General Plan:

From October 28 to November 1, 2024, I will be attached to the Rehabilitation and Wellness Services, 12th floor of Virtus Medical Tower at Central, from 9 am to 5pm daily, with a one-hour lunch break. During this time, I will be shadowing physiotherapists and other professional staff members to observe patients undergoing various forms of physiotherapy and wellness training. Additionally, if time allows, I will help to compile sports rehabilitation protocols.

I look forward to watching and/or doing various kinds of physiotherapy and wellness training in a real clinical centre. This is because I have an interest in studying and working in a healthcare setting in the future. Prior to the attachment, I will prepare my mindset to be ready to learn. I will also practise my communication skills so I can clearly express my ideas, and will do some research on basic physiotherapy concepts and methods. I know the exact location of the place so I will take the MTR and then walk there because it is within walking distance from the Central MTR station. I will buy food on the way there.

I feel excited because this will be the first time ever for me to be able to observe and learn full time in a medical care setting. I bought two sets of black shirts and pants from UNIQLO since I understand that the physiotherapy staff there routinely dress in black. I like to be a small part of the professional team there.

Day 1 : 

Today I had a tour around the clinic and I learned how to use the machines there as well as the functions of all the machines. I also observed some patients and familiarised myself with their illness conditions. I was able to learn about tennis and golf elbows which are common conditions there.

I also learned about internal (or intrinsic) and external (or extrinsic) factors to injury. Thus, internal would be something inside your body like degeneration, and external would be something outside your body like your exercise form being incorrect. Both types of factors may coexist in a given patient and interact to cause soft tissue and other musculo-skeletal pathologies. I was lucky enough to be able to use a dynamometer which is for the isokinetic testing of knee flexors and extensors.

Next time, I will take notes so I can retain and reuse the knowledge better. I also learned that the relationship between the staff and the patients (i.e., rapport) has to be good, or else there will be no trust and the patients will not believe the treatments work. They may not return for therapy and will drop out.

Today, I started to get to know the staff and see what they normally do. I feel that physiotherapy is an art as well as a science. There is indeed a lot waiting for me to learn about how it is effectively applied to rehabilitation and wellness.

Day 2 : 

Today, I knew the place and people better and met a lot more patients. One of the patients I met tore their Anterior Cruciate Ligament (abbreviated as ACL) twice and then injured their meniscus, and today the staff administered shockwave therapy as well as electric Russian therapy. I learned about ACL injuries and stuff related to it, like the percentage of people that would be able to return to competitive play after an ACL injury, an issue that matters especially to athletic people and sportsmen generally.

I tried out the electric Russian therapy on myself to feel the experience of it. It will contract your muscle without you having to do anything. It is for strengthening the muscle if you cannot control it because of paralysis or other causes. I also learnt the Oxford muscle grading scale which is a scale of 0-5. 0 is when you have no muscle contraction, and 5 is when you have movement against gravity and resistance. I enjoyed learning about these things today. 

Day 3 : 

Today, there were fewer patients there. I was told fluctuations in attendances were normal in a private treatment centre. Thus, I only met one. He suffered from a chronic wrist injury. This was his second time coming here. We gave him some physical tests and then iced and compressed his wrist. Rest, Ice, Compression and Elevation or “RICE” has been the standard of physiotherapy management of acute soft tissue injuries. Since the patient’s wrist problem is chronic and not associated with acute painful swelling, Rest and Elevation were not applied; only Ice and Compression were. I hope and believe he will make further progress with treatment. 

I learned about proprioception exercises, which serve to help one’s balance and stabilise one’s joints in dynamic and static movements. I also tested out an interesting AI posture assessment device. It gave me a simple and fast breakdown of my body alignment and how I could fix my posture and shoulder alignment.

After lunch break, I did some training with a medicine ball to train my arms and rotational ability. I also used the exercise bike with intensive sprints to cool down for 5 sets. Then I did 3 sets of 5 motions with the medicine ball again. I felt tired after this, which shows the effectiveness of these exercises and the limits of my strength and endurance. I have a long way to go!

