Future of rehabilitation in Asia – Q&A with Professor Wee

Author:

Jason Yeo

Head of Sales Hospital and Clinic Market, APAC Region

Associate Professor Wee Seng Kwee is a Senior Principal Physiotherapist who has been working at Tan Tock Seng Hospital’s Rehabilitation Centre for the past 26 years.

He is a certified Brain Injury Specialist and a Vestibular Rehabilitation Therapist who manages patients with acquired brain injury, balance, and vestibular dysfunction.

When Prof. Wee is not at his clinic, you will find him lecturing at the Singapore Institute of Technology, sharing his knowledge and expertise in neuro and vestibular rehabilitation, as well as advance robot-assisted rehab therapies. It is therefore fitting that Prof. Wee recently joined Hocoma’s Scientific Advisory Board, making him the first and only member on the board from Asia.

Assoc Prof Wee Seng Kwee

For this opportunity, we got together with Prof. Wee for a Q&A session regarding the changes he had witnessed in the delivery of rehab in the last decade and how the rehab clinic will change in the face of advancing technologies.

DIH: How much has the rehabilitation clinic changed in the last decade and what changes do you expect to see in the next 5 years?

Prof. Wee: Rehabilitation practice has changed significantly over the last decade. Extensive rehabilitation research has shaped and guide good clinical practice. There are still numerous unknowns about the optimal therapy intensity and dosage to yield the best outcome in neurological patients. Hence, there will be more research on innovative solutions in rehabilitation in the next 5 years. With new findings, better rehabilitation techniques and better features in rehabilitation technology systems can be developed to help patients recover. I sincerely wish that more clinician-scientists can help to push the frontiers of rehabilitation.

With the rapid development of artificial intelligence (AI) in the next 5 years, adjustments of software parameters for rehabilitation will become intuitive. Therefore, therapy prescription may become more precise to target patients’ problems. The synergy between AI, rehabilitation technology and the soft art of rehabilitation will create an exciting change in rehabilitation practice.

Another exciting area of development in the next 5 to 10 years is the brain-computer interface (BCI). Wireless BCI cap may be used to activate upper and lower limb exoskeletons. This groundbreaking innovative approach will truly be state-of-the-art rehabilitation technology. A day will come when a person with paralysis think about doing a task in a certain way, the electroencephalogram (EEG) signals picked up by the BCI system can trigger the exoskeleton rapidly to move the person’s limb at will in the correct pattern to perform activities of daily living. That will be very empowering for people with disability and they can experience a better quality of life.

DIH: Comments on The Future of Rehab in Asia and why the delivery of rehab will change drastically in the face of advancing technologies?

Prof. Wee: It is indeed exciting times with the advancements in rehabilitation technology! One of the current trends in neurorehabilitation is the utilization of rehabilitation technology to augment conventional approaches in the rehabilitation of patients with neurological disorders. There is certainly the huge potential of various techniques, such as robotics, virtual reality, wearable sensor, electrical stimulation, non-invasive brain stimulation, in enhancing patient care. Research evidence clearly demonstrated a trend of a positive outcome after intensive training using technology-aided approach coupled with conventional therapy. Hence, it is imperative that clinicians keep an open mindset to embrace and adopt technology to complement their clinical work in order to optimise patent outcome.

Many of the rehabilitation technology systems include stimulating games to make training fun, interactive and engaging. This will motivate patients to participate actively in therapy. In addition, the rich data generated by the rehabilitation technology systems provide objective information about patients’ performance.

These data, together with clinical scales, will aid clinicians in monitoring patient’s progress and recovery. The data will guide clinicians to prescribe customised exercises to train them at an appropriately challenging level; hence, increasing engagement and facilitating neuroplasticity. The data is also useful on the research front to deepen scientific knowledge of neurological recovery. I strongly believed that rehabilitation practice will transform greatly with the use of advanced rehabilitation technology.

DIH: How can clinicians and therapists prepare themselves for this change?

Prof. Wee: Rehabilitation professionals should keep themselves abreast with the latest research findings and developments in the arena of rehabilitation science and therapy. This will facilitate the adoption of new rehabilitation techniques so that best evidence-based care can be provided to patients.

DIH: What can they expect to come with these changes, in terms of their job scope, patient load and outcomes?

Prof. Wee: Rehabilitation professionals will harness the potential of technology in their work, guided by evidence-based practice guidelines. With the utilisation of technology, productivity may be increased. For example, one therapist may be able to supervise a few patients undergoing rehabilitation therapy once they are safely fitted into various rehabilitation technology systems.

With fun, interactive rehabilitation systems, patients will be more motivated to participate in therapy. That can improve attention and exercise compliance and prevent the risk of deconditioning or learned non-use of the paretic limbs.

DIH: How can clinicians and therapists help support such changes to the rehabilitation services in their organizations?

Prof. Wee: There is a need to garner buy-in from the senior management level as well as clinicians and therapists on the ground for them to know the latest evidence. The patient outcome should be shared at ward rounds or case conference so that the team know the efficacy of certain interventions. The appropriate referral will gradually flow in. That is one way to ensure the sustainability of the service.

We would like to thank the Professor Wee Seng Kwee for sharing with us these insightful inputs about the future of rehabilitation!

Originally published on 10.2.2021

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