Improving Patient Care through Applied Research 17 December 2020Wong Boon SengAssociate Professor, Singapore Institute of Technology The Centre of Health Sciences Research and Innovation (CHeSRI) is set up within the Health and Social Sciences (HSS) cluster as a strategic initiative to consolidate all health and social sciences research activities within SIT. CHeSRl's main aim is to develop a coherent applied research agenda that demonstrates the clinical effectiveness of allied health and nursing, as well as improve patient care and promote healthy living. Its research activities are grouped under four key themes: Care Service Orientation, Community Health, Digital Health, and Healthcare Engineering. Many of CHeSRl's research projects cut across two or more themes and often involve collaborating externally with healthcare partners and other autonomous universities, as well as internally, with colleagues from other clusters and the Professional Officers Division. Some research outcomes have had implications on enhancing healthcare solutions, while others could be used to advance the education of healthcare. Applied Research towards Enhancing Healthcare Provision Here are some projects that the team at CHeSRI has been working on. chevron--up Mobile Robotic Balance Assistant President Halimah viewing a demonstration of the Mobile Robotic Balance Assistant in action.A/Prof Wee Seng Kwee, a Senior Principal Physiotherapist at Tan Tock Seng Hospital (TTSH) with a joint appointment at SIT, was the Clinical Lead working with the engineers with Nanyang Technological University (NTU) that developed the Mobile Robotic Balance Assistant (MRBA). The MRBA is essentially a "follow-me" robotic wheelchair designed to administer both standing and mobile balance control assistance, as well as training for the user on level ground, under versatile settings. A patent has been filed for the MRBA, due to its novel design and functional use to rehabilitate patients with problems in balance and mobility. chevron--up LIVEN Jurong Health Lifestyle Intervention Study The Jurong Health Lifestyle Intervention (LIVEN) Study is a community programme that uses a behavioural change framework to target people with pre-diabetes. This study is funded by the National Medical Research Council (NMRC) and led by Asst Prof Muhammad Rahizan Zainuldin, who is a Visiting Expert at Ng Teng Fong General Hospital (NTFGH). The programme is run by a multi-disciplinary team of physiotherapists, dietitians, and clinical psychologist, alongside SIT's physiotherapy undergraduates.Preliminary findings on two LIVEN groups showed that 20% of the participants were able to reach a 5% weight loss - a level that is considered important in terms of observing changes in blood sugar level, according to both national and international guidelines. chevron--up MOTIVATE - A Multi-Modal Training Programme for Stroke Survivors Some of the members from the MOTIVATE study team, with A/Prof Kwah (second from right) and Dr Shamala Thilarajah (middle) from SGH.A recent survey by SIT and Singapore General Hospital (SGH) showed that factors hindering stroke survivors from being active go beyond a lack of motivation. This survey, supervised by A/Prof Kwah Li Khim, looks at barriers to physical activity faced by community stroke survivors. They discovered that the top three barriers are (1) a lack of suitable exercise programmes for stroke survivors at fitness centres, (2) a lack of assistance from fitness centre staff, and (3) feelings of fatigue. Expanding the initial study team to include professionals from SportCares-ActiveSG, Singapore National Stroke Association, and Republic Polytechnic, the new team introduced MOTIVATE, a multi-modal training programme to improve stroke survivors' access to fitness centres to promote physical activity. The initial study team members that conducted the survey include SIT's physiotherapy students Favian Lim, and Raylynn Teo, A/Prof Kwah Li Khim, as well as Dr Shamala Thilarajah from SGH. chevron--up Brain Computer Interface (BCI) Applications to Improve Health Outcomes Cognitive remediation using brain computer interface (BCI) application is an intervention method to improve cognition and functional outcomes for people with stroke and mental disorders. Two BCI projects, involving SIT's allied health undergraduates doing their Honours thesis modules, were conducted using the SenzeBand-Memorie platform.The first study, supervised by A/Prof Tan Bhing Leet, investigated the feasibility of incorporating BCI games in existing cognitive remediation programmes for patients at the Institute of Mental Health (IMH). The study found that participants showed improvements in various symptoms of schizophrenia, verbal memory, as well as their overall ability in community living.A/Prof Wong Boon Seng and Asst Prof Andy Lee supervised the second feasibility study for community stroke survivors at Kwong Wai Shiu Hospital's Senior Care Centre, where along with a team of students from SIT's Occupational Therapy and Diagnostic Radiography programmes, they observed a trend association between game score and cognitive function. The usability surveys from both studies showed that participants found the games to be useful. chevron--up Enhancing Diagnostic Radiography with Al A group of Diagnostic Radiography Honours Thesis students, supervised by A/Prof Eric Chua, is collaborating with SGH to harness artificial intelligence (Al) for diagnostic radiography purpo ses. The intention is to help SGH radiographers enhance their capabilities in scoping and articulating clinical needs through Al, to improve radiography outcomes for patients. Applied Research Towards Improving Health Education Here are some projects that the team at CHeSRI has been working on. chevron--up 3D Printing Anatomy as Learning Tools A separate cross-disciplinary project is led by Prof P Gopalakrishnakone, A/Prof Ooi Chin Chin, and A/Prof Desmond Chong from the SIT faculty team; Justine Ramos, Hajmath Begun, and Michael Nielsen from the SIT Professional Officers team; Muhammad lllyas from SGH; and a Diagnostic Radiography Student, Lai Hui Qi. The project team looked at creating 3D printed models of the human wrist and knee joints, using Computerised Tomography (CT) scan data.With the COVID-19 pandemic leading to restricted access to the NUS Anatomy Museum, the 3D printed human anatomical models became valuable learning tools for SIT's Year 1 HSS students - a testament to how applied research and applied learning can work hand in-hand.Figure 2. 3D printed bones of the wrist (A, B & C) and the knee joint (D). Flexor Carpi Ulnaris muscle and tendon attached to the pisiform bone (E). Figure 3. Assembled 3D printed wrist joint (Left) and knee joint (Right) chevron--up Digital Health Literacy Survey Nursing students from the Population Health module have conducted a survey to determine the level of digital literacy among adults living in Punggol. The study, supervised by Prof Alan Wong and Senior Lecturer Jade Soh, found lower digital health literacy among older adults, whereas there is higher digital health literacy in younger adults and older people who own a mobile phone. This observation reinforces the need to identify Singaporeans with poor e-health literacy and to equip them with appropriate digital skills, especially pertinent in the current pandemic when most health information is relayed through the digital media. The study findings inform the Health Promotion and Population Health modules for nursing, physiotherapy, and dietetics students. Further research collaboration is being planned with community partners.