Teams with the Physiotherapy Department at Hamad Medical Corporation’s (HMC) Qatar Rehabilitation Institute (QRI) have provided rehabilitation services to patients during more than 28,000 patient visits this year, representing about half of the total outpatient services provided at the region's largest tertiary rehabilitation hospital.
This figure is expected to reach 30,000 by the end of December, an increase of 15 percent from last year’s recorded patient visits. Mr. Al Madzhar Ahmadul, Physiotherapy Supervisor at QRI, says the increase in the number of patients requiring physiotherapy treatment highlights both an overall rise in the number of patients being cared for across HMC and also an increased demand for services focused on developing, maintaining, and restoring movement and functional ability threatened by age, injury, disease, or environmental factors.
He says while the majority of patients cared for at the Physiotherapy Department include those with neuromuscular challenges resulting from stroke and other neurological diseases, about 30 percent are older adults, patients 70 years of age and above, with musculoskeletal impairments, including arthritis and joint pain.
“We also treat patients with progressive disorders of the nervous system, such as multiple sclerosis and we see children with cerebral palsy, 14 years of age and above. Although the scope of physiotherapy services at QRI is mainly neurological and geriatric, we accommodate other patients, especially if the service they require is not offered in another HMC facility,” says Mr. Ahmadul.
Ms. Noora Al Mudahka, Chief of Physiotherapy, says the adherence of QRI’s physiotherapists to a structured stroke Clinical Practice Guideline (CPG) has helped to enhance the effectiveness of post-acute stroke physical therapy. She notes that QRI’s results are comparable with international benchmarks and says since introducing the CPG the Department has successfully rehabilitated thousands of stroke patients.
Mr. Ahmadul said the implementation of the stroke physical therapy CPG has been significant in terms of aiding clinical decision making and applying evidence-based treatment.
“In 2014, under the guidance and vision of the Chief of Physiotherapy, Ms. Noora Al Mudahka, we commissioned a team of specialists to generate a physiotherapy-specific guideline for post-acute stroke care for all physiotherapy staff across HMC who specialize in neurological physiotherapy. After a year of intensive work, the team successfully produced the PAAS Guideline (Physical Therapy After Acute Stroke). Staff were trained in the use of the Guideline through a one-day workshop,” said Mr. Ahmadul.
Follow-up workshops were also organized to train staff to perform all the physiotherapy outcome measures included within the Guideline and monitoring tools were developed to measure compliance to the standard. According to Mr. Ahmadul, implementation of the Guideline has helped improve the role that physiotherapists play in the rehabilitation of stroke patients.
“Just like other members of the multi-disciplinary team, physical therapists play a major role in stroke rehabilitation. Commonly, stroke survivors requiring rehabilitation exhibit movement and mobility deficits such as turning, sitting, standing, and walking. This is where our expertise as physical therapists and movement scientists is valuable as we make use of specialized assessment tools, analyze relevant findings, and formulate individualized plans of care,” said Mr. Ahmadul.
“If a patient is unable to perform a simple task such as standing, the task is broken down into easier-to-perform subtasks. We’d ask the patient to practice forward reaching during sitting, for example, as forward reaching is an initial component of standing,” added Mr. Ahmadul.
Mr. Ahmadul noted that QRI’s advanced facilities, which include seven hydrotherapy pools, eleven advanced gyms, a specialist sensory room, and an Assisted Living Unit in which patients can relearn simple daily tasks and readjust to life at home, make it one of the most impressive facilities of its kind in the region.
“The combination of conventional physiotherapy with adjunct treatments such as robot-assisted gait training and aquatic therapy contribute to better and faster patient outcomes and culminate into a shorter ‘length of stay’ in hospital for our patients,” added Mr. Ahmadul.