to

1

• WELCOME
• to
• Tan Tock Seng Hospital
• Rehabilitation Centre
• Singapore

2
TTSH Today
1,456 beds 3,900 staff

• TTSH Main Building
• 1,172 beds
• 66 ICU

• Rehabilitation Centre
• 95 beds
• 1 isolation

• CDC 2
• 94 beds
• 18 ICU
• 76 isolation

• CDC 1
• 91 beds
• 11 isolation

3

• Largest and most established in Singapore
  offering inpatient rehabilitation services
• First set up in 1973 at Mandalay Road
• Relocated to current location at 17 Ang Mo Kio
  Avenue 9 in April 1994.

4
Statistics (2009)

• Admissions per year 1,090
• Total patient days per year 27,717
• Average length of stay 25.8 days
• SOC attendances 9,844
• Therapy sessions 8,768
• Acupuncture 3,958
• Community Rehab Program 5,225 sessions

5
Staffing by Professionals

• Rehabilitation Specialists 11 doctors with
  overseas
• 
  experience in rehabilitation
• 
  centers in US and Australia
• 1
  doctor from South Korea
• Junior doctors (residents) 8
• Medical Admin Assistant 1
• Allied Health (therapists, psychologists, MSW)
  70
• Nurses (all grades) 95
• Ops and Admin 11
• TOTAL 197

6
Spinal Cord Injury Rehabilitation

• Spinal Cord Injuries
• - complete
• - incomplete

7
Orthopaedics and Trauma Rehabilitation

• Amputees
• Arthritis
• Musculoskeletal disorders

8
Stroke Rehabilitation

• Different types of stroke
• - infarct
• - haemorrhagic

9
Brain Injury Rehabilitation

• Individualised and comprehensive physician-led
  rehabilitation program
• Able to manage the most complex brain injured
  patients

10
Community Rehabilitation Program

• Provides rehabilitation services for patients in
  their home environment

11
Medical Acupuncture Services

• Pain management
• Complements physiotherapy and occupational
• therapy for patients with spinal cord injury,
  stroke, brain injury and musculoskeletal
  disorders

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Leveraging on Technology to deliver customized
care

• Vestibular Rehabilitation using the Balance
  Master system
• Advanced Gait Analysis Systems for clinical
  utility
• - GaitRite system for clinical analysis,
  outcomes monitoring
• and research
• Robot-Assisted Gait Training with the Lokomat
• - commenced in September 2008

13

• Vestibular
  Rehabilitation
• - Management of patients with dizziness and
  balance dysfunction by using the SMART Balance
  Master system

14

• DYNAVISION
• - to provide training for persons whose visual
  and motor
• function has been compromised by injury or
  disease

15

• GAITRite
• Portable electronic walkway system
• measuring
• - temporal (timing)
• - spatial (distance) gait parameters
• connected to the serial port of a
• notebook computer
• Advanced gait analysis

16
RoboWalk Program
The program involves the usage of a robotic gait
orthosis (Lokomat system) which assists walking
movements of patients
17
A Feasbility Study Using Interactive Commercial
Off the Shelve Computer Gaming in Upper Limb
Rehabilitation of Stroke Patients - accepted
for publication 2010Tjan SY, Xu D, Kong KH, Loh
YJ, Christopher KWK, Thia CK

• n 20 stroke patients
• mean 26.3 days post-stroke
• Each patient received 6 sessions gaming over 2
  week period
• Each session 30 mins
• Outcome measures
• 1) Fugl-Meyer Assessment (FMA)
• 2) Motricity Index (MI)
• 3) Modified Ashworth Scale (MAS)
• 4) Visual Analog Scale (VAS) for pain

18
TTSH Rehabilitation Research Collaborations
Development of Advanced Rehabilitation
Technologies
19
Haptic Knob
Haptic Knob research

• Lambercy et al (2009) Rehabilitation of
  grasping and forearm pronation / supination with
  the Haptic Knob

20
Research Brain-Computer Interface (BCI) Robotic
Rehabilitation for Stroke

• Collaborative translational novel research funded
  by The Enterprise Challenge (S650 000 for 1 year
  duration)
• New rehab device based on advanced BCI technology
  developed at I²R using thought detection
• Stroke patients undergoing rehab will control a
  robotic shell with the help of BCI
• Randomised controlled clinical trial

21

• Brain Computer Interface (BCI) for Rehabilitation

TTSH Rehab Centres research collaboration with
National Neuroscience Institute and ASTAR
(Agency for Science, Technology and Research)
22
Research collaboration with Nanyang Technological
University of Singapore
23
Biofeedback Gait Device for Spinal Cord Injury
and Stroke Patients
TTSH Rehab Centres collaboration with Nanyang
Technological University, Singapore