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Physical Rehabilitation

Physical Rehabilitation, defined as “a set of measures that assist individuals, who experience or are likely to experience disability, to achieve and maintain optimum functioning in interaction with their environments” (WHO, 2011), is instrumental in enabling people with limitations in functioning to remain in or return to their home or community, live independently, and participate in education, the labour market and civic life.

Rehabilitation measures are aimed at achieving the following broad outcomes:

  • prevention of the loss of function
  • slowing the rate of loss of function
  • improvement or restoration of function
  • compensation for lost function
  • maintenance of current function.

The physiatric (Physical Medicine and Rehabilitation) model of care is based on fundamental understanding of the individuals’ unique conditions as it relates to the concept of impairment, disability and handicap.

Impairment is the loss or abnormality from psychological, physiologic, and functional perspectives that results from acquiring a painful condition.
Disability is a restriction and/or lack of ability to perform activities owing to an impairment (e.g., pain).
Handicap is a disadvantage that an individual possesses due to the impairment and disability that affects his or her role in society.

Physical rehabilitation offers a unique approach in which the management of the patient is focused on the whole person rather than an isolated condition. As such, the patient is managed through a patient-centered, multidisciplinary approach in which the specialists of various disciplines (e.g., physician, occupational therapist [OT] and physical therapist [PT], psychologist, Speech Therapist [ST], dietician, nurse, social worker) contribute their expertise to ongoing patient care.

Physical Rehabilitation uses a variety of techniques to help improve, maintain or restore physical strength, cognition, communication and swallowing as well as mobility with maximized results. Physical Rehabilitation also helps people gain greater independence after illness, injury or surgery.

Physical rehabilitation is provided in acute and subacute rehabilitation settings by interdisciplinary teams consisting of therapists, doctors, nursing staff, dieticians, psychologists and social workers. We provide both inpatient and outpatient services to clients with the following conditions;

  • Spinal cord injury
  • Stroke
  • Acquired brain injury
  • Amputation
  • Multiple trauma
  • Guillain Barré
  • Degenerative neurological disorders
  • Neuropathies and other neurological conditions
  • Burns
  • Paediatric trauma and acquired childhood illnesses
  • Joint replacements with complicating co-morbidities or limited pre- morbid functioning
  • Generalised weakness post prolonged ICU stay which limits functional independence compared to pre-morbid abilities.
  • Patients for whom bed rest has been medically instructed e.g. patients on traction, pressure ulcer management.
  • Ageing population: persons with chronic medical conditions who contract an acute illness (e.g. pneumonia) which results in a decline in the level of functioning.
  • On-going medical interventions such as Renal Dialysis, Chemotherapy, Radiation therapy which has an effect of physical and/or functional abilities.
  • Acute illness or surgery in a patient with a pre-existing functional limitation leading to a decrease in their level of functional independence and as a result the incident affects their level of functional independence.

Our rehabilitation program works according to the ICF model and is outcomes-based.

Various standardised outcome measures are used to evaluate the patient’s impairments and functional status, including the FIM/FAM burden of care measure. The patient’s rehabilitation program focuses on appropriate re-integration of the patient into his/her home, community and possible return to productive activity.

As part of our service delivery an initial planning meeting is carried out for each patient within the first 48-72 hours of admission and a comprehensive individualized rehabilitation plan is developed, considering pre-existing or complicating conditions and pre-morbid level of function. Treatment is tailor made to each patient and carried out in close collaboration with the family and caregivers. Patient, family and caregiver education and training is an integral part of the rehabilitation process and resources and materials are provided as necessary. Caregiver training and family counselling are also provided. The therapists assist with equipment procurement.

Formal interdisciplinary goal setting meetings are held weekly to discuss progress and challenges, review rehabilitation goals and focus on discharge planning which includes the appropriate discharge destination, equipment needs, education and training needs, as well as psychosocial factors impacting on rehabilitation.

Each facility has an integrated unit with a dedicated space equipped with the necessary rehabilitation apparatus which includes but is not limited to:

  • Exercise equipment for strength and endurance training
  • Tilt tables, standing frames and parallel bars
  • Motorised assisted cycling
  • Treatment plinths and floor mats
  • Mobility equipment including wheelchairs, walking frames and crutches
  • Assistive devices to assist in the training of ADL’s
  • Cognitive/perceptual assessment and treatment tools
  • Speech therapy assessment and treatment tools including VitalStim® Therapy

Effective discharge planning starts on admission. Progress reports are provided to the funder and referring doctor on a weekly basis for inpatients and on a needs basis for outpatients. This report includes an appropriate outcomes scale such as the FIM/FAM burden of care measure. A full report is given to the patient and family on discharge.

We offer an outpatient service at most of our locations, enabling the consolidation of residential reintegration goals and addressing reintegration into the community and workplace with vocational training where appropriate.

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