Moving Towards a Healthier Future

By Grace Lim

For patients recovering from cardiac surgery, regaining their strength and independence as quickly as possible is often their most pressing concern. Team Movement Matters from Cardiac Physiotherapy and Rehabilitation Services (CPRS) understands this deeply.

Functional independence, which refers to the ability to stand, walk, and move independently from one location to another, is a key measure of how post-operative patients are recovering. The team notes that patients who have not yet achieved functional independence by the fifth day after a cardiac operation (Post-Operative Day 5, or POD 5) may face a higher risk of deconditioning-related complications such as pressure ulcers, deep vein thrombosis, and psychological distress, often associated with extended bed rest.

As Singapore's population ages, the team has observed that fewer patients are achieving functional independence by POD 5. Drawing on their experience and expertise in cardiac care, they recognised the importance of refining care strategies to support faster recovery with fewer health complications and hospital readmissions.

One such care strategy was enhancing post-operative physiotherapy exercise.

Team Movement Matters from Cardiac Physiotherapy and Rehabilitation Services (L-R): Team Facilitator Chen Hebin, Assistant Director; Team Leader Nadiah Binte Mohamed Rahim, Senior Physiotherapist; Team Members Muhammad Isa Bin Mohd Musa, Senior Physiotherapist; Wan Hui Ling, Senior Physiotherapist; Khoo Teng Yap, Senior Physiotherapist and Nai Thye Heng, Senior Therapy Assistant.

The team identified two opportunities for improvement in the existing post-operative physiotherapy exercise methodology. The first was the need for a more standardised protocol for patient mobilisation; the second was the absence of clear criteria to determine the number of physiotherapy sessions needed. Addressing these areas meant that treatment decisions around the frequency, type, and intensity of exercise could be made more consistently.

(L-R) Examples of exercises featured in the project, including lower limb exercises, strength exercises, pedal cycle exercises, and ambulation exercises.

In response, the team developed a Mobilisation Care Bundle, a structured exercise plan designed to help patients regain strength and independence. The programme includes clear guidelines on patient suitability, and safety measures tailored for deconditioned patients. A Physiotherapy Prescription Algorithm was also established, standardising twice-daily rehabilitation sessions from the fourth to tenth day after surgery, with exercises adapted to each patient's individual needs.

The results have been encouraging. About 87% of patients achieved functional independence by POD 5, up from the earlier 80.4%. Rates of deconditioning fell significantly from 16.5% to 5.95%, and the average time taken to achieve functional independence shortened from 10.68 to 7.24 days.

The benefits extended beyond patient outcomes. The team also helped optimise healthcare resources by reducing the level of nursing assistance required, saving approximately 117 manpower hours annually. These results have had a ripple effect: patients felt more confident in their recovery journey, and team members have found greater satisfaction in seeing the tangible impact of their work.

"Our team's efforts demonstrate that small, meaningful changes can make a lasting difference for both patients and staff, reflecting our commitment to continually improving the way we deliver care," said Team Leader Nadiah Binte Mohamed Rahim, Senior Physiotherapist from CPRS.

Team Movement Matters' dedication to improving post-operative care was recognised at the Team Excellence Assessment (TEA) 2026 with a Gold Award. Congratulations to the team on this well-deserved achievement!