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ROYAL REHAB PRIVATE & METROREHAB NEWSLETTER • ISSUE 4 • DEC 2021

Rehab Matters at Royal Rehab Private and MetroRehab Hospitals

New Rehabilitation Technology Benefiting Patients

Contents The Advanced Tech Devices Empowering Rehabilitation 02

Patients with injury, illness and disability are the big winners from Royal Rehab’s commitment to advanced rehabilitation technology. A new range of devices is enhancing our multidisciplinary therapy programs, accelerating patients’ recovery and increasing their strength and mobility — with more equipment and exciting plans to look forward to in the coming months.

A Message From Our MetroRehab GM

Playing Our Part in COVID-19 Response

‘’Royal Rehab is on a mission to shake up the status quo and raise the standard of rehabilitation services in Australia,’’ said CEO Matt Mackay.

Rehabilitation Care Coordinators — B y Our Patients’ Sides

Multidisciplinary Rehab and Holistic Care in Parkinson’s Disease

A Message From Our RRPH GM

Rehabilitation Following Trauma

Spotlight on Our Health Professionals

Behind the scenes, Senior Physiotherapist and Assistive Technology Project Lead, Jason Redhead, is working with clinicians and suppliers to continuously research and trial the latest assistive technologies. This includes neurological rehabilitation devices for cognitive, motor and cardio training; upper-limb robotic equipment; and software that gives patients intensive and targeted exercises following stroke, spinal cord injury, multiple sclerosis, Parkinson’s disease and more. “By using a combination of traditional and modern rehab strategies, research has shown that clients can recover more quickly and achieve their goals faster,” Jason said. “It’s also fantastic to see how this kind of technology is assisting our talented clinicians, as they support our clients to improve their outcomes.” The introduction of new rehab technology is part of Royal Rehab’s plans to build technology-driven rehabilitation centres of excellence. The first of these centres is set to be established at the Ryde campus in 2022.

Read about the new technologies our hospitals are using over page.

Visit our new look websites! metrorehab.com.au royalrehab.com.au/private-hospital/

The Advanced Tech Devices Empowering Rehabilitation H-Man The H-Man is an upper-limb robotic device used for the rehabilitation of patients living with functional impairments in the upper arm. This is suitable for people with stroke, brain injury, Parkinson’s disease and more. A patient can select from a diverse offering of visually engaging games that cater to their specific needs, from coordination control to agility and strength training. Once a game is chosen, the patient will simply follow the prompts of the game using the H-Man handle. During this training, the H-Man assesses patient arm movement, automatically modifies training, and adapts applied forces to ensure optimal relearning in each session. Data is collected during the session for assessment by the patient and therapist. Patients typically perform 10 times more repetitions per session than during conventional therapy.* The H-Man is available at MetroRehab Hospital and Royal Rehab Private Hospital. *Based on clinical studies — contact ARTICARES for more details: www.articares.com.

SMARTfit® Mini Ideal for people with stroke, brain injury, spinal cord injury and other neurological conditions, the SMARTfit® Mini focuses on concentrated cognitive and motor training. The combined cognitive and motor skills training is known to significantly speed up neuroplasticity in the brain, improving patients’ overall functional gain and mobility in the upper limbs. The station can be optimised with different game combinations to suit patients’ particular rehab needs. The SMARTfit® Mini is available now at Royal Rehab Private Hospital.

SMARTfit® Strike Pods Our SMARTfit ® Strike Pods are perfect for neurological rehabilitation via cognitive, motor and cardio training. SMARTfit ® Strike Pods can be placed anywhere — such as on shelves, walls or floors — to create vertical, horizontal or 360-degree playing environments. This flexibility allows therapists to create endless combinations of workout environments, each with unique ergonomic, physical and cognitive challenges. The Strike Pods are suited for people with neurological conditions such as stroke, brain injury, multiple sclerosis, Parkinson’s disease and other neurological conditions. The devices are at Royal Rehab Private Hospital and MetroRehab Hospital.

