Division of Rehabilitation Medicine

2024/06/14

Introduction

"Rehabilitation Medicine aims to help individuals achieve their highest functional potential, life goals, aspirations and best quality of life for them and their loved ones"

"Our clinical care is integrated across all hospitals in the National University Health System (NUHS), ensuring that patients receive the best rehabilitation care in a timely manner."

Vision

Our vision is a population enabled to achieve its best potential through compassionate care, applied research and innovation, spanning the entire rehabilitation journey from hospital to community. We aspire to a life without limits for our patients.

Mission

Excellence in person-centred care

Leaders in rehabilitation practice and care innovations 

Availing evidence-based advances in rehabilitation care and technologies to our patients through systematic integration into clinical practice

Our current research projects (already listed on our website - recently reviewed) include noninvasive spinal cord stimulation, brain network reorganisation and predictors of outcome post-stroke. We are also exploring the use of vision-based motion capture systems as biomarkers of health and function, along with community screening for long-term post-stroke complications.

Our current services include those for stroke, acquired brain injury, spinal cord injury, cancer and pain.

Our clinics include general rehabilitation medicine, spasticity, COVID-19, rehabilitation procedural clinics, as well as specialised clinics in spine (with orthopaedics), multidisciplinary spinal cord injury (with urology), functional upper limb surgery (with HRM) and cancer rehabilitation (NCIS).

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Our Team

Head of Division & Senior Consultant

Dr Effie Chew

Senior Consultant

Dr Lim Jeong Hoon

Consultants

Associate Consultant

Dr Yen Jia Min

Resident Physicians

Dr Mary Anne Lim
Dr Lalaine Tan Lua
Dr Sung Mei-Fen
Dr Michael Kwan
Dr Nicodemus Edrick Oey

Clinical Services

We provide comprehensive rehabilitation care from the acute phase of illness to inpatient intensive rehabilitation and outpatient rehabilitation in the community. The same team offers inpatient and outpatient services at NUH, Alexandra Hospital and Ng Teng Fong General Hospital, ensuring high standards of care and appropriate siting across these hospitals. Our services include:

Inpatient care:
Comprehensive post-acute interdisciplinary inpatient rehabilitation for conditions including:

Stroke
Acquired brain injury
Spinal cord injury
Cancer
Post-cardiac surgery
Neuropathies: Neurodegeneration, Acute neurological disorders including Guillain- Barre Syndrome, myopathy 
Amputee rehabilitation, including prehabilitation and pre-amputation evaluation

Outpatient clinics:
General rehabilitation medicine

Focuses on conditions such as neuro-rehabilitation and cancer rehabilitation.

Rehabilitation Intervention

This group practice clinic provides medications and interventional spasticity management, including botulinum toxin and chemical neurolysis, alongside rehabilitation interventions such as serial casting, functional electrical stimulation and functional retraining.
Pain management interventions include physical modalities, deep joint injections such as facet joint blocks, sacroiliac joint injections and trigger point injections.

Neuro-urology

A one-stop multidisciplinary clinic led by rehabilitation physicians, urologists and urology nurses. It caters to patients with spinal cord injuries who have urinary issues. This clinic address all aspects related to spinal cord injury, including mobility, bladder, bowel, skin, spasticity, pain, fertility and return to work .

Spine

Rehabilitation physicians contribute to the multidisciplinary Spine clinic under Orthopaedic Surgery, offering expert diagnosis and multimodal treatment for spinal disorders.

Sports Medicine

Rehabilitation physicians manage the Sports Medicine clinic under Orthopaedic Surgery, focusing on the management of sports and musculoskeletal injuries. Treatments include extracorporeal shock wave therapy, platelet-rich plasma injections and other intra-articular injections.

Neurodiagnostic

Provides EMG services for the diagnosis and prognosis of nerve or muscle disorders.

Long Covid

Patients receive care from a multidisciplinary team for common long Covid symptoms such as fatigue, breathlessness and cognitive issues.

Our Education

Rehabilitation Medicine is involved in both undergraduate and postgraduate education.

We offer a Senior Residency programme with the NHG Rehabilitation Medicine Senior Residency Programme.

We also offer a one-year fellowship programme in Neurorehabilitation.

Fellowship in Neurorehabilitation 

1. Entry requirements: Candidates must hold an MBBS or equivalent degree, have completed one year of postgraduate training in rehabilitation medicine or related specialties (such as neurology, geriatric medicine, occupational health, etc) and be registered as a clinical fellow with the Singapore Medical Council (SMC).

2. Duration: 1 year

3. Objectives:

a) Develop competency in the assessment and management of a range of neurorehabilitation conditions, including stroke, traumatic brain injury and spinal cord injury

b) Acquire key knowledge to address medical complications and functional limitations in neurorehabilitation

c)  Gain skills in the therapeutic use of motor point blocks and nerve blocks for spasticity management

d) Develop clinical skills for the approach, investigation and management of various rehabilitation issues

Our Research

Rehabilitation Medicine is actively involved in numerous research activities, conducting multicentre clinical trials in collaboration with multiple academic institutions. Our research interests range from the mechanisms of neuroplasticity to health services research aimed at developing new models of care delivery.

1. Rehabilitation robotics

Clinical studies in collaboration with engineering faculty from local academic institutions, including the development and application of soft robotics in rehabilitation and the development of robotic exoskeletons with novel control algorithms.
Evaluation of robotic exoskeletons in a variety of local rehabilitation care settings, ranging from hospital to community-based environments.

2. Enhancement of neuroplasticity using non-invasive brain stimulation

Clinical studies examining the use of repetitive transcranial magnetic stimulation and transcranial direct current stimulation to enhance recovery in stroke and other acquired brain injuries

3. Technology-enhanced neuro-feedback in neuro-rehabilitation

Clinical studies in collaboration with engineers focusing on the use of brain-computer interface-assisted motor imagery and EEG/EMG biofeedback to enhance rehabilitation performance

4. Neurophysiological mechanisms of stroke recovery

Utilising multimodal functional imaging techniques, including MRI, transcranial magnetic stimulation and EEG, to investigate changes in neuronal networks during stroke recovery and various interventions. This research aims to improve patient stratification and the application of suitable neuromodulatory interventions

5. Novel gait analysis using inertial sensors and vision-based approaches

Clinical studies in partnership with engineers, working on the development of a scalable and cost-effective system for rapid detection and assessment of abnormal gait patterns.