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Physiotherapy

Physiotherapy looks into human functions and movement with an aim to maximize the potential and well-being of an individual. In KKH, we offer holistic approach to restore function, improve activity and increase independence for our patients through preventive health management, treatment, rehabilitation and health promotion.

The core role of Physiotherapists involves examination, evaluation, diagnosis, prognosis, and intervention and outcome assessment to identify and manage patient's potential and existing problems. As professionals, physiotherapists maintain a high level of competence by incorporating into their practice the latest health evidence, which they continually update through continuing education or by conducting or participating in research and educational activities. 


Clinical Services

Typically, a physiotherapist will review the medical and social history of the patient before conducting a thorough assessment to identify the patient's potential and existing problems. This serves as baseline for designing individualised treatment plans which may include manual therapy, therapeutic exercises and use of electro-physical modalities or prescription of assistive devices to optimise recovery.

Physiotherapists in KKH rehab provide rehabilitative services in the women's and children's wards, as well as outpatient services in Rehab department. The physiotherapy services has extended to other outpatient clinics in other departments like orthopaedic, neurodevelopment, urogynaecology, gynae-oncology, breast oncology, voiding dysfunction and sexual health. In addition, a significant part of physiotherapy services involve extended coverage in the intensive respiratory care and emergency management.


The following are the various physiotherapy services we offer:

Women’s Services:

Paediatric Services:

General


Women's Services

Obstetric Care

Antenatal and Postnatal Care: Our physiotherapists provide education for antenatal and postnatal care. These may include back care, teaching of pelvic floor exercises and other appropriate exercises. Physiotherapy services in obstetric  wards include respiratory, musculoskeletal and pre-post surgical management of conditions in association with pregnancy and delivery related complaints.

Physiotherapy Management: Patients who present with cardiorespiratoy conditions are taught breathing and coping strategies to optimise the lungs. Women with musculoskeletal complaints are assessed, treated and educated on pain-relieving strategies, taught exercises to improve symptoms and provided assistive devices such as maternity belts where indicated. The physiotherapist can help with common problems like perineal pain and swelling through ice therapy/ultrasound treatment and pelvic floor education after delivery. Patients  Patients are also screened and prescribed anti-embolism stockings to promote blood circulation and prevent blood clot information i.e. deep vein thrombosis which can be potentially fatal.

Inpatient group physiotherapy services:

  • Postnatal care Programme

Outpatient group physiotherapy services:

  • Antenatal Education Programme at Patient Education Centre, KKH
  • Aquafitness In Pregnancy
  • Baby Massage Program (For infants 1-12 months of age)
  • Pre/Postnatal Fitball Class

Gynaecology Care

Physiotherapy services include:

  • Pre/Post-operative Physiotherapy
  • Palliative Care
  • Musculoskeletal Conditions
  • Walking Aids Training


Pre/Post-operative Physiotherapy

Patients undergoing surgery may require pre-operative physiotherapy to help them have a better understanding of the implications of surgery on them. Patients are assessed on their respiratory, circulatory and functional status prior to surgery, and educated on ways to prevent post-operative complications and facilitate early mobilization. Anti-embolism stockings are prescribed for patients to wear during and after surgery to preven the development of deep vein thrombosis and potentially fatal, pulmonary embolism.

Post-Operative Physiotherapy aims to facilitate patients' recovery within the shortest time possible without preventable complications. The physiotherapist is involved in postural advice, teaching exercises for respiratory care, circulatory care, moving out of bed and assisting patients to walk. Caregiver training is also provided to help carers cope with caring of the patients at home when needed.


Physiotherapy for Palliative Care Patient

Physiotherapists support and assist palliative care patients towards the end of life. These include pain management, respiratory care, circulatory care, and relaxation exercises. Patients with complaints of pain are assessed and managed with a range of treatment depending on the needs of patients.

Additional treatments like manual lymph drainage may also be offered to provide comfort and relaxation to the patients with lymphatic congestion.


