PHYSIOTHERAPY DIVISION

The World Confederation for Physiotherapy (WCPT) defines physical therapy as “services provided by physical therapists to individuals and populations to develop, maintain and restore maximum movement and functional ability throughout the lifespan. The service is provided in circumstances where movement and function are threatened by ageing, injury, pain, diseases, disorders, conditions and/or environmental factors and with the understanding that functional movement is central to what it means to be healthy ".

Services 

1. Pulmonary Rehabilitation

• Pulmonary Rehabilitation is an evidence-based and comprehensive intervention for patients with chronic respiratory diseases.

• The treatment is integrated and tailored into individualized treatment of each patient, whereby it is designed to reduce symptoms, optimize functional status, increase participation, and reduce health care costs through stabilizing or reversing systemic manifestations of the diseases. 

• There are 5 essential components in a Pulmonary Rehabilitation Program:

1. Patient assessment

2. Patient exercise training

3. Patient education

4. Program evaluation

5. Maintenance

• Pulmonary Rehabilitation Program consists of three phases: 

1. PHASE 1 

This phase starts during the hospital stay and includes education and a limited exercise program.

2. PHASE 2 

This is an 8 to 12 week outpatient therapy program. At the beginning of the program, you will be asked to complete a six-minute walk test. This test provides a starting point to determine your beginning exercise prescription.

3. PHASE 3 

This is once a month for at least 3 months in a row. This is a voluntary lung health maintenance program. Phase III is designed to help you become more independent and responsible for your prescribed exercise program. It offers moderate monitoring and helps from medical professionals.

2. Cardiac Rehabilitation

• Physiotherapy in Cardiac Rehabilitation provides a supervised exercise program that will develop into a sufficient level of exercise tolerance, increase physical activity and increase exercise capacity for patients who have heart problems. Supervised exercise programs includes exercise training, education on heart-healthy living, counselling to reduce stress and help in returning to an active life.  

3. Electrotherapy Services and Pain Management

• Electrotherapy is primarily used in physical therapy treatment. Electrotherapy is a gentle and non-invasive modality that works by stimulating nerves and muscles through the surface of the skin. It is mainly used to treat chronic pain, musculoskeletal injuries, muscle wasting, and nerve pain. Electrotherapy work in a variety of ways, including:-

1. Deliver electrical impulses that block or interfere with the body's pain signals, leading to pain reduction.

2. Help release endorphins that naturally decrease pain in the body.

3. Create a thermal effect within the body which improves circulation and stimulates healing.

4. Stimulate cells which reduce inflammation, promote collagen production, and inhibit pain. They are generally used to treat chronic pain.

4. Musculoskeletal Rehabilitation

• Designated exercises program to improve range of motion, flexibility, strength and endurance-based on patients’ specific problems to improve the quality of life. 

• Musculoskeletal rehabilitation also includes the Pre-operative Management where the patients are empowered with exercises to gain the optimal range of motion and strength prior to any musculoskeletal operation such as ligament or joint replacement.

5. Hand & Upper Limb Rehabilitation

• Our physiotherapists in Hand and Upper Limb employ specialized skills in assessment and treatment in the care of upper extremity conditions and injuries including hand, wrist, elbow and shoulder. 

• We promote the goals of prevention of dysfunction, restoration of function, and/or reversal of the progression of pathology in order to enhance participation in life for individuals with upper limb quarter disease or injury. 

6. Sports Rehabilitation

• Comprehensive exercises program are administered based on the specific protocol with aim of controlling the swelling, pain, restores range of motion and building up muscle strength and performance for patients after ligament reconstruction or joint debridement surgery. The physiotherapy is attending the patient from day one operation until return to sport without fear of reinjury. 

• Sports rehabilitation also involves attending serial sessions with the patient after surgery of joint replacement from day 1 post surgery until the patient can walk comfortably with optimal quality of life, physically, emotionally and socially. 

7. Neurology Rehabilitation

• In Neuro-medical Rehabilitation, the Physiotherapists provide assessment and intervention to restore motor function through attempting to overcome motor deficits and improve motor performance with neurological conditions such as Stroke, Parkinson’s Disease, Multiple Sclerosis etc. 

• These conditions often present themselves as muscle weakness, poor balance and coordination, uncontrolled muscle spasm and tremors and loss of function. 

8. Acquired Brain Injury Rehabilitation

Physiotherapy in Acquired Brain Injury Rehabilitation provides an exercise program for patients who have brain injury that includes damage sustained by infection, disease, lack of oxygen to the brain or physical impact especially that results from car accidents or falls. The Physiotherapist will look at up to independent walking then progress into faster walking  then into running especially for young adults. The goal in the program involves:

1. To develop, maintain and restore maximum movement & functional ability throughout the lifespan that includes general physical condition, endurance, and activity level.

2. To improve safety for gait & mobility.

3. To improve functional balance in increasingly challenging contact-specific situations.

4. To improve independent community level mobility.

5. To educate on the symptom, identifying issues that trigger and develop coping strategies to minimize the effects.

9. Spinal Cord Injury Rehabilitation

• Spinal Rehabilitation is the discipline of medicine that guides the physical, psychological, and social recovery of individuals who become partially or totally disabled because of spinal disease or injury.

