Progress is constantly reviewed. The carer/family member is encouraged to be an active participant in the rehabilitation process.
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 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
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
- 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.
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
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.
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.
- The Re-ARM Programme
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.
- The Total-WALK Programme
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.
- The i-Balance Programme
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.
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.
- The ROBO-Walk Programme
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.
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.
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
- 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 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
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.
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.