives of older people, prior qualitative studies mainly focused on the lived experiences of older people with CLBP in Western countries. Given cultural and contextual differences and poor understanding of CLBP in older women with CLBP, it is important to better understand the concerns and lived experiences of Chinese older women with CLBP. The current study aimed to investigate the experiences, challenges, concerns, and coping strategies of older women with CLBP in Hong Kong. Research Design and Methods: A total of 15 community-dwelling older women with CLBP aged ≥60 years were recruited from a physiotherapy clinic or a community center for semi-structured interviews. The interviews were audio recorded and transcribed ‘verbatim’. The transcription was imported to NVivo 12 software. Thematic analysis was conducted using Braun and Clarke’s method. Results: Five themes were identified: (1) physical impacts of CLBP on daily life; (2) psychological influences of CLBP; (3) management of CLBP; (4) family support; and (5) social activities and support. Discussion and implications: Negative physical and psychosocial impacts of CLBP were common among older women, and they adopted diverse pain management strategies, although some of their treatment options were influenced by the Chinese culture. Misbeliefs and responses of family and friends also affected their management strategies. Elderly community centers are a significant source of social support for older women with CLBP, making it an ideal platform for establishing self-help groups to facilitate their self-management of CLBP.
Is impaired lung function related to spinal deformities in patients with adolescent idiopathic scoliosis? A systematic review and meta-analysis—SOSORT 2019 award paper Mandy M. P. Kan, Stefano Negrini, Francesca Di Felice, Jason P. Y. Cheung, Sabrina Donzelli, Fabio Zaina, Dino Samartzis, Esther T. C. Cheung, Arnold Y. L. Wong European Spine Journal, 2023 Purpose Some teenagers with adolescent idiopathic scoliosis (AIS) display compromised lung function. However, the evidence regarding the relations between pulmonary impairments and various spinal deformity parameters in these patients remains unclear, which affects clinical management. This systematic review and meta-analysis aimed to summarize the associations between various lung function parameters and radiographic features in teenagers with AIS. Methods A search of PubMed, Embase, PEDro, SPORTDiscus, CINAHL, Cochrane Library, and PsycINFO (from inception to March 14, 2022) without language restriction. Original studies reporting the associations between lung function and spinal deformity in patients with AIS were selected. Independent reviewers extracted data and evaluated the methodological quality of the included studies according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Pearson correlation and 95% confidence intervals were calculated using random-effects meta-analysis. Results Twenty-seven studies involving 3162 participants were included. Limited-quality evidence supported that several spinal parameters were significantly related to lung function parameters (e.g., absolute value and percent of the predicted forced vital capacity (FVC; %FVC), forced expiratory volume in one second (FEV1; %FEV1), and total lung capacity (TLC; %TLC)) in AIS patients. Specifically, meta-analyses showed that main thoracic Cobb angles in the coronal plane were significantly and negatively related to FVC (r = − 0.245), %FVC (r = − 0.302), FEV1 (r = − 0.232), %FEV1 (r = − 0.348), FEV1/FVC ratio (r = − 0.166), TLC (r = − 0.302), %TLC (r = − 0.183), and percent predicted vital capacity (r = − 0.272) (p < 0.001). Similarly, thoracic apical vertebral rotation was negatively associated with %FVC (r = − 0.215) and %TLC (r = − 0.126) (p < 0.05). Conversely, thoracic kyphosis angles were positively related to %FVC (r = 0.180) and %FEV1 (r = 0.193) (p < 0.05). Conclusion Larger thoracic Cobb angles, greater apical vertebral rotation angle, or hypokyphosis were significantly associated with greater pulmonary impairments in patients with AIS, although the evidence was limited. From a clinical perspective, the results highlight the importance of minimizing the three-dimensional spinal deformity in preserving lung function in these patients. More research is warranted to confirm these results.
Experiences of community-dwelling older adults with chronic low back pain in Hong Kong and Switzerland – A qualitative study Veronika Schoeb, Marceau Misteli, Crystal Kwan, Chris W. Y. Wong, Mandy M. P. Kan, Emmanuelle Opsommer, Arnold Y. L. Wong Frontiers in Rehabilitation Sciences, 2022 IntroductionThe prevalence of chronic low back pain (LBP) increases with age and older adults are more vulnerable to develop chronic LBP. A recent Swiss study has shown that 78% of community-dwelling older adults aged ≥65 years experienced chronic LBP. Similarly, a study in Hong Kong found that approximately 30% of people aged above 60 years experienced chronic LBP. The aim of this collaborative research project was to illuminate older adults' experiences of living with chronic LBP and its implication on older adults' daily life in Western and Eastern cultures.MethodsTwenty-five older people experiencing chronic LBP living in Switzerland or Hong Kong were recruited through health professionals or community centres. Using semi-structured interviews, participants shared their experiences regarding chronic LBP and its implications on their daily life. The interviews were recorded and transcribed “ad verbatim” in the original language. An inductive thematic analysis was used, using a qualitative data analysis software program (NVivo) and a shared code book in English. The Swiss and Hong Kong research teams engaged in collaborative analysis until a consensus was established, taking into consideration of cultural specificities. Ethical approval was obtained from the local ethic committees in both regions.ResultsThemes were related to negative perceptions/experiences: (1) interferences of daily function; (2) pessimistic attitudes toward their conditions/prognosis; and (3) self-perceived burden related to families. Conversely, four themes revealed attributes to social roles: (1) maintaining their roles in families; (2) experiencing supports from family and friends; (3) being content despite LBP; and (4) enjoying social activities. Cultural differences between Switzerland and Hong Kong were related to social circles and offers from the healthcare system, influencing individual experiences and perceptions.DiscussionAlthough chronic LBP may negatively impact older adults, individual approaches as well as social and health system supports influence older adults' attitude toward their pain and self-management strategies. Developing effective and culturally sensitive interventions for an elderly population with chronic LBP can be challenging but essential for the development of innovative healthcare services tailored to the population's needs. The methodological approach used for this research project establishes the framework for developing and evaluating complex interventions.
