Out-Patient Departments

We offer our services at various out-patient departments in the suburbs of Cape Town. We deliver a quality rehabilitation service by offering thorough assessments and appropriate rehabilitation based on the latest research.

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Physiotherapy @ Grassy Park - Dr Khan Medical Practice

Here are some of the services we offer at our Out-Patient Department’s:

Orthopaedic Rehabilitation

Orthopaedic physiotherapy is the provision of care for those individuals of all ages with disorders or dysfunction of the musculoskeletal system. Orthopaedic physiotherapists are skilled in the diagnosis, management, and prevention of musculoskeletal disorders. We are experts in the assessment of movement and can help individuals move better, often with less pain, through skilled hands on techniques, therapeutic exercise and patient education.

Pre-Surgical Rehabilitation

The waiting period involved prior to any surgery can be valuable time that can be utilized to prepare the body for surgery and facilitate a better outcome after the surgical procedure. When muscles, bones and joints are in optimum condition before the procedure, the impact of the inevitable muscle loss and joint stiffness can be minimised post operatively. Essentially, the more prepared physicically a person is going into surgery, the better the chances of an easier and faster recovery after the surgery.

Those who participate in a pre-surgical rehabilitation program tend to regain function and return to their daily lives faster than individuals who do not participate in pre-surgical rehabilitation. Traditionally, a physiotherapist helps with post-surgical rehabilitation and can also be your biggest ally during the “pre-hab” process.

Do you have an upcoming surgery planned? Did you know that by beginning “pre-hab” exercises 6 weeks or more before your surgery can dramatically improve your outcomes and allow for quicker recovery after surgery? We will help you build strength, endurance, balance and flexibility prior to your surgery.

Post-Surgical Rehabilitation

Have you recently had a surgery? Has it been weeks or months since your surgery and you still have persistent pain, weakness, swelling, or range of motion limitations. Has your home health therapy ended and you feel unsafe at home or are unable to return to your previous activities? If the answer to any of these questions is yes, give us a call and get started with your therapy program today!

Chest Physiotherapy

Chest physiotherapy consists of external mechanical manoeuvres, such as chest percussion, postural drainage, and vibration, to augment mobilization and clearance of airway secretions. It is indicated for patients in whom cough is insufficient to clear thick, tenacious, or loculated secretions. Examples include patients with cystic fibrosis, bronchiectasis, lung abscess, neuromuscular disorders, asthma, and pneumonias in dependent lung regions

Neurological Rehabilitation

HNA Physiotherapy offers Neurorehabilitation for those who have may have had a:

– STROKE,
– BRAIN INJURY,
– BRAIN TUMOR,
– SPINAL CORD INJURY, or who have been diagnosed with:
– MOVEMENT-RELATED DISORDERS such as
– PARKINSON’S DISEASE,
– MULTIPLE SCLEROSIS,
– GUILLIAN BARRE and other DEMYLINATING POLYNEUROPATHIES.

Neurorehabilitation requires expertise and manual skills that promote NORMAL movement patterns. All of our therapists have backgrounds in providing intensive neurorehab to such patients. Our passion is to provide our client tactile cues that retrain their brain to control their affected extremities much in the same way they did prior to their injury. We believe that in order for you to return to living the life you want, it is important to retrain your body to function as it did before your injury. This can lead to decreased time in therapy as you will not have to unlearn bad habits. The goal is to bring each patient to his or her highest level of functional independence and to be able to remain in their home environment.

HOW MUCH THERAPY WILL I NEED?

This will depend on your specific injury, your level of independence prior to your injury, any other medical conditions you may also have, your family support and your motivation.
Each treatment session and plan of care is specific to each person.
In general, 2-3 times per week for a minimum of 8-12 weeks is recommended. In some cases, you may need maintenance therapy a couple times per year.

WHAT SHOULD I EXPECT ON MY FIRST VISIT?

