Rehabilitation Medicine Department

  • About
  • Our Services
  • Community Rehabilitation
    Programme (CRP)
  • Volunteer Patient
    Programme (VPp)

Comprising a multi-disciplinary team of specialist physicians, physiotherapists, occupational therapists, speech therapists and language therapists, psychologists, nurses, medical social workers and dieticians, we treat a full range of complex rehabilitation conditions and provide comprehensive rehabilitation programmes.

Our rehabilitation programmes are physician-led and team-based to meet specific physical, cognitive and emotional needs.

Progress is constantly reviewed. The carer/family member is encouraged to be an active participant in the rehabilitation process.

How you can help:

  • As a patient, it helps to maintain a positive attitude
  • Participate actively in all your therapy sessions, build rapport with members of the rehabilitation team
  • Report any discomfort and lack of wellbeing so that we can render medical attention early
  • Be prepared to be independent within the safety limits set by the staff that is taking care of you

How your family can help:

  • Have a positive attitude and participate actively in the patient’s progress, to help them be as independent as possible in future
  • Meet the rehab team as soon as possible after admission, to handle administrative matters and share relevant information about the patient, his family and their social and financial background
  • Decide how and where the patient will be cared for after discharge, so that we can arrange for appropriate caregiver training if necessary
  • Participate actively in caregiver training as the skills taught are practical and will help boost your confidence in managing your loved one at home
  • Encourage the patient and understand his moods and fears

Click the links below for information on our services:

Acquired Brain Injury & other Neurological Conditions Rehab

We maximise our patients’ function to achieve independence within their disability and facilitate their reintegration into their home and community. 

Some of the common issues are:

  • Paralysis of limbs
  • Inability to walk, speak or swallow
  • Loss of sensation
  • Inability to attend to self-care needs
  • Cognitive problems which may include poor memory, inattention, confusion and irritability
  • Changes in behaviour and personality
  • Lack of motivation

Our services include:

  • A safe environment using the brain injury monitoring room for agitated or restless patients
  • Activities of daily living training
  • Speech and language training
  • Dysphagia therapy for swallowing
  • Instrumental and radiographic-aided evaluation of swallowing disorders
  • Dietary and nutritional counselling
  • Limb splinting services
  • Orthotic assessment and fabrication
  • Comprehensive spasticity management including serial casting and regional spasticity interventions
    • nerve and motor point blocks
    • intramuscular Botulinum toxin injections
    • evaluations for intrathecal Baclofen pump trial
  • Cognitive assessment and retraining in conjunction with pharmacological therapy
  • Behaviour assessment and modification therapy
  • Individual caregiver training and patient/family education
  • Ward based multi-disciplinary group recreational therapy
  • Family counselling and psychosocial support
  • Post discharge memory re-training group sessions for suitable patients
  • Community reintegration assessment and training
  • Individualised return to work assessments and follow-up for suitable patients
  • Comprehensive outpatient, medical and rehabilitation post discharge follow up
  • Links to community resources for post-discharge social activities, psychosocial support and education, computer training

Amputee Rehabilitation

Referral to Amputee Clinic

Download referral from here.

Amputee rehabilitation refers to rehabilitation of a patient after amputation. 

The final aim of amputee rehabilitation is not just the fitting of a suitable artificial limb; but to promote independence and return to daily functions after an amputation.

Our services include:

  • Assessment for suitability to enter program by a rehabilitation physician
  • Wound management
  • Pain control
  • Care of residual limb (assisted by podiatrist from Foot Care and Limb Design Centre)
  • Psychological counseling and education
  • Reconditioning and mobility training
  • Teaching the patient to perform activities of daily living in a safe manner
  • Treatment of underlying health conditions
  • Fitting of prosthesis (artificial limb) (assisted by Prosthetist & Orthoist from Foot Care and Limb Design Centre)
  • Planning for supported discharge back home and continuation of rehabilitation
  • Rehabilitation towards returning to work for appropriate patients

Medical Acupuncture

Acupuncture is an ancient traditional Chinese therapeutic modality which aims to restore health by balancing the body’s “yin” and “yang” and restoring the body’s flow and source of “qi” or vital energy.

It works by releasing various chemical substances inherent in our bodies, e.g. endorphins which are the body’s natural painkillers.

It involves the insertion of very fine, sterile stainless steel needles at specific locations called acu-points on the surface of the body, which are manipulated manually or by electrical stimulation.

The needles are retained for an average of 20 to 30 minutes each time and each course of treatment may consist of approximately 5 to 10 sessions.

