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Precision Rehabilitation

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​Clinical PI Dr CHUA Sui Geok Karen
Senior Consultant​
Tan Tock Seng Hospital
​Technical PI Dr Cyril John Wil​liam DONNELLY
Principal Research Fellow
Rehabilitation Research Institute of Singapore

The Precision Rehabilitation research arm or the Rehabilitation Research Institute of Singapore (RRIS) is focused on the effective integration of technology within best practice patient care. The general research goal of this group is to build an open-source integrated human movement analysis (SPM1D) and optimization framework (OpenSim) that will allow clinicians the ability to both identify and prescribe optimal movement prescriptions in-silico (computational framework) at the patient level.  Though this human movement analysis and optimisation framework can be applied to a wide variety of neuro-musculoskeletal movement pathologies, the primary focus of this research group is on Stroke and knee osteoarthritis (Knee OA). 


In the US, the direct costs of total post-stroke rehabilitation services alone accounted for 67% (USD 44 B) of the total health care cost in 2008. Within Singapore, the latest estimation of stroke-related direct medical cost for outpatient service is S$613 per day, which is heavily subsidized by the government.  It is believed with the correct implementation of integrated technologies within Singapore and the world, such Stroke rehabilitation costs can be alleviated via tailored patient-level rehabilitation programmes. 


Despite the life span of a knee replacement only being 10 to 15 years, Singapore performs almost 200,000 (3% of population) knee arthroplasties each year.  With each surgery costing between S$5,216 to S$34,014 (ward class dependent) these costly treatment pathways have the potential to cripple Singapore’s health care economy.  Like oncology research, it is becoming a growing consensus in the knee OA literature that as the population ages, it is the early detection vs. reactionary treatment of knee OA that will lead to the sustainable management of this debilitation aged related health care disorder. 



Stroke Rehabilitation


The effect of Stroke on an individual’s neuromusculoskeletal system (NMS) is complex mutlifaceted and  dynamic influencing their upper body, lower body or whole body movement proficiency in unique ways. As such the NMS treatment plans for every stroke patient is personalised, and adaptable, in that it can change as a stroke patient progresses through their rehabilitation pathway (particularly the first 6 months).


Through a collaborative research and working arrangement between Dr Karen Chua Sui Geok from Centre for Advanced Rehabilitation Therapeutics (CART) at Tan Tock Seng Hospital (TTSH) and Dr Cyril Donnelly from the Rehabilitation Research Institute of Singapore (RRIS) at Nanyang Technological University (NTU), they hope to develop a movement proficiency identification and optimisation framework within a Stroke patient rehabilitation pathways to assist with improved patient recovery during their first 6 months and beyond (See figure 1)


Knee Osteoarthritis 


It can be argued that conventional knee OA management and rehabilitation is limited in two ways: 1) NMS training and movement prescriptions are not tailored to the patients and 2) whole body, time varying, 3D movement patterns are not being objectively monitored prior to and through their rehabilitation period. As such, the unfortunate reality for most knee OA patients is that their disease progresses to a point where cost ineffective knee arthroplasties are recommended (see plot in Figure 2).


Working with Dr Bryan Tan, Dr Michael Yam and Dr Michelle Pereirafor from various health care groups in Singapore, Dr Cyril Donnelly from the RRIS@NTU is helping them develop a human movement analysis and optimisation tool bespoke for knee OA populations. The outcome will be an SPM1D variate of established Movement Proficiency or Gait Proficiency Indices – termed Knee OA (GPI-KOA).  Moreover, the bespoke SPM1D analysis framework, in combination with the in-silico Rehabilitation platform will be capable of handling high dimensional data (inter-limb covariance) when designing patient level prevention and rehabilitation pathways. From here, an objective assessment of a patient’s movement proficiency, optimal movement pattern prescription, combined with other clinically relevant factors associated with knee OA such as pain and function will be used to optimise patient outcomes.  The overall goal of this approach will be to prevent the increasing number of total knee arthroplasty being performed in Singapore, mitigating the potential for this age related disorder from crippling Singapore’s health care economy.​


 


