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Functional Rehabilitation

Neurological/Neuro-surgical conditions

    These conditions may include stroke, trauma brain injury, etc.

Problems are usually very complicated. There is a wide range of severity and different combinations.

Problems may include dysfunction of physical, cognitive, emotional, behavioral, and may interfere with activities of daily living, social interactions and employment.

That is why it is so important that every client needs to be evaluated individually and the program planned and adjusted according to individual needs. In order to ensure adequate quality of life, the program must encompass all aspects of life.

It is our goal to improve our clients’ ability to function as independently as possible at home, in community and, if applicable, at study/work situation. We also help them to adapt to disabilities or make changes in life to accommodate their impairments, paying attention to psycho-social issues when these emerge.

    Physical problems:
  • Hemiplegia:

    Very often, hemiplegia is observed in clients, i.e. reduced active control of one side of the body, such as reduced action of right arm and right leg. Often spasticity is involved, and makes the active movement even more difficult.

    - Lower limb: This affects walking gait and balance. This usually restores quicker than the upper limb.
    - Upper limb: This affects upper limb coordination and use of hand.

    This requires a long period of physical function rehabilitation, in terms of years, with better result for early intervention, before compensatory or trick movements are established.

    Therapy would also need to concentrate on normalization of muscle tone as the spasticity will make client’s active control more difficult.

  • Sensory problems:

    There maybe some sensory problem related with the hemiplegia. It maybe confusing to the client, e.g. there’s someone else in my bed, but in actual fact, it is the unaffected leg being aware of the unfeeling leg.

    Sensory re-education program will help.
  • Visual problems:

    Clients may not be able to see part of the visual field or to interpret what they are seeing. Again, re-education of perception or compensatory techniques would be needed to ensure safety.

    Oral-motor / articulation difficulty:

    Some clients may have difficulty chewing and swallowing, and in speaking as they used to speak. Re-education will be necessary.
    Cognitive problems:
    This may include:
  • Impaired attention
  • Disrupted insight
  • Judgment
  • Reduced processing speed; distractibility
  • Memory
  • Deficit in executive function (such as abstract reasoning, planning, organizing, making judgment, problem-solving, and multitasking)
    This is an integral area of training in the program.

We incorporate element of cognitive function that requires training into a program of normal daily functional activities in order to facilitate generalization of improved skills and to improve self-esteem of clients as they would not feel like “students” or “inmates”.
    Communication problems:
    There maybe articulation, or comprehension and expressive difficulty. Our therapy team will engineer opportunities for practice of such skills.
    Psycho-social problems:
    There maybe emotional symptoms or behavioral problems. We encourage discussion with any member of the therapy team that the client feel comfortable with. If necessary, we will refer to psychological practitioners.
    Self-care problems:
    The above problems will affect clients’ ability for self care. And practicing of self-care activities would also be beneficial for improving the above problems.

Such as putting on a jacket, in a specified manner with minimum compensatory movement, will improve upper limb active control of movement and memory and executive functioning.

Doing shopping for the family, with specified number of items, is good training for memory, organization, walking and balance, safety on the road, planning of route, etc.
    Community re-integration:
    Our therapy team will help clients to plan and implement steps towards re-integration into the community. To be safe and effective would be one of the main goals.
    Education/work problems:
    Sometimes it may not be possible for client to return to pre-injury study or work. Our therapy team will help prepare the psychological adjustment, explore interest and aptitude, and help to identify possible direction.

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