The TTSH medical acupuncture service is staffed by both rehabilitation physicians who are trained in acupuncture and are MOH-registered Traditional Chinese Medicine (TCM) acupuncturists. This ensures a comprehensive and unified East-West approach in the treatment of conditions, with careful consideration to the patient’s existing medical conditions and concurrent medications.

Patients with the following conditions may benefit from acupuncture:

  • Chronic neurological conditions such as stroke, brain haemorrhage or brain injury from various causes, neuromuscular disorders with weakness and myelopathy.
  • Painful conditions such as:
    • acute sprains
    • contusions
    • headaches
    • osteoarthritis of various joints
    • cervical or lumbar spondylosis
    • frozen shoulder
    • back pain
    • tennis elbow
    • painful peripheral neuropathy
    • trigeminal neuralgia
    • Herpes Zoster and other chronic painful conditions

Patients with the following conditions are advised NOT to undergo Acupuncture:

  • Valvular heart disease
  • Prosthetic heart valve
  • Cardiac pacemaker
  • Bleeding disorder or tendency
  • Person taking blood thinners such as Warfarin
  • Unstable blood pressure or other medical conditions
  • Active untreated infection

Consultation with your physician would be required to determine the appropriateness of treatment with acupuncture if you have any of the above conditions.

Orthopaedic and Trauma Rehabilitation

We work with patients who have the following conditions:

  • Hip fracture
  • Chronic arthritis with the possibility of joint surgery (replacement)
  • Chronic backache with severe limitation of function or poorly controlled pain
  • Prolonged bed rest with generalized weakness after surgery (deconditioning)

And may be experiencing one or more of the following complaints:

  • Post surgical pain or chronic pain
  • Loss of mobility and confidence
  • Inability to care for simple daily needs
  • Loss of self image and depression

The length of stay is dependent on the patient’s potential for further recovery and the rehabilitation goals set, and may last between 2 to 6 weeks.

Therapy sessions are conducted from Monday to Friday, with rest over the weekend and public holidays which can be spent in the care of family and friends at home.

The programme is staged according to the patient’s:

    • weight-bearing status (how much body weight you are medically allowed to place on your legs as you stand)
    • disease status
    • general fitness
  • Realistic goals will be set at weekly intervals which will include inputs from the patient and family
  • Besides emphasizing walking/mobility and self care, you will also be taught joint precautions (e.g. after hip replacement), skin and stump care
  • You may be prescribed an artificial limb and taught how to put it on
  • You may be prescribed assistive devices (e.g. walking aids) and home modifications
  • Before discharge, caregiver training, vocational and leisure assessments will be provided if necessary
  • Upon discharge, you will be advised of outpatient therapy at an appropriate facility with necessary medical follow up

neuroREHAB @ TTSH Rehabilitation Centre

We offer 4 comprehensive neurorehabilitation packages to optimise the patient’s functional ability following a stroke, brain injury, spinal cord injury or other neurological insults.

neuroREHAB2

Each package includes:

  • Comprehensive assessment by a rehabilitation physician, physiotherapist and/or occupational therapist specialised in neurorehabilitation;
  • Individualised programmes with emphasis on intensive training;
  • Clinical and technology-based assessments both before and after training by experienced, senior therapists in neurological rehabilitation;
  • Summarised discharge report on performance measurements and goals achieved.
  1. The Re-ARM Programme
  2. This aims to enhance the recovery of a paralysed arm following a stroke or brain injury through the use of electrical stimulation, Constraint-Induced Movement Therapy (CIMT) and other evidence-based neuro rehabilitation training methods.

    Re-ARM is suitable for those with partial arm and hand recovery only. A dedicated schedule of 2 weeks (10 working days), consisting of 3-hour one-to-one training sessions with a specialist therapist.

    GaitRITE
  3. The Total-WALK Programme
  4. Walking is a complex task involving many body systems such as motor strength, balance, coordination, vision and higher brain processing centers. Total-WALK makes use of quantitative gait assessment technology to assist in retraining walking ability after stroke or brain injury. It is coupled with one-to-one training to improve gait, walking speed, distance and functional independence.

    Total-WALK includes an assessment of the patient’s posture, strength and flexibility, a balance assessment, a walking endurance test and a GAITRite analysis of the walking pattern.

  5. The i-Balance Programme
  6. Using the Neurocom Balance Master® technology to aid diagnosis and treatment of symptoms like dizziness, vertigo, unsteady gait and falls, an improvement in balance and overall function can be achieved. This will make your walking steadier and safer, and improve your quality of life.

    Balance Master

    i-Balance includes a clinical assessment of balance control (during standing and walking related functions), visual-motor function and vestibular reflexes (for dizziness) and computerized testing of your balance abilities using advanced technology. 