MediTouch 3D Tutor The MediTouch 3D Tutor uses powerful rehabilitation software that gives patients with neurological and orthopaedic conditions such as stroke, spinal cord injury, multiple sclerosis, Parkinson’s disease and brain injury, an intensive and controlled exercise. The software gives instructions and feedback on movement that prevents the development of compensatory behaviour and ensures better performance of functional tasks for improved strength, mobility and function. This device also offers accurate real-time data on insights such as speed and range of motion. This supports therapists in their analysis and feedback, allowing patients to better understand their progress. The MediTouch 3D Tutor is available now at MetroRehab Hospital.

NOW AVAILABLE

Ergo Trainer The Ergo Trainer is used for gait training, motor function and strength rehabilitation — perfect for people with conditions such as stroke, Parkinson’s disease, brain injury, spinal cord injury and other neurological conditions. Therapists can adjust the support of the Ergo Trainer for patients and when paired with treadmills, step-machines and exercise bikes, the device provides greater freedom to confidently move. When used in conjunction with a treadmill, it is possible for patients with impaired walking ability to correct their gait. Recent studies show that with the Ergo Trainer, gait speed increased by 62 per cent in 6-minute walk tests.* Available now at MetroRehab Hospital. *Based on clinical studies — contact Neurotek for more details: www.neurotek.com.au

Tyromotion Suite A powerful new suite of devices from leading tech-device manufacturer Tyromotion is now available at Royal Rehab Private Hospital Day Rehab. The Myro, Pablo and Tymo products bring advanced robotics, sensor systems, virtual reality, and gamification functionality into rehabilitation — perfect for people who have experienced stroke, brain injury, spinal injury and musculoskeletal injuries. Offering highly intensive and targeted training, the devices allow clinicians to focus intensive rehabilitation on upper and lower extremities, and cognition and balance goals.

For more information, contact Royal Rehab Private Hospital on (02) 9808 9222 or MetroRehab Hospital on (02) 8585 4900.

235 Morrison Road, Ryde NSW 2112 p | 02 9808 9222 w | royalrehab.com.au

A Message From Our MetroRehab GM Welcome to the latest issue of Rehab Matters, designed to keep GPs and specialists up to date on the latest in rehabilitation medicine. You may have noticed a new look for MetroRehab Hospital! After being acquired by Royal Rehab in 2019, we are delighted to now proudly reflect the same visual identity. While we continue to deliver strong clinical outcomes for patients, being part of Royal Rehab has brought exciting new developments to our hospitals, such as the launch of a range of advanced assistive technology products. As part of our commitment to delivering quality rehabilitation care, we are excited to announce that we have recently established a new care-delivery model. Rehabilitation care coordinators are now dedicated to each patient and provide support, information and guidance from admission through to discharge. The enhanced personal experience has been well received by patients and families alike. As we welcome the easing of restrictions around the COVID-19 pandemic, you can be confident knowing that at MetroRehab Hospital the health and wellbeing of our patients and staff will always be our top priorities. While research shows that large numbers of people have put off seeking healthcare over the past months, we know that delaying care can have long-term consequences. Now is the perfect time to encourage patients to seek the care they need. For more information regarding referrals, please contact us on (02) 8585 4900. We wish you and your patients a Merry Christmas and a Happy New Year!

Nick Edwards

General Manager and Director of Clinical Services MetroRehab Hospital

Rehabilitation Care Coordinators – By Our Patients’ Sides

Playing Our Part in the COVID-19 Response

MetroRehab Hospital has introduced rehabilitation care coordinators to provide personalised and enhanced customer experience for our inpatients.

When the NSW Ministry of Health approached Royal Rehab to support the broader network’s response to the pandemic, our teams were proud to rise to the challenge. Public patients with complex rehab needs were welcomed to our facilities from acute hospitals including Royal North Shore, Prince of Wales, and Balmain Hospitals.

