TTSH's 'runways' for rehab

SINGAPORE - Highly motivated after an international conference on patient rehabilitation in South Korea, Ms K. Patmawali and Mr Lim Pang Hung wanted to do more for their patients.

But what?

Their "eureka" moment came as the plane they were in was taxiing on the runway.

The year was 2007.

Today, almost five years later, under the Let's Walk programme, there are three "runways" at the wards at the Tan Tock Seng Hospital (TTSH) Rehabilitation Centre to get patients onto the fast lane to recovery.

Many of them suffer from stroke, fractures and head injuries.

Ms Patmawali, 54, the centre's assistant director of nursing, said: "It took us over a year after the conference to look through the logistics (of the Let's Walk initiative).

"We also had several sessions to get the nurses here to buy into the programme."

It was only in 2009 that a prototype of the Let's Walk system was set up within the ward environment for a trial run.

"We started out with the stroke patients, but other departments like orthopaedic and trauma wanted their patients to participate to fast-track their recovery," said Mr Lim, 43, the principal physiotherapist at the centre, which is in the Ang Mio Kio-Thye Hua Kuan Hospital.

The Let's Walk rehabilitation exercises are conducted in the wards on customised tracks with distance markers, guiding lines and visual cues to align the direction the patient would be heading.

Patients would be put through the paces for a 15-minute session daily and they are expected to walk 600m to 1km in 14 days to complete the programme.

During the exercises, nurses would measure the distance and time a patient takes to complete it. They would also observe his gait and balance, and provide necessary walking aids and gait belts.

Stroke patient Cheng Lee Keow is undergoing the Let's Walk therapy.

"I think it has helped strengthen my legs. I feel my muscles are less tight with these regular walks," said the 64-year-old housewife.

Retiree Koh Ah Kow, 85, said he has completed three rounds and is looking forward to more.

Each patient's progress is tracked daily for possible early discharge from hospital.

Before the Let's Walk programme came into being, patients were scheduled for one to two hours of physiotherapy weekly, which include speech and occupational therapies.

Said Mr Lim: "It is estimated that in total, the patient would be on his feet between 30 and 45 minutes for every session at the gym.

"Since many are not allowed to roam on their own, they are confined to their beds the rest of the time. This hampers fast healing."

'Weekend syndrome'

'Weekend syndrome'

Nurse clinician Derek Tan, 36, who deals with patients with fractures, said: "Then there is what we call the weekend syndrome - when patients do not get on their feet at all because there is no physiotherapy session.

"With the 'runways' in place, patients can at least walk with help within the ward."

The Let's Walk initiative has helped cut patients' length of hospital stay from 27 days to 25. About 350 patients have completed the programme since its implementation.

Its initial success has led to other related programmes which aim to impart to patients basic life skills to help integrate them back into the community.

The team is looking at using the Wii, a video game console, as part of this.

Mr Tan and a colleague, senior staff nurse Wang Dan, 32, were also co-opted to push Let's Walk further.

Wanting to share their project with other rehab centres here and in the region, the team has started research to come up with scientific proof to show that the Let's Walk programme can improve recovery and cut down the length of ward stays.

The team hopes to have its findings published in an international peer-reviewed journal.

"To help our patients recover and function normally at a much faster rate, we as rehab practitioners must look ahead to translational medicine and not merely accept the status quo," Ms Patmawali said.

juditht@sph.com.sg

This article was first published in The New Paper .

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