S$4.48m community rehab programme aims to help 2,000 Parkinson's patients over five years

S$4.48m community rehab programme aims to help 2,000 Parkinson's patients over five years More than 10,000 people in Singapore are estimated to be living with Parkinson's – the country's second-most common neurodegenerative disease. SINGAPORE: Mr Eric Chen, 55, has been living with Parkinson’s disease for two decades. Diagnosed at just 35, he found that staying active helps him manage the progressive neurological condition. He was also among the first participants in a new community rehabilitation programme designed specifically for people with Parkinson’s. "I noticed that there are certain daily activities which I used to have challenges with that have gone away,” said Mr Chen. “It's a lot easier to move about and I'm more mobile." The programme, called Kickstart Exercise and Empower Parkinson’s (KEEP), is part of a S$4.48 million (US$3.5 million) initiative by the Lien Foundation in partnership with Parkinson Society Singapore (PSS), NHG Health’s Tan Tock Seng Hospital (TTSH), the National Neuroscience Institute (NNI) and other SingHealth institutions. Kicked off in January, it is being progressively rolled out across 13 day rehabilitation centres, with 2,000 people in the early to middle stages of Parkinson’s expected to benefit over the next five years. EXERCISE, DAILY FUNCTION AND MENTAL HEALTH KEEP was co-designed by physiotherapists, occupational therapists, medical social workers and Parkinson’s movement disorder specialists from NNI and TTSH. It introduces fitness and rehabilitation in the earlier stages of the disease, while also incorporating group sessions to tackle the social isolation that can develop as Parkinson’s progresses. Parkinson’s affects the regulation of movement, but patients can learn strategies to move more effectively, said Dr Chloe Chung, senior principal physiotherapist at TTSH. “Physiotherapy focuses on training patients how to be able to take bigger steps when they walk, so that they don't trip over, and so that they can walk faster,” she said. Turning can also increase the risk of falls for people with Parkinson’s. The sessions aim to teach strategies to turn safely to prevent falls. To ensure participants receive timely support if their symptoms evolve, they will also undergo regular assessments. “We will check in with them every six months from the date of enrolment, for up to two years to adjust their rehabilitation and mental health plans if any decline is detected,” said Dr Chung. EARLIER INTERVENTION Parkinson’s involves the gradual loss of dopamine-producing nerve cells, leading to symptoms such as tremors and slowness of movement. More than 10,000 people in Singapore are estimated to be living with the condition. It is the country’s second-most common neurodegenerative disease, after Alzheimer’s. As Singapore’s population continues to age, doctors expect the number of people living with the disease to rise. “If we go through the normal wait-and-see reactive approach … we will be laden with a lot of healthcare needs, falls, admissions, complications,” said Associate Professor Tay Kay Yaw, head and senior consultant at NNI’s Regional Department of Neurology (North). Evidence suggests that fitter patients tend to deteriorate more slowly, he said. “So why not take this proactively – strengthen the patients better, make the patients fitter.” TACKLING SOCIAL ISOLATION Beyond physical symptoms, Parkinson’s can also have significant social and psychological effects. “Sometimes (patients) feel very depressed because society will expect them to perform certain social norms, and they fear being judged all the time with the tremors,” said Ms Phyllis Lim, executive director of PSS. “They fear going out even,” said Ms Lim. For caregivers, this can mean having to continually encourage their loved ones to remain active and socially engaged as the disease progresses. “The caregivers find it very challenging to have to always motivate them and encourage them to journey with this disease, which won't go away with a snap of a finger,” said Ms Lim. The KEEP programme also provides support for caregivers, who will receive six training sessions to help them cope with the demands of caregiving. “We aim to help caregivers better understand Parkinson’s and how to adjust their daily routines and expectations, so they can support their loved ones, reduce the risk of burnout and improve the quality of life for both (of them),” she said. KEEP is being rolled out through day rehabilitation centres operated by six community care providers in Singapore, including AWWA, Care Corner Seniors Services Singapore and NTUC Health. PSS will serve as the master trainer and primary training site for community partners to enhance rehabilitation standards. Of the Lien Foundation’s S$4.48 million investment, S$1.2 million has been set aside to co-design and launch a second PSS centre. Beyond rehabilitation, a public awareness campaign is in the works to build empathy and reduce the stigma associated with Parkinson’s. A public symposium and activation will be held on Oct 31 at the Singapore Institute of Technology campus in Punggol Digital District.