Singapore Health Services
MOHH Cluster | SingHealth

Making Footprints in Limb Transformation

Inspired by her grandmother’s resilience, Healthcare Scholar Liu Chang found her calling as a Prosthetist and Orthotist. This path empowered her to spread joy and transform lives through her work.
Singapore Health Services

Liu Chang is a recipient of the Healthcare Merit Award (offered by MOH Holdings) and holds a Bachelor of Science (Honours) in Prosthetics and Orthotics and a Master of Science in Public Health. She works as a Prosthetist and Orthotist at KK Women's and Children's Hospital (KKH), Orthotics and Podiatry Service.

From a young age, Liu Chang got to know about prosthetics after her grandmother lost her right leg due to a workplace accident. Rather than allowing the setback to limit her, Liu Chang’s grandmother displayed resilience as she adapted to life with a prosthesis while nurturing Liu Chang. The device restored her mobility and freedom of movement, showcasing its transformative potential for those who have lost their limbs.

This experience sparked Liu Chang’s passion for designing and crafting customised prostheses and orthoses. “It also helped that I enjoy art and working with my hands. A job involving workshop machinery, design, and patient interactions really appealed to me,” she shared.

Boundless Beginnings

Driven by this passion and guided by her aspirations, Liu Chang’s path became clear when she stumbled upon the prosthetics and orthotics profession while exploring allied health specialties listed on the BrightSparks website.

In essence, prosthetics entails crafting sockets that attach functional artificial body parts like knees and feet to the residual limb. Orthotics, on the other hand, focuses on designing body braces that either support or correct existing body parts.

“The prosthetics and orthotics profession caught my eye as it looked to be a challenging role that integrated my passion for both biology and engineering. The idea that I could potentially provide prosthetics services for my grandmother in the future and improve her quality of life while helping so many others like her really appealed to me,” she reflected.

To fulfil her ambition, Liu Chang ventured to the University of Strathclyde in Glasgow to pursue a Bachelor of Science (Honours) in Prosthetics and Orthotics, with the support of the Healthcare Merit Award. Besides providing financial support for conferences and extra-curricular trainings, the scholarship also provided opportunities for Liu Chang to connect and bond with other healthcare scholars from the Singapore Healthcare Society (SHS) through local and overseas gatherings.

“It would not have been possible for me to pursue an overseas education without the support from a scholarship. This opportunity to live and learn in Glasgow was an invaluable experience. I learned from some great instructors who remain good friends and mentors till this day. I was able to exercise independence and resilience, which have very much shaped my character and outlook in life today,” she mused. Studying abroad also gave her the confidence to volunteer for a summer internship in the United States with e-NABLE, an international network of volunteers that design and 3D-print upper-limb prostheses for those in need. Recognising the gap in clinical knowledge amongst the volunteers, she subsequently continued to volunteer as a student consultant with e-NABLE and founded a subsidiary student club in her university upon her return.

Anticipating a fulfilling career upon her return to Singapore, Liu Chang was driven to acquire new knowledge and develop her skills to better aid her future patient’s post-graduation. “I wanted to learn and grow as much as I could so that I could help my patients when I returned to work after my graduation,” she said.

During her clinical training, Liu Chang dedicated herself to refining her skills and expanding her knowledge in specialised paediatric orthotics, including spinal orthotics for scoliosis and ankle-foot-orthotics (AFOs) for paediatric neuromuscular conditions.

Expectedly, Liu Chang’s dedication and efforts enabled her to become more proficient in the core aspects of paediatric orthotics by the end of her placement. This proficiency was pivotal in her seamless transition from a student to a competent full-time clinician.

Crafting Mobility, Creating Fulfilment

After graduating and returning to KK Women’s and Children’s Hospital (KKH) as a Prosthetist and Orthotist (P&O), Liu Chang is now fulfilling her aspirations of making a profound difference in the lives of those in need.

“As a P&O, we typically form long-term relationships with our patients as we are involved in every stage of their treatment journey,” she said.

Her workdays vary significantly, from assessing patients in the clinic and capturing limb shapes to devising precise prescriptions and designing orthoses via plaster-modelling in the workshop or computer-aided-modifications (CAM). Liu Chang oversees the fittings of orthoses for her patients and plays an important role in helping them integrate the use of these braces into their daily lives. This cyclical process involves regular check-ins every few months to troubleshoot, modify, or repair devices as required.

As a paediatric orthotist, Liu Chang’s patients consists of teenagers coping with adolescent idiopathic scoliosis, who require spinal braces to prevent the progression of their scoliosis curves; and children with neuromuscular disorders like cerebral palsy, who rely on AFOs for gait improvement, rehabilitation, and lower limb positioning.

“Each orthosis is custom-made for the patient. Occasionally, innovative solutions are needed for patients with high-functioning complex musculoskeletal or neuromuscular needs. These are the more challenging cases, but they also bring a deep sense of fulfilment,” she explained.

Embracing Challenges with Empathy

Working with young patients and their caregivers comes with challenges and may be demanding at times, but Liu Chang takes it all in her stride.

“It can be challenging to integrate orthotics treatment effectively into the children’s lives, perhaps because of the complexity of some of their conditions, expectations of the caregivers, and some may even be unwilling to wear a brace,” she detailed. “Instead of feeling frustrated, I try to understand more about my patients’ daily needs and habits, express empathy towards their caregivers, and discuss with other healthcare providers to develop a more holistic treatment plan.”

Witnessing the successful integration of orthoses into her patients’ lives brings immense satisfaction. One poignant memory stands out — the journey of a toddler with complex paresis and deformation of one lower limb. Through meticulous adjustments to the toddler’s AFO, it eventually enabled her to run independently and safely.

“Over the past four years, I have watched her grow while she regained her mobility and normal foot shape. I always look forward to seeing her again in the clinic to hear about her latest escapades!” she exclaimed.

Liu Chang

Liu Chang

Making a Broader Impact

Liu Chang is enthusiastic about the future of paediatric P&O in KKH. Having been established just five years ago, her department has come a long way. Her team’s standout achievement was fabricating the Reciprocating Gait Orthosis (RGO), enabling a child with paraplegia to walk upright for rehabilitation—the first such feat among Singapore public hospitals.

Motivated by a commitment to excellence, Liu Chang actively imparts knowledge through in-service education for P&Os and healthcare professionals. “Orthoses are only part of the treatment process for many of our patients, and cross-disciplinary collaboration is often required to put together an effective treatment plan for them. For example, we work very closely with orthopaedics for our scoliosis patients,” she elaborated.

And that is not all. Liu Chang’s pursuit of excellence extends beyond Orthotics. Her attainment of a Master of Science in Public Health illuminates her aspirations to shape Singapore’s health policies both within and beyond the domains of P&O. “My master’s degree in public health allowed me to round out my understanding of how P&O plays a part in the wider determinants of health, and how policies are evaluated and implemented to produce optimal health outcomes,” she said.

Drawing from her journey, Liu Chang encourages aspiring health science students to explore opportunities abroad with scholarships like the Healthcare Merit Award. “Studying abroad not only enables you to learn from different experts in your field, but also to learn about yourself and grow,” she said. “It is an opportunity to immerse yourself in diverse perspectives, forge lifelong friendships, and cultivate skills that transcend the academic sphere. These will serve you well when you return to face challenges and opportunities in the many roles you will play in the future!”