Three dedicated rehab care coordinators — all allied health professionals with expertise in neurological, cancer, orthopaedic and other rehab areas — have been appointed to the roles. From the time of referral and throughout admission, treatment, discharge and post-hospital follow-up, the rehab care coordinators are by our patients’ sides to inform, empower and support them.

Royal Rehab was also pleased to support the government’s COVID-19 vaccination program by recently hosting a temporary Pfizer hub at the Ryde campus for Heathcare Australia. Hundreds of customers with disability, injury or illness, their carers and frontline staff were vaccinated.

Meet Our Rehab Care Coordinators

Royal Rehab also opened its facilities to Healthcare Australia to support other disability support providers.

Nick Edwards, General Manager of MetroRehab Hospital, said, “We are committed to providing our patients with an exceptional customer experience. From past experience and patient feedback, we know that having a familiar face throughout the journey can be of great value.”

Caleb Showyin — orthopaedics, reconditioning and post–spinal surgery portfolio. “It is most rewarding to meet a patient and witness their improvement and progress, and use my expertise to help guide them.”

Brittany Ainge — cancer, brain tumour and neurosurgery portfolio. “Progressing to rehab for most patients can be a little daunting. I enjoy being able to utilise my understanding of rehabilitation to help patients and their families prepare for their journey, and continuing to assist them throughout.”

Virginia Agosti — stroke and neuro rehab portfolio. “I enjoy educating and empowering clients, as well as their families, friends and community members, to help them achieve their goals and link them into other services or support networks.”

New look, same great service!

MetroRehab Hospital has a brand new look! We are proud to deliver the same great services under the Royal Rehab brand. Visit our new website today! metrorehab.com.au

Multidisciplinary Rehabilitation and Holistic Care in Parkinson’s Disease By Dr Anuka Parapuram, Rehabilitation Specialist

Parkinson’s disease (PD) is a multi-system neurodegenerative disorder characterised by motor and non-motor symptoms. It is a global phenomenon affecting 1 per cent of people over 55 years of age. Symptoms of PD include impairment of speech, swallowing, gait, movement and balance, which can affect a person’s ability to carry out day-to-day activities.

Case Study: Wayne

More than 90 per cent of patients with PD will have issues with their speech and swallowing, which can result in inactivity, embarrassment and social withdrawal, according to selfreported data. Additionally, cognitive and behavioral changes are other non-motor symptoms that can occur early in PD.

At Wayne’s first session, the team assessed his function and the impact of PD on his quality of life, before helping him set goals for his program. He wanted to improve his balance to reduce the risk of falling; retain his fine motor skills; and regain strength in his speech.

The strongest evidence of efficacy of rehabilitation occurs through early intervention. Rehabilitation plays a key role in maintaining mobility, balance and endurance, and preventing secondary complications from reduced physical activity.

At the end of his program, Wayne’s quality of life score had improved significantly. PDQ-39 is a PD questionnaire that assesses how often someone with the disease experiences difficulties in their daily activities. Wayne’s score had improved from 37 to 15, indicating that his condition is having less of an impact on him and his daily life.

The European Physiotherapy Guidelines for Parkinson’s disease recommends patient-centred care, as it is associated with greater wellbeing and physical functioning. Recent empirical evidence also suggests exercise programs may be an effective way to delay or reverse functional decline, as exercise may trigger neuroplasticity in the brain. At MetroRehab and Royal Rehab Private Hospitals, we offer two programs specifically designed for people with PD: PD Warrior®, a high-intensity exercise program with cognitive retraining to slow the symptoms of PD, and Lee Silverman Voice Therapy LOUD, an intensive speech treatment program to improve hypophonia. The teams provide goal-orientated, patient-centred programs with the aim of improving the quality of life with PD patients.

Excellence in medical rehabilitation

Sixty-seven year old Wayne was diagnosed with Parkinson’s disease in 2020. Soon after, he was referred to Royal Rehab Private Hospital to benefit from a personalised multidisciplinary therapy program.