  7. The ROBO-Walk Programme
  8. LOKOMAT Training

    This uses the LOKOMAT® robotic aided system in combination with over-the-ground walking in order to improve walking for people with varying degrees of paralysis. The LOKOMAT® is a robotic device that is strapped to an individual’s body and legs to guide them through the ideal walking motion. A harness is used to support the bodyweight while the person walks on a controlled and moving treadmill.

    Research has shown that the two keys to successful gait training after injury are intensity and task specific training. This means frequent and repeated practice in walking tasks. Technology can enhance conventional therapy to provide you with the practice that you need. This programme helps you walk longer and take more steps in the right way as your recover from your injury.

Spinal Cord Injury Rehabilitation

You or your loved one has just suffered an injury to the spinal cord.

This may have occurred suddenly, after an accident or gradually as a result of a disease of the spine or spinal cord.

You may now be having some of the following complaints:

  • Inability to move your legs partially or totally and having difficulty walking
  • Inability to move your hands partially or totally
  • Numbness of the lower and /or half of your body
  • Difficulty in passing urine or moving your bowels
  • A sense of helplessness and despair

Our rehabilitation team will help set you on the path towards functional recovery.

Your stay with us may last between one to three months. Apart from learning to walk or use a wheelchair, and to take care of yourself, you will start a personal bladder training programme to prevent complications from changes in your bladder function.

Physiotherapy and occupational therapy sessions are from Monday to Friday to improve mobility and the ability to take care of yourself.

Therapy may not continue if the doctors decide that your condition is unstable. Your progress will be monitored weekly and your programme reviewed. You will be prescribed any necessary mobility and self care aids such as wheelchairs, walkers and commodes.

Before discharge, we will discuss any relevant issues or concerns you may have with you and your family, such as fertility and sexuality issues, home and work assessment and modification, and vocational advice.

Spine, Sports & Musculoskeletal Rehabilitation

Most overuse injuries of muscles, ligaments and tendons, as well as sports and occupational related musculoskeletal injuries are not surgical problems.

Common conditions treated at TTSH are:

  • Back and neck pain
  • Chronic pain syndromes including fibromyalgia and myofascial pain syndrome
  • Sports injuries
  • Sprains and strains
  • Tendonitis and bursitis
  • Pinched nerve
  • Carpal tunnel syndrome

Our Area of Expertise:

  • Biomechanical assessment
  • Physiotherapy:
    • Physical modalities & therapeutic exercises
    • Performance enhancement programme
  • Occupational Therapy:
    • Braces, orthostics & shoewear
    • Ergonomics & injury prevention
  • Acupuncture & myofacial injections
  • Referral for:
    • X-ray guided spinal joint injections
    • Specialized nerve and muscle testing (Nerve Conduction Studies and Electromyography)
  • Chronic pain management programme
    • Our interdisciplinary approach and individualised therapy programmes are coordinated between a rehabilitation physician, a physiotherapist, an occupational therapist and a psychologist.

Our comprehensive rehabilitation programmes go beyond the relief of symptoms. The goal is to restore function and performance, return to normal daily activities and prevent recurrent injuries.

Stroke Rehabilitation

Stroke patients may have the following problems:

  • Weakness and numbness on one side of the body
  • Inability to feed, dress or toilet yourself
  • Inability to express feelings and emotions or comprehend language/instructions
  • Swallowing problems
  • Memory loss, reasoning difficulties and mood disturbances
  • Incontinence

Our rehabilitation team will help direct your rehabilitation programme. Your stay with us may last from 3 to 6 weeks depending on your rate of recovery.

Our rehabilitation programme aims to help you be as independent as possible:

  • You will have daily therapy sessions, with rest over the weekend
  • Your progress will be monitored weekly and goals will be reset, if needed
  • About one to two weeks prior to discharge, training sessions for caregivers will be provided if necessary. Vocational opportunities, mobility aids, safety issues, housing modifications and leisure alternatives will also be discussed.
  • Upon discharge, outpatient therapy at an appropriate facility may also be considered.

 

You may be interested to read about
Rehabilitation Medicine Specialists and Clinic details
Rehabilitation Nurse Clinicians

Our Services2

Patients are managed by an interdisciplinary team led by a physiatrist (a physician specialising in physical medicine and rehabilitation) working together with physiotherapists, occupational therapists, speech therapists, nurse clinicians, medical social workers, psychologists, acupuncturist and other support staff to give patients the best care. There are also weekly dietician, urologist and orthopaedic sepcialist consultations.

On admission, an individualised and goal-directed programme, geared towards functional improvement, is prescribed and initiated. Weekly team conferences are held to discuss problems and rehabilitation progress, and also to plan for reintegration of patient back to home and society.