Physiotherapy for Musculoskeletal Conditions

Inpatient and outpatient services:

  • Musculoskeletal Management
    Physiotherapists assess patients with acute or chronic musculoskeletal conditions (e.g. neck/back pain and poor posture) and prescribe exercises or management techniques to help regain functions or lessen symptoms. We also provide post-surgical rehabilitation such as for patients who have undergone total knee replacement. Assistive devices are prescribed where required. 
  • Hydrotherapy
    Hydrotherapy is a form of physiotherapy treatment conducted in a heated pool by a hydrotherapy-trained physiotherapist. The patients undertake specifically designed exercises to regain or enhance their physical well-being.


Walking Aids Training

Our physiotherapists assess and train patients on the use of walking aids for mobility on level ground and stairs. This is accompanied or followed by relevant lower limb exercises.


Fall risk assessment and Geriatic Care

Our physiotherapists attend to women above the age of 65 in the inpatient wards. Inpatients are assessed for their balance and safety within the ward in order to ensure that adequate care is provided to prevent falls during their stay and that this is translated to their daily activities. Our physiotherapists also attend to those referred for orthopaedics or osteoporosis related problems in the outpatient clinics. This is to ensure continued safety beyond the hospital stay to their return back home.

Inpatient physiotherapy services:

  • Fall assessments for all above the age of 65 or those with existing movement limitations
  • Prescription and sale of appropriate walking aids such as walking stick and walking frame to ensure stability and safety
  • Teaching of strengthening and balance exercises to prevent muscle wasting associated with reduced walking and long periods of hospital stay
  • Education on fall’s prevention upon returning home
  • Care giver training
  • Assist in the coordination of step down care such as community hospitals, rehabilitation centres or day care centres
  • Inpatient group exercises

Outpatient physiotherapy services:

  • Individualised outpatient clinic for individualised assessment and prescription of treatment and exercises
  • Aquafitness in adult musculoskeletal for patient with musculoskeletal conditions

Bone Health Programmes

These outpatient group programs are aimed at frequent fallers and those with greater risk of falling, as well as those with osteopenia or osteoporosis.

  • Bone Building exercise group class: an advanced exercise class targeted at preventing and managing osteoporosis
  • General exercise group class: an intermediate exercise class targeted at improving fitness, core muscle strength and balance and coordination for those at risk or with osteoporosis.
  • Bonefit class: a supervised, individualised gym based group class targeted at improving strength and balance in falls' risk reduction and maintaining bone health.

Continence Management and Pelvic Floor Rehabilitation

Physiotherapy plays an important role in optimizing bladder and bowel functions due to incontinence (urine or faecal leakage), detrusor instability, urge incontinence, stress incontinence or pelvic organ prolapse. These problems can occur antenatal, postpartum, before, during and after menopause or any other time period in a woman. Our physiotherapists also attend to children with the urinary or faecal incontinence and overactive bladder syndrome.

Individualised assessment and treatment will be provided according to the condition. Treatment method consists of education of pelvic floor and its relationship with the bladder and bowel, education on normal function of bladder and bowel, pelvic floor exercises, bladder retraining programs, electrical stimulation and lifestyle advices.

Children or Women with these conditions can be seen in the wards and as an outpatient.


Physiotherapy Management of Pelvic Floor Pain and Sexual Dysfunction

Physiotherapy is part of Sexual Health team that helps couples with sexual dysfunction. Couples will be assessed by the team to consider the physical, psychological or social factors that causes the problem.

In addition, women that suffer from pelvic floor pain that can affect movement, bowel/bladder functions and/or sexual function will be assessed and treated as needed.

Physiotherapy management for pelvic floor pain & sexual dysfunction will consist of:

  • Down-training of the Pelvic Floor Muscle
  • Stretches
  • Relaxation techniques
  • Manual therapy

Gynaecological and Breast Cancer Care

We are part of a multidisciplinary team which attends to patients with breast or gynaecological cancers in order to provide a holistic assessment and obtain an understanding of their existing function and support. Our services extend beyond the routine pre and post surgical care to educate and equip patients and carers with information, skills and exercises to optimise their potential and independence. This is to ensure that our patients are discharged with the appropriate amount of support and care to able to manage at home to enhance their quality of life.

