Physiotherapy and Rehabilitation

Managing a patient’s condition requires a multidisciplinary approach. Aside from providing principal treatment, another important dimension of holistic care is to facilitate the patient’s recovery through rehabilitation.

The goal of rehabilitation is to enhance and restore functional ability and quality of life for those with physical impairments or disabilities. Return to function can be achieved via a few methods; with physiotherapy and occupational therapy being at the forefront.

Physiotherapy deals with returning and improving regular bodily movement with focus on a specific body part, while occupational therapy aims to return the affected individual to their daily routine with focus on ability to complete tasks and activities.

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Conditions and symptoms that require rehabilitation

Disabilities that require rehabilitation can be due to a myriad of causes such as occupational and sports injuries, motor vehicle accidents, diseases, or side effects of medical treatment. Lower back pain is one of the most common musculoskeletal conditions which require rehabilitation.

Other common symptoms and problems that are usually presented to the therapists include:

1. Muscle stiffness or soreness
2. Muscle weakness
3. Neck and back pain
4. Specific musculoskeletal pain (such as Carpal Tunnel Syndrome)
5. Elbow pain
6. Knee pain
7. Foot pain
8. Limited range of joint movement
9. Gait problems
10. Falls and fractures
11. Pelvic issues, such as bladder and bowel problems related to childbirth (incontinence)
12. Mobility issues following neurological diseases such as Parkinson’s and multiple sclerosis
13. Palliative care-related symptoms such as fatigue

Physiotherapists and Occupational Therapists can help with medical conditions such as:

1. Arthritis
2. Cancer
3. Cerebral palsy
4. Cardiovascular disease
5. Chronic Obstructive Pulmonary Disease (OCPD)
6. Dementia
7. Type 2 Diabetes
8. High blood pressure
9. Osteoporosis
10. Stroke

Each patient will have a unique concern and their problems can vary greatly in severity, necessitating tailored care and treatment. Without adequate and proper treatment, pain and discomfort can interfere with a patient’s daily routines and potentially limit their independence.

Who Needs Rehabilition & Physiotherapy

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Diagnosis and screening for conditions that require rehabilitation

A well-formulated diagnosis helps to guide physiotherapists and occupational therapists in determining the prognosis and most appropriate intervention strategies for a patient.

Upon referral, the therapist learns about the patient’s medical history, existing or potential impairments and previous treatments received (if any). Based on this information, they will prescribe a course of tailored exercises and use of relevant assistive devices.

Both physiotherapists and occupational therapists share common traits – they both educate patients on injury prevention, healing process, and assist in improving a patient’s regular body movements.

Physiotherapists focus on evaluating and diagnosing movement dysfunctions, and work to improve a patient’s ability to perform specific body movements. Beyond managing pain and movement problems, a physiotherapist also helps patients to prevent future injuries from occurring, evade surgery or long-term reliance on medications.

Occupational therapists help reinstate a patient back into their daily lives with minimal support. This is performed by focusing on the functionality of an individual instead of the movement of a singular body part.

An occupational therapist works to comprehensively evaluate the following aspects:

1. Necessity: Help to identify alternatives to the function of the affected parts. For example, a hobbyist tennis player with elbow injury, they may suggest an alternate sport.
2. Stress: Help to identify symptoms related to stress and suggest methods to cope with them. A referral to a psychotherapist might be needed, in case of psychosomatic disorders (physical manifestation of a mental health state).
3. Motor skills: Offer highly efficient exercises and techniques to enhance functionality for individuals with certain afflictions (Down syndrome, muscular dystrophies, and Parkinson’s disease to name a few).
4. Lifestyle and environment: Recommend important lifestyle modifications such as grab-bars and anti-slip mats for older individuals and higher seating and increased cushioning for those with arthritic joints.

Treatment options used by physiotherapists and occupational therapists

Each treatment plan prescribed by the therapist is unique since every patient’s need is different.

Tasks that are appropriately addressed in a rehabilitative program include:

1. Training of functional tasks:
   • Rolling, positioning for comfort and/or pressure relief, bridging (lifting pelvis off the bed), and movement of supine-to-sit and sit-to-supine
   • Transfers, set up (e.g., positioning of wheelchair in relation to the bed), sit-to-stand, pivot (or slide) and stand-to-sit
   • Ambulation or gait assessment, assistive device placement, and foot placement
2. Post-surgery exercises:
   • For individuals who are recovering from a condition, after undergoing surgical procedures, or seeking relief from pain and discomfort whilst recovering from injury, the role of a physiotherapist is invaluable
   • They help to relieve symptoms by introducing a focused set of exercises for the affected body part
3. Strengthening and mobility exercises for muscle weakness and joint problems:
   • Commonly prescribed exercises include muscle strengthening and range of movement exercises
   • These exercises help to build up strength and restore the movement range of body parts that have been dormant
4. Heating and cooling techniques
   • Depending on whether there is recent injury, old trauma, or the presence of conditions such as arthritis, focused heat/cold application techniques can introduce noticeable change
5. Electrical Nerve Stimulation
   • Electrical Nerve Stimulation may be performed by attaching pads to the skin (transcutaneous stimulation is known as TENS) or other techniques
   • The aim is to stimulate neighbouring muscles to trick the body into believing that pain is reduced so that initiation of exercises can be smooth, at which point the therapist would be able to identify the exact cause of pain
6. Hydrotherapy (water), cryotherapy (freezing temperatures), etc
   • New treatment modalities are always under development, therefore they may not be uniformly available at all locations
   • It is advisable to visit your nearest therapist to identify the best technique for you

When should you go for rehabilitation?

The following are signs that you should consider making an appointment with a therapist:

1. Recurring pain that sometimes seems to get better but always comes back
2. Pain when you sit at your desk. This can include back pain or headaches
3. You experience a lack of balance
4. You are experiencing a decline in mobility
5. You are affected by urinary incontinence
6. You have a neurological disorder, for example, stroke victims
7. Pain medication prescribed for an injury is not working
8. You have a sports injury
9. You have diabetes and need help with a diabetes management plan

The rehabilitation team at Pantai Hospitals are trained to provide the best care for our patients. Because each patient is different and will present with their own set of issues and symptoms, treatment plans are personalised.

Make an appointment with us today as physiotherapy can help increase your functional independence and assist with strength and mobility in many conditions.

Read more about Orthopaedic care and services at Pantai Hospitals.