FOR INPATIENTS:

  • Spinal Cord Injury Rehabilitation
  • Stroke Rehabilitation
  • Acquired Brain Injury and Other Neurological Conditions Rehabilitation
  • Orthopaedic and Trauma Rehabilitation (including Amputee Rehabilitation)

 FOR OUTPATIENTS:

  • General Rehabilitation (including discharged inpatient rehabilitation)
  • Medical acupuncture
  • Spinal urology services including urodynamic assessment
  • Specialized chronic pain management
  • Dysphagia management (FEES, VFS), speech and language therapy
  • Neurorehabilitation packages: ROBO-walk, I-BALANCE, Re-ARM and Total-WALK
  • Specialized rehabilitation nursing
  • Vestibular and balance rehabilitation
  • Wheel chair seating assessment
  • Sexual counselling after disability

OTHER REHABILITATION SERVICES:

What is the Community Rehabilitation Programme (CRP)?

The Community Rehabilitation Programme (CRP) is a community outreach project by Tan Tock Seng Hospital (TTSH) Community charity Fund. It aims to provide home rehabilitative services to needy patients with neurological / orthopaedic disabilities who have rehabilitation potential but are unable to access rehabilitation facilities due to financial problems, difficulties with transportation accessibility and / or mobility.

Our Mission

To provide holistic rehabilitative care for needy patients with neurological / orthopaedic disabilities in their home environment

Our Objectives

  1. To provide home management and rehabilitation programmes tailored to the needs of the patients.
  2. To improve patients’ functional status at home and to assist in gaining functional independence.
  3. To holistically manage patients through team approach.
  4. To train care givers in assisting patients competently with daily functions and exercises.
  5. To integrate patients back to society within their best capabilities.

Our Services

Our team comprises of the following professionals:

  • Physiotherapist
  • Occupational Therapist
  • Speech Therapist (Part-time)
  • Staff nurse
  • Medical Social Worker
  • Therapy Assistant

Our team members will assess the individual patient’s eligibility status for the programme, identify areas of need and set realistic goals with the patient and their family members. Patients will be seen an average of 1 session per week.After discharge from the programme, eligible patients will be referred to appropriate agencies for continuation of care.

Eligibility Criteria

  • Low income family
  • Patients who are medically stable
  • Patients who have the potential to improve their functional independence

Fees (Inclusive of GST)

A maximum fee of $40 per session will be charged according to household income assessment by a CRP team member.

Referral Procedure

All referrals must be from a Medical Practitioner. To obtain copies of the referral form and further enquiries, please call 6450-6238. Referral forms can be faxed or posted to:

Community Rehabilitation Programme
c/o TTSH Rehabilitation Centre 
17 Ang Mo Kio Ave 9
Singapore 569766
Fax: 64540718

About Volunteer Patient Programme (VPp)

Volunteers are important in supporting patients in their inpatient rehabilitation journey and their reintegration to the community. One pertinent role volunteers can play in patient care is to complement the rehabilitation team in preventing unscheduled readmissions due to social reasons.

Volunteers contribute by outreach work that focuses on re-educating patients on skills taught during the inpatient rehabilitation programme and by providing timely feedback to the Rehabilitation Centre’s Medical Social Workers on patients struggling or not coping with self care.

TTSH Rehabilitation Centre’s Volunteer Patient Programme was established in May 2009.

Roles of Volunteers

The roles volunteers can play in TTSH Rehabilitation Centre are:-

  • Befriending patients
  • Engaging patients in social activities in the ward and in the community
  • Assisting in practical matters like reading letters, ordering and/or purchasing basic necessities and, if required, escort patient for his 1st medical appointment

Recruitment of Volunteers

Those in the age group of 16 to 62 years old are welcome to register as volunteers in the TTSHRehabilitation Centre’s Volunteer Patient programme.

Volunteers’ Knowledge Development

Acquiring knowledge on disability issues and effective communication skills are paramount to the volunteers’ roles. For this matter, experienced professionals from TTSH Rehabilitation Centre will conduct a half day training session for you prior to your volunteer work.

The table below describes the in-house training programme to be conducted for newly registered volunteers.

KEY AREAS CORE COMPETENCIES (TOTAL TRAINING TIME – 2.5 HOURS) STAFF-IN-CHARGE
1. Understanding disability Basic understanding of disability Rehabilitation Physician
2. Befriending skills Conversational skills & skills in asking questions Medical Social Worker
3. Wheelchair handling Understanding safe wheelchair handling Occupational Therapist
4. Infection control Understand and practice good hand hygiene practice Nurse Clinician
5. Fire Safety Understand and know fire safety in the ward Ward Fire Warden