Physiotherapy services:

  • Pre-operative assessment and prescription of exercises before surgery for breast or gynaecological cancer
  • Post-operative exercises and facilitating return to previous independence
  • Respiratory care for cancer patients with lung complications
  • Strengthening and balance exercises during or following treatment for cancer
  • Caregiver training to ensure competency and safety in assisting with the care of patients
  • Lymphoedema management with manual lymphatic drainage and compression therapy
  • Palliative care such as pain and symptom management, care giver training, goal setting to maintain quality of life
  • Outpatient follow up for the progression of exercises following breast surgery to regain shoulder movement and strength
  • Outpatient individual cancer rehabilitation programme

Lymphoedema screening and management

All patients who have undergone surgical removal of lymph node and/or radiation therapy as part of their cancer treatment are educated on lymphoedema risk reduction strategies prior to discharge. These patients are followed up by a specialised group of lymphoedema trained therapists in a monitoring clinic.

Patients who develop lymphoedema are treated subsequently in the Rehabilitation department with a combination of:

  • Advice on skin care
  • Therapeutic exercises
  • Manual lymphatic drainage
  • Compression garment prescription
  • Compression bandaging

Children's Services:

The physiotherapists in Rehabilitation Department offer children's services in the areas of early intervention, neurological rehabilitation, developmental, cardiopulmonary and orthopaedics.


Physiotherapy for Paediatric Neurological Rehabilitation & Early Intervention

Our physiotherapists will carry out standardised neuro-developmental assessments on the child both in inpatient and outpatient settings and prescribe him/her with any exercises required to help facilitate his/her development.

Physiotherapists treat children who are born prematurely, children with significantly low birth weights and children with neurological conditions / syndromes to provide them with the exercise they need to reach their maximum potential.

Conditions managed by our team of Physiotherapists include:

  • Cerebral palsy
  • Gross motor delay
  • Muscular dystrophies, e.g. Duchenne’s Muscular Dystrophy, Spinal Muscular Atrophy
  • Brain injury, e.g. post-road traffic accident, stroke, encephalitis, brain tumours
  • Developmental Coordination Disorder
  • Arthrogryposis
  • Spina bifida

Apart from managing neurological conditions, our physiotherapists also run specialised services such as:

  • Developmental screenings for at - risk infants such as the growing premature infant
  • Serial casting for neurological conditions
  • Customised non weight bearing splinting
  • Pre and post botox rehabilitation
  • Pre and post epilepsy surgery rehabilitation
  • Holiday group classes for children with Cerebral Palsy
  • Holiday group classes for children with Developmental Coordination Disorders


Management:

Our physiotherapists will carry out assessments on the child to establish the level and frequency of therapy intervention required. Physiotherapists will work closely with parents to devise an individualised home exercise program designed specifically to achieve set goals.

Exercise programs prescribed are intended to improve muscle strength, prevent muscle tightness, facilitate normal patterns of movement, manage movement dysfunction, weakness and deformities.

Exercise plans can be carried out on land or in the water (hydrotherapy) which takes place in a heated pool located in the department. Hydrotherapy can provide vital support, balance and strength training, to give control to the child that cannot be achieved on land. The warm water aids relaxation of muscles.

Our therapists are trained in specific, advanced techniques which include Bobath/NDT (Neuro-Development Training), Theratogs, PNF (Proprioceptive Neuromuscular Facilitation) and hydrotherapy. Physiotherapists work closely with medical doctors and run combined clinics with neurologists, neonatologists and orthopaedic surgeons. Our combined clinics include the Spasticity Clinic, Neuro-Ortho Clinic, Neuro-muscular, Neonatal Multidisciplinary and Premmie Clinics.


Respiratory Physiotherapy Management

Many children and infants present to hospital with illnesses relating to the lungs. This can be caused by pneumonia, chest infection and excessive phlegm, or when they have trouble clearing their own phlegm. Respiratory physiotherapy aids the recovery of the child by using manual techniques, positioning and exercises, as well as therapeutic devices. The aims of physiotherapy are to improve ventilation and maintain clear airways.


