What is vestibular rehabilitation therapy (VRT)?

Vestibular rehabilitation is a specialized form of therapy intended to alleviate both the primary and secondary problems caused by vestibular disorders. Specific manoeuvres can be done by a Physiotherapist and an exercise-based program can be designed to reduce vertigo and dizziness, gaze instability, and/or imbalance and falls.

 What are the vestibular conditions that can be treated by a Physiotherapist?

• Benign Paroxysmal Positional Vertigo (BPPV)
• Vestibular Neuritis
• Labyrinthitis
• Ramsay’s Hunt Syndrome
• Acoustic Neuroma
• Vestibular Migraine
• Bilateral Vestibular Hypofunction
• Meniere’s Disease

The Physiotherapist will perform a specific assessment with you to determine which of the vestibular conditions you may have. Following the assessment, a specific programme will be designed for you to treat your symptoms. The treatment programme will include a home programme for you to do at home which will progress your recovery period.

Occupational therapy is the health profession that enables individuals who have an impairment or disability to function independently in their daily activities and do the things they need to do in order to get back to living their lives at home, at school, at work, and in the community, that is, to be independent with their daily activities and to be self-sufficient regardless of their physical or mental disabilities.

What Conditions Do Occupational Therapists Treat

Conditions or illnesses that could benefit from the care of an Occupational Therapist include Autism, Stroke, Alzheimer’s disease, Developmental coordination disorder, learning disabilities, Down syndrome, Osteo and Rheumatoid arthritis, Parkinson’s disease, Multiple sclerosis, Spinal cord injury, motor vehicle accidents, burn injuries, mental and behavioral problems and many others.

Services offered

•  Therapeutic exercise
• ADL training
• Home/workplace assessments and modifications
• Prescription of assistive devices
• Counselling

The Falls Prevention Program helps patients prevent falls. Falls are a leading cause of injury and hospitalization for elders. Falls are a major public health problem because they are common in people aged 65 and older and are the leading cause of injury in this age group. Falls can have serious consequences: trauma, pain, impaired function, and loss of confidence in carrying out everyday activities, loss of independence and autonomy, and even death. Around one-third of generally healthy people aged 65 and older will have at least one fall each year, and a key concern is that the rate of falls and severity of the resulting complications increase dramatically with age.

A physiotherapist will help you identify why you have been falling. The physiotherapist will perform a physical assessment, to check your balance, mobility, muscle strength and if you have a fear of falling. The physiotherapist will work with you on your physical abilities, provide you with recommendations for lifestyle changes and discuss with you whether you need to modify your home to make sure you’re safe.

APSIC runs an early morning exercise programme focusing on core training. Patients with back or other musculoskeletal problems who have received a course of individualized physiotherapy treatments can progress to join the class. The class also accommodates individuals who wish to stay fit and strengthen their core muscles; abdominals, lumbar and pelvic muscles.

The Instructor for the class is a certified Physiotherapist and focuses and trains participants in the class to correctly perform core muscle exercises. The physiotherapists’ knowledge of muscle control, injury prevention, breathing and pain management will help you to achieve and maintain strong abdominals, back muscles, pelvic and hip muscles and learn to use effective breathing techniques to improve your cardiorespiratory function. During the class, the physiotherapist will assess your progress and modify the exercises as required to ensure each individual is able to achieve their goals.

Classes are on Mondays, Wednesdays and Fridays 6-7am. This allows participants in the class to shower change and get to work. The class starts with a 20-25 minute walk/jog/run in the neighbourhood and 30-40 minutes of core exercise.

The pelvic floor muscles (PFM) form an elastic sheet below the pelvic outlet to support the pelvic and abdominal contents; uterus, bladder, bowel, intestines etc. The pelvic floor muscles play a crucial role in controlling and maintaining bladder and bowel function and also play a role in labour and delivery, sexual sensation and function.

In both women and men, at different stages of life, the pelvic floor muscles may become weak and underactive, or overactive and lacking coordination.  More than 50% of women are unable to correctly contract their pelvic floor muscles with verbal instruction alone.

Our Pelvic floor physiotherapy will help to rehabilitate the function of these muscles, as well as providing extensive bladder and bowel health advice to ensure all underlying issues perpetuating the problem are addressed.  On average 60-80% of bladder and bowel problems can be resolved with pelvic floor muscle and bladder and bowel retraining.

Conditions that our Women’s Health Physiotherapist can assess and treat include:

• Bladder and bowel issues– this is the leakage or difficulties with emptying.
• Pelvic organ prolapse– this is a common condition which can occur after childbirth or after menopause.
• Pelvic and sexual pain– which includes tailbone pain, rectal spasm, bladder irritation, pain and difficulty with penetration and/or inserting a tampon
• Pelvic surgery – preparation and rehabilitation following, hysterectomy, vaginal repair, and colorectal surgeries.

A session with our Women’s Health Physiotherapist consists of:

• A thorough internal assessment of the pelvic floor and pelvis in a private room
• Identifying the problem
• Designing a treatment programme with you, this may include; pelvic floor muscle exercises (Kegels), biofeedback, electrical stimulation, bladder retraining

As in women the pelvic floor muscles play a crucial role in controlling and maintaining bladder and bowel function, but in men the pelvic floor muscle are key component for erectile function, sexual sensation and function and post prostatectomy urinary dysfunctions such as leakage, retention or urge incontinence.