Wayne also participated in speech therapy, which helped him increase the volume of his voice, allowing him to communicate more confidently. “My tip for others is this — go into rehabilitation as soon as possible,” said Wayne. Right: Dr Anuka Parapuram, Rehabilitation Specialist at MetroRehab and Royal Rehab Private Hospitals.

275 Addison Road, Petersham NSW 2049 p | 02 8585 4900 w | metrorehab.com.au

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Rehabilitation Following Trauma

A Message From Our RRPH GM

By Dr Tram Bui, Senior Rehabilitation Specialist

In overseas countries, advanced rehabilitation technologies such as robotics and artificial intelligence are revolutionising the way rehabilitation is delivered. Following research into some of the world’s best rehabiliation centres, Royal Rehab is proud to be introducing advanced tech into our therapies. Starting with last year’s first-to-market launch in Australia of robotic exoskeleton, called EksoNR, we are excited to announce our portfolio of assistive rehabilitation technology. From the H-Man to the Tyromotion suite, your patients can benefit from cognitive, strength and motor training that can deliver greater intensity and faster results. I am enormously proud of how our team has navigated the COVID-19 pandemic and played an important role supporting the wider health system. As restrictions ease, we remain committed to providing our services to our patients in a safe and accessible way. For more information regarding referrals, please phone (02) 9808 9222. Wishing you and your patients a Merry Christmas and a Happy New Year!

Selina Rowe

History According to Simon’s discharge summary, he lost consciousness for three minutes at the scene of the accident. His Glasgow Coma Scale was 9/15 on arrival at the hospital, and there was CT evidence of bi-frontal contusions. Simon had post-traumatic amnesia for six days and was diagnosed by his rehabilitation specialist as having had a moderately severe traumatic brain injury. He also had multiple rib and pelvic fractures extending into his left sacroiliac joint and was treated with open reduction internal fixation Simon was in an acute hospital for weeks prior to his transfer to rehabilitation. He had touch weight bearing on his left leg for a further two weeks. Simon wanted his pain and dizziness to be better managed, and to know when he could resume driving and return to work.

Examination On examination, Simon was in pain, and while he responded appropriately to questions, he was forgetful and had impaired concentration. He was noted to have anosmia. A positive Dix-Hallpike’s test indicated benign positional vertigo. Brief cognitive screening with the Montreal Cognitive Assessment showed memory loss and language impairments, with a total score of 24/30. Simon was also found to have a low mood.

Management

General Manager Royal Rehab Private Hospital

New look, same great service!

Simon, a 25-year-old single male patient, was transferred to Royal Rehab Private Hospital with a traumatic brain injury as a result of a motor vehicle accident. He had orthopaedic injuries, pain, dizziness, poor concentration and moods of “feeling down”.

Simon was managed with topical lignocaine patches and a combination of paracetamol, NSAIDs and titration of opiate analgesia, resulting in a significant improvement in symptoms. Benign paroxysmal positional vertigo is a common finding following traumatic brain injury, occurring in up to 30 per cent of patients after a head injury. Simon’s symptoms responded well to the Epley manoeuvre, which was performed during his inpatient stay with resolution of his dizziness. Simon’s mobility upgraded

Royal Rehab Private Hospital has a brand new look! Visit our new website today! royalrehab.com.au/private-hospital/

07 after his orthopaedic review at two weeks and his gait was stable with a crutch. He participated in speech pathology and occupational therapy to improve his word finding, reduce his mild cognitive communication deficits and provide him with memory strategies. He was referred to a clinical psychologist for adjustment issues post trauma. Simon was advised not to drive for three months after receiving the brain injury, given the severity of his injury, risk of emergent seizures, persistent symptoms and cognitive impairment. Anosmia is common after traumatic brain injury, and while improvement can occur up to 12 months after the injury, most patients will have some persisting deficit. Safety measures such as installation of smoke alarms and monitoring of food storage were discussed with Simon. Following discharge, Simon was referred to his local brain injury service for further cognitive assessments, multidisciplinary rehabilitation and return-to-work planning.

e c a p s my e c a l p My

Discussion Patients with moderately severe traumatic brain injury are best treated with a multidisciplinary approach. Rehabilitation starts from an inpatient setting with expertise in neurological injuries and continues in the community.