You will have the same expert therapist working with you on every visit. On the day of evaluation, your therapist will conduct an in-depth examination that may include all or some of the following:

  • Strength testing
  • Perceptual testing (how you see your body in space)
  • Memory and cognition testing
  • Speech and hearing testing
  • Vision testing
  • Sensation testing (can you feel light touch, pain, whether your limb is moving)
  • Range of motion of your joints
  • Pain
  • Reflexes and involuntary movements, muscle spasms
  • Balance and coordination testing
  • Functional movement testing (can you get dressed, can you stand up from a chair, bathe yourself, etc.)
  • Gait/walking ability, stair climbing ability
  • Wheelchair mobility
  • Caregiver’s ability to help you at home

Based on the results of your examination, we will customize a treatment plan of care for you. Your family and/or caregiver will always be welcome and will be included in the treatment plan, as we want to be sure that they can safely assist you as needed.
Treatment may include some or all of the following:

Physiotherapy

  • Gait training to promote improved skills for walking
  • Use of motor learning devices
  • Balance training (fall risk reduction)
  • Transfer training (sit to stand, wheelchair to bed or chair, floor to stand)
  • Training with equipment for increased independence with mobility
  • Joint range of motion, strengthening and endurance
  • Orthotics management
  • Pool therapy
  • Patient and family education
  • Caregiver training

Other therapies that you may need:

Occupational Therapy

  • Strengthening and range of motion (more focus on the arm and hand)
  • Coordination training
  • Self-care skills training (activities of daily living), including: dressing, bathing, toileting, self-feeding
  • Home management, leisure and work skills training
  • Functional cognitive/safety training
  • Adaptive equipment for self-care and home management
  • Low vision training
  • Patient and family education
  • Caregiver education

Speech Therapy

  • Articulation and voice improvement
  • Aphasia/Language therapy
  • Cognitive retraining for memory and attention as well as organizing and planning
  • Computer aided speech or alternative non-vocal communication
  • Swallowing therapy
  • Patient and family education
  • Caregiver education

Advanced Wound Care

DO YOU HAVE A NON-HEALING WOUND AND AREN’T SURE WHERE TO GO FOR HELP?

Addressing a growing need in our community, we utilize expert wound protocols that have proven time and again to have excellent outcomes for our patients. We aim to provide pain-free, expedient treatments that speed up the healing process. Physiotherapists are uniquely qualified to manage your wound as we are the experts in positioning, offloading, functional mobility and exercise. All of these factors must be addressed in order for your wound to heal.

Aggressive physiotherapy wound care may include the following modalities:

  • Laser
  • Ultrasound
    Some of the most common types of difficult healing wounds we manage include:
  • Venous and/or arterial insufficiency wounds
  • Diabetic wounds
  • Pressure ulcers
  • Traumatic wounds
  • Difficult healing surgical wounds
  • Many other types of chronic and difficult healing wounds

WHAT SHOULD I EXPECT DURING MY FIRST VISIT?

You will have the same expert physiotherapist working with you on every visit. On the day of evaluation, your therapist will conduct an in-depth examination that may include all or some of the following:

  • Nutritional status
  • Blood flow and circulation
  • Swelling
  • Pressure relief abilities
  • Support surfaces
  • Functional Mobility
  • Size of wound
  • Sensation
  • Strength
  • Ability to off-load the wound area

We will collaborate with your physician, orthotic and/or prosthetic experts, nutritionist and caregivers as applicable in order to maximize the wound healing process.

HOW MUCH THERAPY WILL I NEED?

This will depend on the type of wound you have, your age, any chronic medical conditions you have, your nutritional status, your ability to off-load your wound, and also on your treatment plan. In general, we will see you 2-3 times per week. If your wound is acute (less than 30 days old), your treatment time will most likely take less time than if your wound is chronic (present for longer than 30 days).

HAVE TROUBLE GETTING TO THE CLINIC?

We can bring the wound clinic to you if you cannot attend our outpatient facility!
Wound services are also provided at our HNA Grassy Park facility, Monday – Friday. After hours and weekend appointments arranged on a case-by-case basis.

