10:00 – 10:30
Management of the Hemiplegic Upper Extremity – What Is The Evidence?
Hotel Intercontinental 2nd Floor Ballroom
Impaired upper extremity function is a devastating lost for most of the stroke
survivors and hence, a formidable challenge for attending therapists. Rehabilitation
of the hemiplegic limb remains difficult to achieve, with only 5% of complete paralysis
stroke survivors regaining functional use of their impaired arm and hand (Dombovy 1993,
Gowland 1982, Kwakkel et al. 2001).
There are numerous techniques, technologies, strategies, medical management and
orthoses used world wide in the management of the hemiplegic upper extremity. Some
of them are training techniques that evolved from motor learning theories years back
whereas some are novel and recent. Until recently, many therapists have employed a
hypothetical, "experimental" approach in the rehabilitation of the hemiplegic
upper limb. Hence, a good review at current developments in evidence-based practice for
upper extremity management will help therapists to critically analyze these interventions
and to facilitate their application appropriately and effectively when treating the stroke
survivors.
10:50 – 11:20
Achieving Ambulation in the Stroke Survivor – Novel Techniques
Hotel Intercontinental 2nd Floor Ballroom
Gait retraining after a stroke takes up a sizeable proportion of a patient’s
rehabilitation program. It is often a key factor in length of stay and discharge
decision making. Fortunately, it is also one of the earliest motor functions that
many patients do relearn during the first few months of their rehabilitation. However
with an ongoing drive for shorter length of stay in today’s healthcare resource
management, the proportion of patients that could achieve early ambulation and the time
taken to successfully achieve ambulation have been keenly contested in researches of post
stroke gait retraining. With productivity and safety (of patients and therapist) being
requisites of an efficacious training regime, has technology been successfully utilized
to augment or replace existing traditional methods of gait relearning? It will be
constructive to understand and consider the unique advantages of both traditional
hands-on techniques and current gait training technology in meeting the needs of gait
relearning so as to innovate new and better means of carrying out the works.
11:20 – 11:50
Post-stroke Mood Disorders – Are We Providing Optimal Care?
Hotel Intercontinental 2nd Floor Ballroom
Neuropsychiatric conditions, such as Depression, Aggression, Personality Change and
Cognitive Impairment, are common after stroke. Yet, they are often unrecognized,
under-diagnosed or under-treated. This can result in poor Quality of Life for patients,
stress for the caregivers, or sometimes even tragic consequences. More can be done to
improve the care and community services to help patients after stroke. These include
the education of medical personnel and caregivers, research into Post-Stroke
Neuropsychiatric Disorders and their management and expansion of community services.
11:50 – 12:20
Alternative Therapies in Stroke Rehabilitation in Singapore – What Do We Know?
Hotel Intercontinental 2nd Floor Ballroom
Alternative therapies can be defined as therapies or treatments which are not
generally recognized by the medical community as standard or conventional. Use
of alternative therapies is common in Singapore, given its predominantly Asian
population. An outpatient survey of 119 patients with stroke and brain injury at
Tan Tock Seng Hospital Rehabilitation Centre in 2002 revealed that almost 50% of
patients had experience with at least 1 form of alternative medicine. The range
of alternative treatments varied from acupuncture, herbal medicine (Traditional
Chinese Medicine and Ayurvedic herbs), body massage, foot reflexology,
aromatherapy to magnetotherapy. Given its popularity, it is surprising to note that,
with the exception of acupuncture, there are very few studies evaluating the efficacy
of alternative treatments. For clinicians managing stroke patients, apart from
understanding the reasons and motivation for seeking alternative therapies, it will
also be useful to have a basic understanding of the mechanism of action and possible
side-effects of common alternative therapies used so that proper counseling and advice
can be provided.
12:20 – 13:00
Questions & Answers
Hotel Intercontinental 2nd Floor Ballroom
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TECHNICAL PROGRAMME
Neurorehab Workshop 1A
Incorporating Acupuncture/Acupressure in Stroke Rehabilitation – An Experiential Approach
24th April, 14:00 – 17:30
NLB, 3rd Floor, Visitor Centre
Acupuncture is a Traditional Chinese Medicine-based treatment modality that has been used
for since ancient times to treat a variety of illnesses. Increasingly, it has been used
as an adjunct to standard treatment of stroke and there is evidence suggesting that it
may facilitate functional recovery after a stroke. Furthermore, it is also useful in
alleviating poststroke complications of pain and spasticity.
This workshop consists of didactics, case studies and hands-on demonstration on mechanisms
of action of acupuncture in stroke recovery, commonly used acupuncture points and techniques
of acupuncture/acupressure.
At the end of the workshop, participants will have a better understanding of mechanisms
of acupuncture in stroke recovery and recognize acupoints commonly used for treatment
of poststroke pain e.g. hemiplegic shoulder pain and spasticity.
Neurorehab Workshop 1B
Stroke Rehabilitation Nursing – Current Practice and Future Challenges
24th April, 14:00 – 17:30
NLB, 3rd Floor, Function Room 3
Stroke is one of the leading causes of disability. More than fifty percent of
stroke patients are left with moderate functional impairments with severe disability.
Problems associated with each stroke are identified that may include paralysis,
communication problems, swallowing difficulty, urinary incontinence, mental &
emotional problems, fatigue etc.
These stroke survivals require extensive support to cope with and adjust to the
consequences of stroke. An effective rehabilitation intervention initiated early
after stroke can enhance the recovery process and minimize functional disability.
Rehabilitation nurses play a key role in facilitating individual recovery. A range
of strategies is adopted to prevent further deterioration in the patients' condition,
to prevent harm, and to maintain safety.
This workshop aims to provide tips on maintenance of existing abilities and roles;
promotion of health; prevention of further impairment; prevention and reduction of
disability; restoration of function and roles; and minimization of handicap.
Neurorehab Workshop 1C
Electromyography (EMG)-guided Biofeedback and Motor Recovery in Stroke
24th April, 14:00 – 17:30
NLB, 3rd Floor, Function Room 2
Electromyography (EMG)-guided biofeedback has been shown to facilitate motor and
functional recovery after a stroke. Dr Tsirkin will discuss the indications for use
of EMG-biofeedback in stroke and demonstrate the use of the BOSLAB neurobiofeedback
on stroke patients.
This workshop is suitable for physicians, therapists and psychologists interested
in understanding EMG-guided biofeedback in stroke recovery.
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TECHNICAL PROGRAMME