• It involves a team and patient-centered approach. The aim is to enable the person with Spinal Cord Injury to return to a productive and satisfying life.

10. Paediatric Rehabilitation

• Paediatrics physiotherapists work with people of varying ages from premature babies to adolescents. Paediatric physiotherapist managing patients with genetic, neurological, orthopaedic and respiratory conditions. The main goal is to achieve the optimal physical function of development, movement, coordination, posture and the cardiorespiratory system.

11. Amputee Rehabilitation

• The role of Physiotherapy in Amputee rehabilitation involves management of patients with amputated limb either arises from infected diabetic foot ulcer,  blood vessel diseases, cancer or trauma. Therapeutic & physical exercises sessions help to promote wound healing, minimize pain, improve patient's overall strength and shaping of the residual limb after the amputation. Besides, amputee rehabilitation also focuses on pre and post-prosthetic training to prepare patients for the next phases to improve their quality of life. 

12. Geriatric Rehabilitation

• Physiotherapy in Geriatric Rehabilitation specialized to cater the needs of the elderly. The elderly may lose strength, mobility and flexibility due to the ageing process and they are also at high risk of falls. Geriatric physiotherapy treatment offers prevention and intervention measures to protect and enhance their quality of life by improving their mobility and balance, build muscle strength and joint flexibility, and also boost confidence in their physical condition.

13. Vestibular Rehabilitation

• Vestibular rehabilitation is an exercise-based program designed to promote central nervous system compensation to improve balance and dizziness related to the problem.

14. Men’s Health Rehabilitation

• Men’s Health Therapist assess, evaluate and treat conditions pertaining to the male pelvic floor such as erectile dysfunction, urinary or faecal incontinence, mucosal prolapse, overactive bladder, etc.

15. Women’s Health Rehabilitation

• Women's health physical therapists evaluate and treat the musculoskeletal disorders that may occur to women throughout their lifespan, with a specialized understanding of the physiological differences and the impact of hormones on their condition and recovery.

• Services under the Women’s Health area:

1. Pelvic Floor Dysfunction: Pelvic organ prolapse, chronic constipation, bowel or bladder dysfunction (frequency, urgency, retention and/or incomplete emptying).

2. Incontinence: Urinary (stress, urge, mixed, overflow), faecal.

3. Pregnancy and Postpartum Care: Obstetrical low back pain, sacroiliac joint pain, pubic symphysis, sciatica, diastasis recti.

4. Pre-Post-Surgical: Hysterectomy, caesarean, episiotomy, sling procedure, prolapse repair, radiation.

16. Lymphoedema Rehabilitation

• Provides rehabilitation services especially for patients with breast cancer, cervical cancer and prostate cancer who undergo surgery and ongoing cancer treatment.

• Our services include rehabilitation for pre and post breast cancer operation and rehabilitation for post-cancer treatment side effects including joint stiffness, muscle tightness muscles weakness, pain reduction and lymphoedema care.

17. Burns Rehabilitation

• Rehabilitation is an essential and integral part of burn treatment. The aims of physiotherapy in Burn Rehabilitation is to minimize the adverse effects caused by injury in terms of maintaining range of movement, assist wound healing, reduce contracture and impact of scarring, maximizing functional ability and maximizing psychological well being.  

18. Hydrotherapy Services

• Hydrotherapy is a good therapeutic, low impact exercise and treatment for people of all ages and different medical conditions carried out in a warm pool. Hydrotherapy uses the physical properties of water to assist in patient healing and exercise. 

• Water is buoyant and reduces the effect of gravity, less resistance on the body and less pain. This makes it easier to do exercises that increase your muscle strength, endurance, flexibility and overall fitness.

19. Palliative Care Rehabilitation

• Physiotherapy in palliative care is a management of patients with life-limiting illnesses such as cancer, chronic obstructive pulmonary disease, motor neuron disease (MND) and multiple sclerosis . The goals of physiotherapy in palliative care include:

1. To remain as independent as possible/maximize independence and daily function.

2. To optimize and maintain quality of life (QoL) – determined by physical functioning and   psychological symptoms

3. Reduction/control of the consequences of the illness 

4. Coping mechanisms and self-management– to be in more control of their lives.

5. To avoid secondary complications associated with life-limiting illnesses.

6. Psychological support

20. Home / Work Site / School Visit Program

• Visit by a physiotherapist  to a patient’s home, work area or school.

• Purposeful interaction directed at promoting adequate and effective physical care

• Service includes assessing environment, function and accessibility of equipment’s

21. Smoking Cessation Program

• Evidence shows that exercise and physical therapy interventions stimulate endorphin release that can help mitigate symptoms of nicotine withdrawal.

• Exercise and increased physical activity may help reduce cravings, negative changes in mood, and withdrawal symptoms as an aid to cessation.

• Aims of physiotherapy in smoking cessation are to identify patients’ level of addiction, and their intention to quit, to prescribe appropriate exercise program for smokers who are keen to quit smoking and to provide ongoing support during the cessation process.