Management:

Our physiotherapists will carry out a thorough assessment of the patient before designing individualised treatment plans which include:

  • Positioning of the child in postures which facilitates the removal of secretions by using gravity to help drain phlegm towards the nose and mouth for suctioning or coughing
  • Assisting the drainage of phlegm using manual techniques, such as vibrations and percussions, to the chest wall
  • Improve lung volumes and the amount of inspired air with exercises such as incentive spirometry
  • Prescribing airway clearance devices to aid the removal of phlegm, e.g. Acapella and Bubble PEP (Positive Expiration Pressure)
  • Prescribing Inspiratory Muscle Trainer (IMT) to children with neuromuscular diseases at risk from weakened respiratory muscles
  • Conducting cough assist assessment and treatment for patients with weak inspiratory and expiratory muscles to enhance airway clearance 

Pre/Post-operative Physiotherapy

Patients who are at risk of post-operative complications will be attended to as an inpatient prior to their surgery or pre-admission in the outpatient setting. They will be taught exercises and techniques to prevent lung collapse, chest infections, maintain a clear airway and maximise respiratory function. They will also receive advice regarding the importance of exercise after surgery.

Post-operatively, patients receive treatment involving techniques to improve the respiratory function, such as breathing exercises, supported coughing and incentive spirometry. They are also educated about the importance of early mobilization post-op, as well as being taught safe and correct ways of moving and exercising to minimise pain and prevent further complications.


Physiotherapy for Musculoskeletal/Orthopaedic Conditions

Our physiotherapists provide specialist Physiotherapy assessment, treatment and management advice for patients with a wide range of musculoskeletal/orthopaedic conditions. These include pain in the joints, muscles or tendons, sprained ligaments, pre/post-operative orthopaedic surgeries, sporting injuries and arthritis. The physiotherapy consultations are individualised and thorough assessments are carried out to ensure and accurate diagnosis is made before a treatment plan is developed.


Management:

Our physiotherapists undertake a holistic approach when formulating an individualised treatment program which may consist of the following: pain management, exercise rehabilitation, manual therapy, gait re-training, education, long term self-management strategies and/or provision of orthoses/walking aids. Electrical modalities may be used as an adjunct to physiotherapy management.

  • Hydrotherapy
    Hydrotherapy may be used as a part of Physiotherapy treatment to help regain or enhance physical well-being in a warm-relaxing environment. It is conducted in a heated pool led by physiotherapists, where patients undertake individually tailored exercises to regain or enhance their physical well-being.

  • SpineCor Brace and Physiotherapy Treatment
    SpineCor brace and physiotherapy exercise treatment are provided for patients with adolescent or juvenile idopathic scoliosis by our SpineCor accredited physiotherapists. SpineCor brace is a dynamic non-rigid brace to help control the scoliotic curve progression, which works via the corrective movement principle. The treatment also helps to rebalance and strengthen the abnormal musculature, improve posture and reinforce and integrate neurological feedback.

  • Some of the conditions treated by our physiotherapists include:

    • Wry neck (torticollis)
    • Back/neck pain
    • Scoliosis
    • Shoulder/elbow injuries
    • Hip injuries
    • Knee injuries
    • Ankle and foot injuries
    • Sports injuries, return to sports rehabilitation
    • Post fractures with joint stiffness
    • Congenital dislocation of hips
    • Congenital club feet


Our Experts

​Satyaki Sengupta​Deputy Director
​Elizabeth Chan JiahuiHead of Department​
​Chua Bee Hong Catherine​Senior Principal Physiotherapist
​Parveen Kaur Sidhu​Senior Principal Physiotherapist
​Chua Shiling Caroline​Senior Principal Physiotherapist
​Ng Shin HueySenior Principal Physiotherapist
​Maheswari Vellaichamy​Principal Physiotherapist
Lindsey Jean Ross Weller​​Principal Physiotherapist
​Asila Alia d/o K O NoordinSenior Physiotherapists
Aye Aye Myint​​Senior Physiotherapist
​June Fengcai Nunez​Senior Physiotherapist
​Shelly-Anne Marie Sherwood​Senior Physiotherapist
​Tan Wan Qian Priscilla​Senior Physiotherapist
​Toh Siao Hui​Senior Physiotherapist
Wee Chun-Sian Barbara​Senior Physiotherapist

 


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