 
​Projects 

Gait Analysis in Knee Osteoarthritis

Research Progammes

Precision Rehabilitation​ RRG3-19002/CG001

Clinical PI

Dr Bryan TAN Yijia
Associate Consultant, Woodlands Health Campus

Guiding Best Practice Clinical Care with In-Silico Rehabilitation and Statistical Parametric Mapping (SPM 1D) for Unilateral Chronic Hemiparetic Stroke and Trans-Tibial Amputation
Research Programmes Precision Rehabilitation / RRG3-19002?
Clinical PI Dr CHUA Sui Geok Karen
Senior Consultant, Rehabilitation Medicine
Tan Tock Seng Hospital
Technical PI Dr Cyril John William DONNELLY
Principal Research Fellow
Rehabilitation Research Institute of Singapore
 

​Act.Sense - Active Sensorimotor Training for Chronic Stroke Survivors
Research Programmes Precision Rehabilitation ​ / RFP19002
Project PI
Research Fellow, Rehabilitation Resea​rch Institute of Singapore 
Clinical PI Dr LOH Yong Joo
Adjunct Senior Research Scientist Deputy Director (Clinical) Rehabilitation Research Institute of Singapore Consultant and Deputy head of department in Rehabilitation Medicine, Tan Tock Seng Hospital​
​Mentor​ ANG Wei Tech
Executive Director Rehabilitation Research Institute of Singapore Associate Professor School of Mechanical & Aerospace Engineering and LKC School of Medicine, Nan​yang Technological University, Singapore

Novel Support Surface Based on Smart Material to Alleviate Pressure Ulcer Formation During the Rehabilitaion of Immobile
Research Programmes Precision Rehabilitation / RRG2-16005
Clinical PI Dr WONG Chin Jung
Consultant, Department of Rehabilitation Medicine
Tan Tock Seng Hospital
Technical PI Dr CHIAM Keng Hwee
Principal Investigator, Bioinformatics Institute, Agency for Science, Technology and Research

Multimodal Imaging of Neuroplasticity in Upper Limb Recovery with Early Increased Upper Limb
Research Programmes Precision RehabilitationRRG1-16015
Clinical PI Ms CHIN Lay Fong
Principal Physiotherapist, Rehabilitation Centre, Tan Tock Seng Hospital
Technical PI Dr HUANG Weimin
Senior Scientist, Neural & Biomedical Technology Department, Institute for Infocomm Research (I2R)

 

Feasibility Study of BCI-Based Adaptive Sensing and Feedback Training for Chronic Pain Management
Research Programmes Precision RehabilitationRRG1-16013
Clinical PI Dr YANG Su-Yin
Clinical Lead, Principal Pyschologist, Pain Management Clinic
Tan Tock Seng Hospital
Technical PI Dr ZHANG Hai Hong
Lab Head, Neural & Biomedical Technology
Institute for Infocomm Research (I2R)

Automated Low Vision Rehabilitation System Using Real-Time Analysis (ARIANA)
Research Programmes Precision Rehabilitation / RRG1-16009
Clinical PI Dr Augustinus LAUDE
Senior Consultant Ophthalmology Department, National Healthcare Group Eye Insitute, Tan Tock Seng Hospital
Technical PI Dr WONG Wing Kee, Damon
Department Head, Ocular Imaging Department
Insititute for Infocomm Research (I2R)

Exploring New Treatment of Spinal Cord Injury by Synergising Regenerative Medicine and Rehabilitation
Research Programmes Precision Rehabilitation / ?RRG1-16004
Clinical PI Dr Adela May TOW
Senior Consultant, Department of Rehabilitation Medicine
Tan Tock Seng Hospital
Technical PI Associate Professor CHEW Sing Yian
School of Chemical & Biomedical Engineering,
Lee Kong Chian School of Medicine, Nanyang Technological University

Wristbot: A Novel Device for Assessment of Proprioceptive Deficits after Stroke
Research Programmes Precision Rehabilitation?RRG1-16003
Clinical PI Dr CHUA Sui Geok Karen
Senior Consultant, Rehabilitation Medicine
Tan Tock Seng Hospital
Technical PI A/Prof Domenico CAMPOLO
Associate Professor, School of Medical & Aerospace Engineering
Assistant Chair (Research)

 


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