Day 4 : 

Today, I reviewed intrinsic and extrinsic factors causing musculo-skeletal problems with Dr. Man Chung who headed the centre and supervised my attachment. I met a patient today that just underwent a knee surgery because of degeneration, and we helped him rehabilitate his knee with various exercises and therapies. Because of that, I found out that Russian electric therapy is extremely important for all rehabilitation. It helps contract and control your muscles, which become strengthened as a result.

I learned to do more medicine ball exercises. I also tried intermittent therapy which is pushing yourself to the maximum for 30 seconds and then breaking for 30 seconds and then repeating. I learned to do balance exercises with the Bosu ball trainer and weight. I did treadmill to activate my legs. As well as that, I used a pilates machine which is for strengthening and stretching knees and quadriceps. I look forward to tomorrow, which is the last day of my attachment. 

Day 5 : 

Today was my last day. I tested out all the machines on the floor and the floor below. I did a back stretching machine, another electric therapy but with ultrasound for more stimulation, and shockwave. If you are injured, shockwave will cause you a lot of pain at the sites of pathology before you eventually get well. But since I was not injured, the shockwave just gave me a slight tingling sensation. Then, I tested out the Game Ready Machine. It uses ice and compression to reduce pain and swelling. Lastly, I tested out High energy inductive therapy. It generates a magnetic field of 3 tesla. This stimulates nerve cells, muscles, and blood vessels. This is normally used on the hip or neck.

I also went to the floor below and there were a lot more new machines to test out. These machines were relatively easier to try since they were made for elderly. There was a balancing machine, and a bunch of interactive games that could activate various muscles. The brand is called tyromotion and it has different machines that you can tie yourself to and will isolate different muscles while playing games. In the afternoon, I used blazepods which are pods which you can hit and will have light. This tests your reflexes while letting you have fun at the same time. 

With gratitude, I said goodbye to the staff at the end of my fifth and last day.

Overall Reflections

This internship is without doubt very beneficial and important to me. I learned how to use a variety of innovative and sophisticated treatment machines on real patients. I also personally witnessed how healthcare professionals effectively communicated with and helped patients in a real world clinical setting that is filled with positive staff energy. Patients, too, might have to take active effort in the rehabilitative process, such as in doing exercise training. Treatment can relieve pain as well as induce pain, such as in shockwave therapy. That induced pain is a signal of tissue pathology and has to be painfully endured for recovery to occur.

I would have liked to help in patients’ treatment process more, but I did not have enough time to learn how to properly use the machines. Physiotherapy encompasses multiple human technologies (HT), especially somatic, material, and cognitive technologies, that call for years of professional and practical training to learn well. This five day experience definitely ignited my interest in healthcare and has made me more motivated to pursue more future attachments, study and work experience in the field.

In this self-selected DL+ experience, I feel that a week of full time work attachment is a lot more tiring than year 10 school life at ICHK. This is partly because it was pretty busy at the clinic and everything was new to me. Patients were almost always around so I did not have much resting time apart from lunch. Because of the cramped schedule, I was not able to work on the protocols about rehabilitation that I mentioned in the above-mentioned general plan.

I love playing basketball games and am a member of the school basketball team. This attachment really helped me appreciate the importance of pre-game routines like warming up and stretching, which I often did not do adequately. This is because stretching can loosen up your body and keep it flexible and healthy to prevent serious injuries. Many patients I saw throughout the week had serious sports injuries and most of them did not do proper stretching before exercise. 

Perhaps my deepest reflection for this week is that although I did okay in learning the topics that the staff taught me, my social skills and initiative have a lot of room for improvement. I feel like I should have used more of my social and communication skills but I was kind of shy in a new and unfamiliar setting. So I did not initiate conversation with patients and staff. I hope my increased awareness of these weaknesses will help me enhance myself in the years to come.

I earnestly thank Dr Man Chung, Mr Henry, Kevin, Nam Nam, and all the other staff that had generously helped and enriched me throughout these five days. I admire their professionalism in integrating the science and art of physiotherapy. I also feel grateful for their passion to teach even a 14 year old and medically uninformed student like me. I am lucky to have undergone such a fruitful attachment. I hope all the patients I met will fully recover soon.

Finally, I thank my school for arranging this special Deep Learning Plus week to make this self organised project possible.