Conditions that our Men’s Health Physiotherapist can assess and treat include

• Post Prostatectomy Incontinence: Urinary incontinence is one of the post prostatectomy complications. This problem however is markedly decreased due to the nerve sparing procedure used by surgeons during the prostate surgery and occurs in few instances. Pelvic floor muscle exercises helps to control the leakage which can be resolved within 3 to 12 months post surgery.
• Erectile dysfunction: This can occur following prostate surgery, stroke and other neurological conditions, conditions such as diabetes and hypertension, depression and stress can all contribute to erectile dysfunction.  One in 5 Ghanaian men older than 40 years can be affected with erectile dysfunction. Having erectile dysfunction is not a reflection of one’s manhood, but rather a medical condition.
• Urinary Retention: This is the inability to completely or partially empty the bladder. It may involve the inability to start your urine flow, and when it starts not able to fully empty the bladder. Urinary retention can be caused by an enlarged prostate or muscle or nerve dysfunction.
• Post Void Dribbling: Post void dribbling is defined as the leakage of a small volume of urine immediately or shortly after completing the act of urinating. It can occur in men of any age but rarely before the age of 40. It is more annoying than serious and is often one of the first indications of prostatic enlargement in which the prostate gland gradually increases in size. It may also be the result of the bulbosponginosum muscle, a penal muscle which assists in emptying the bladder at the end of urinating not functioning well.
• Urinary incontinence:This in men is the unintentional loss of urine which results from weak or damaged bladder muscles, overactive bladder muscles, certain prostate conditions and nerve damage. There are however different types of urinary incontinence in men, this includes, stress incontinence, urge incontinence and overflow incontinence. Some men may have one, two, or all three types of incontinence.

A session at Accra Physiotherapy & Sports Injury Clinic involves a thorough assessment with a physiotherapist specialized in Men’s Health to determine the particular diagnosis.

The physiotherapist will then recommend a treatment programme which may include keeping a bladder diary, an ultrasound and urodynamic testing and treatments such as behavioral, bladder training and Kegel exercises, which can help to restore bladder control and strengthen the pelvic floor muscles

Confidentiality is the basic quality of our psychotherapist. This is because our patients are required to share their personal feelings and thoughts with the therapist.

Psychotherapy, or talk therapy, is a way to help people with a broad variety of mental illnesses and emotional difficulties.  Our trained therapist consciously establishes a professional relationship with the patient with the purpose of (1) removing, modifying, or retarding existing symptoms, (2) mediating disturbed patterns of behavior, and (3) promoting positive personality growth and development.

Psychotherapy can help eliminate or control troubling symptoms so a person can function better and can increase well-being and healing.

Problems helped by our trained psychotherapist include difficulties in coping with daily life; the impact of trauma, medical illness or loss, like the death of a loved one; and specific mental disorders, like depression or anxiety.

Therapy Sessions

Our therapist may conduct an individual, family, couple, or group setting, which helps both children and adults. Most sessions are 30 to 50 minutes long.

Psychotherapy can be short-term (a few sessions), dealing with immediate issues, or long-term (months or years), dealing with longstanding and complex issues. The goals of treatment and arrangements for how often and how long to meet are planned jointly by our patient and our therapist.

A physiotherapist will help you identify why you have been falling. The physiotherapist will perform a physical assessment, to check your balance, mobility, muscle strength and if you have a fear of falling. The physiotherapist will work with you on your physical abilities, provide you with recommendations for lifestyle changes and discuss with you whether you need to modify your home to make sure you’re safe.

Our Sports therapists are well trained to diagnose and coordinate the management of sports injuries and musculoskeletal injuries. These injuries involve the bones, muscles, tendons and ligaments of the body.

They also assist with medical problems that may affect and are peculiar to athletes.

The key to the correct management of these conditions is an accurate diagnosis.  This requires a detailed history, competent examination and if necessary, selection of appropriate investigations. Once an accurate diagnosis is made, the precise management can be planned and carried out followed by the appropriate rehabilitation if necessary.

Our therapists are experienced in caring for a variety of sports people and non-sports people at a variety of levels and ages.  Many also have experience with sporting teams in Football, soccer, hockey and gymnastics in Ghana. It may be necessary for referral for X-rays or other investigations such as ultrasound, CT scan or MRI scans and our Sports therapists are in the best position to suggest the most appropriate investigation to meet the individual’s needs. This enables time for adequate history-taking, examination and planning. It may also be necessary for the Sports therapists to involve other practitioners and coordinate their management.  Such practitioners may include an orthopaedic surgeon, general surgeon, physiotherapist, podiatrist, masseur, exercise physiologist.

The clinic offers a Pre-employment functional assessment or FCE (Functional Capacity Evaluation) which provides comprehensive information relating to a potential employee’s physical strength, flexibility and cardiovascular fitness This evaluation can assess whether an employee is a high or low risk for sustaining a work-related injury. It also helps the employee to determine if they can perform the tasks required within a job requirement. This may also assist the employer with matching a worker to a suitable task or roles within the company.

Our physiotherapists will provide you with specific pre-employment assessments depending on the needs of the company.

Our work fitness assessment usually involves an examination of:

• Overall posture & postural fatigue
• Range of joint movement and muscle flexibility
• Strength and endurance
• Manual handling
• Cardiovascular fitness test
• Movement technique & quality include:
• -Bending 
• -Lifting
• -Reaching
• -Squatting
• -Stairs and ladders