Right: Dr Tram Bui, Senior Rehabilitation Specialist at Royal Rehab Private Hospital. This article is a modified version of information from a paper that was co-authored with Dr Stuart Browne, Senior Staff Specialist in Rehabilitation Medicine, and Dr Clayton King, Director of Medical Services and Director of the Brain Injury Unit at Royal Rehab. All work took place in the Brain Injury Unit, Royal Rehab, Sydney, NSW.

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Spotlight on Our Health Professionals Leah Saba

Virginia finds educating and empowering clients to be the most fulfilling parts of her role. She enjoys the process of helping clients achieve their goals and celebrating their progress.

Physiotherapist (BHLTHSC, MPHTY)

Leah graduated from the University of Sydney with a Bachelor of Health Sciences and went on to complete a Master of Physiotherapy.

Brittany Ainge Rehabilitation Care Coordinator (BHLTHSC, MPHTY)

With more than five years of experience in physiotherapy, Leah now works at our Day Rehab centre at Royal Rehab Private Hospital. Leah specialises in treating orthopaedic and neurological conditions in inpatient and outpatient settings. She is also a trained PD Warrior® instructor and an experienced clinical educator. Leah enjoys being part of a dynamic multidisciplinary team at Royal Rehab Private Hospital and is particularly excited to continue her training in using the advanced robotics exoskeleton, EksoNR.

Virginia Agosti Rehabilitation Care Coordinator (BLS, MSLP)

Virginia was warmly welcomed to MetroRehab Hospital in 2021 as a rehabilitation care coordinator, specialising in stroke and other neurological conditions. She graduated with a Bachelor of Liberal Studies, followed by a Master of Speech Language Pathology from the University of Sydney. Virginia has a background in working with adults in acute care, rehabilitation and community health settings with a focus on neurological conditions. She also has experience in health services management, NDIS and education.

Brittany is a rehabilitation care coordinator at MetroRehab Hospital, specialising in cancer, brain tumour, and neurosurgery. She graduated from the University of Sydney with a Bachelor of Health Science, followed by a Master of Physiotherapy. Brittany has over seven years of experience working in the rehabilitation sector, across a range of conditions from orthopaedics to neurological. Brittany enjoys using her understanding of rehabilitation to help patients and their families prepare for their journey and continuing to assist them throughout.

Caleb Showyin Rehabilitation Care Coordinator (BAPPSC Exercise and Sports Science, BAPPSC Physiotherapy)

Caleb works at MetroRehab Hospital as a rehabilitation care coordinator, specialising in orthopaedics, reconditioning and post-spinal surgery. He graduated with a Bachelor of Applied Science (Exercise and Sports Science) and a Bachelor of Applied Science (Physiotherapy).

235 Morrison Road Ryde NSW 2112 p | 02 9808 9222 w | royalrehab.com.au

Caleb has over 17 years of experience in rehabilitation in the public and private sectors. Caleb is passionate about making meaningful and positive contributions to clients’ rehabilitation journeys and using his wealth of expertise and knowledge to guide them.

Luke Maddalena Senior Exercise Physiologist (BEXSC, MCEP)

Luke is a Senior Exercise Physiologist and Program Coordinator for Royal Rehab Private Hospital’s Day Rehab centre. He is trained to help people manage chronic health conditions with exercise prescriptions – ensuring that they are prescribed safe and effective exercise programs that address and manage the symptoms. He enjoys working collaboratively with clients and a multidisciplinary team, and seeing progress. Luke graduated from the Australian National University with a Master of Clinical Exercise Physiology and Bachelor of Exercise Science. He has over 10 years of experience in exercise physiology and has been at Royal Rehab for the last five years.

Visit our new look websites! metrorehab.com.au royalrehab.com.au/private-hospital/