Chronic Disease Management and Physiotherapy Singapore
Chronic disease(s) refer to diseases and/or other human health conditions that are long-lasting (more than 3 months, at least) and persistent. Common chronic diseases includes cancer, asthma and HIV/AIDS.
Depending on the type of conditions and its severity, impact and location in the human body, the role for physiotherapy differs, but generally our role is to decrease pain experienced, increase mobility, function and overall quality of life. Some of the common chronic disease management that we treat includes: autoimmune diseases (ulcerative colitis, lupus); blindness; cancer; cardiovascular diseases such as heart failure, ischemic cardiopathy; chronic fatigue syndrome; chronic osteoarticular diseases such as osteoarthritis and rheumatoid arthritis; chronic renal failure; chronic respiratory diseases such as asthma, chronic obstructive pulmonary disease, pulmonary hypertension; deafness/hearing impairment; diabetes mellitus; osteoporosis.
All the above conditions not only require long term medical care, but also long term physiotherapy, occupational therapy and hand therapy care. In the acute settings, physiotherapy and occupational therapy's role is crucial, but in the community, the occupational therapist has a bigger role to play. For example, in the case of an individual with blindness, the physiotherapist will ensure physiologically and physically, the patient will be strong enough to stand/walk with a walking aid, as well has intact balancing centers. The occupational therapist, on the other hand, will work with more community integration issues such as showering, bathing, dressing, arranging and training the individual how to identify different colors for color matching, how to prepare meals, how to take out the trash, going around the community in public transport etc.
For cancer, the physiotherapist will focus on ensuring that patient's lungs will be clear of fluids to prevent infections, pneumonia and to ensure the lungs are functioning at its maximum capacity. When possible, they will start patients on mobility exercises and walking exercises. The occupational therapist on the other hand, would focus on more preserving activities of daily living and pursue issues such as end of life questions e.g. spirituality, closure (only trained ones), pursuing meaningful leisure activities etc.
Heart-related failures are mainly physiotherapy-related chronic disease management - from ensuring lungs are clear, to advising on prevention of re-injury of the heart, to exercises that are safe, to discharge. Occupational therapy have more limited role.
For patients with chronic fatigue syndrome, the physiotherapist will focus on training to improve, boost or maintain the patient's stamina, stability and strength through exercises gradually. The occupational therapist, on the other hand, would focus on energy management techniques, stress management, deep breathing exercises, scheduling and prioritizing as well as the introduction of ergonomic techniques and products to increase productivity.
For chronic osteoarticular diseases such as osteoarthritis and rheumatoid arthritis, therapy intervention depends on location and intensity. For example, for osteoarthritis of the knee, there would be more physiotherapy input to train the muscles of the thighs, hips and knees to provide a better "buffer" system for the knee joint, but the occupational therapist would focus on teach compensatory management approaches to activities of daily living such as wearing shorts or bermudas instead of long pants, and to wear the pants in seated position instead of standing. If the osteoarthritis or rheumatoid arthritis occurred more in the hands, then the hand therapy deparrment would be strongly involved in decreasing pain experienced, increase range of motion and prevent deformity through the use of splints, braces and adoption of better manual handling techniques.
Patients with deafness usually don't require much physiotherapy intervention, except for occasional intervention by occupational therapy in forms of introduction to communication devices, if the speech therapist has not already introduce communication devices which may be manual or digital. There is a large array of communication tools that people who are hearing impaired may tap on, on top of sign language.
obstructive pulmonary disorder and respiratory-related disorders
require mainly physiotherapy input on chest physiotherapy to keep the
chest/lungs clear, train the lung to increase its capacity, followed by
exercise therapy to improve stamina and strength. Each chronic disease management is handled differently.
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