Balance and Fall prevention therapy

Fall Prevention
Falls can diminish your ability to lead an active and independent life. About one third of people over the age of 65 and almost half of people over the age of 80 will fall at least once this year. There usually are several reasons for a fall. We can help you reduce your risk of falling by:

  • Assessing your risk of falling with a thorough assessment using standardized tests
  • Helping you make your home as safe as possible
  • Educating you about the medical risk factors linked to falls
  • Designing individualized exercises and balance training
  • Working with other health care professionals and community services to create programs for people who want to reduce their risk of falling

How Can We Help?
If you are worried about falling or if you recently had a fall, we can conduct a brief check (“screening”) of your fall risk. If the screening shows that you are at risk, we will perform a thorough evaluation, including:

  • A review of your medical history
  • A review of your medications
  • A simple vision test
  • A home safety assessment
  • A simple screen of your thinking abilities
  • A check of your heart rate
  • Blood pressure measurements while you change positions (from sitting to standing)
  • Feet and footwear assessment
  • Assessment of any nervous system disorders, such as stroke or Parkinson disease
    We also will:
  • Measure your leg strength, using simple tests such as timing how long it takes you to stand from a chair
  • Determine how quickly and steadily you walk
  • Assess your balance—for instance, by having you stand on one leg or rise from a chair and walk
  • Use special tests to measure your balance

Based on the evaluation results, your physiotherapist will design an exercise and training program to improve your balance and strength. A recent systematic review of many published studies found that exercise-based programs in the home or in group settings are effective in preventing falls. These programs are especially effective when balance exercises are performed in a standing position without using much arm support.

Balance Training
Balance training has been shown to be an important and effective part of falls prevention. We will design exercises that challenge your ability to keep your balance, including exercises such as single-leg standing.

Balance and Vestibular therapy

We evaluate and treat dizziness and balance problems that may be caused by any of the following:

  • BPPV (Benign Paroxysmal Positional Vertigo)
  • Unilateral Vestibular Loss following an inner ear infection, acoustic neuroma
  • Bilateral Vestibular Loss following exposure to gentamicin, chemotherapy, and other ototoxic substances
  • Movement related instability, dizziness, intolerance
  • Migraine Associated Vertigo/ Vestibular Migraines
  • Post-Concussion Syndrome
  • Traumatic Brain Injury
  • Parkinson’s Disease
  • Mal De debarquement Syndrome
  • Meniere’s Disease/ Endolymphatic Hydrops
  • Cervicogenic Dizziness
  • Visio-spatial Disorientation
  • Post-Stroke
  • Vestibular loss due to age
  • Imbalance due to peripheral neuropathy
    Your symptoms may include:
  • Dizziness or blurry vision with head movements
  • Neck tightness, stiffness and/or pain
  • Imbalance or the need to hold onto objects when walking
  • Headaches
  • Frequent falls
  • Generalized “dizziness, wooziness and foggy head” feelings
  • Vertigo/spinning
    Treatment for your balance and/or vestibular disorder may include the following:
  • Vision exercises
  • Standing balance exercises
  • Posture training
  • Strengthening exercises
  • Walking training
  • Neck range of motion exercises
  • Manual therapy for the neck
  • Sensation training
  • Repositioning manoeuvres (for those with BPPV – Benign Paroxysmal Positional Vertigo)

Your treatment plan will be customized for you based on your exam findings. Typical outcomes following vestibular rehabilitation include: decreased fall risk, decreased symptoms of dizziness, improved balance, improved ability to stabilize your vision, increased strength, increased independence with functional mobility, increased confidence when walking in the community, improved neck movement and decreased pain.

WHAT CAUSES DIZZINESS?
Dizziness is the most common complaint of patients over the age of 75, but can occur in patients of any age. Dizziness is generally not serious, but is often a sign of a mechanical problem. Dizziness can be due to an inner ear disorder, a side effect of medications, a sign of neck dysfunction, or it can be due to a more serious problem such as a brain or a heart problem. It is important to rule out these more serious problems with your physician.

HOW LONG SHOULD I EXPECT TO BE IN VESTIBULAR THERAPY?
Some patients may be seen for only 1 to 2 sessions; other patients may need continued treatment for a few months. Your physiotherapist will make a treatment plan customized to your needs based on your examination findings.

Maintenance and Wellness Programs

People are living longer than ever these days. Many people are admitted to assisted living or nursing home facilities due to multiple falls at home and/or impaired mobility. Our aim is to keep your loved one in their home as long as possible and living independently. This provides a much higher quality of life and is much more cost effective than living in a facility.

Many people living with progressive neurological disorders have periodic exacerbations and setbacks that impair their mobility. These individuals will benefit from maintenance programs to slow the progression of their neurological deficits. Periodic assessment of mobility will also allow for timely prescription of any necessary equipment such as a walker, power wheelchair, bath aid equipment, etc.