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Healing With a Difference

You need to heal the mind first, before you heal the body. Sonal Vij explains how Indian Spinal Injuries Centre, New Delhi is making a world of a difference by following this principle

The patients are taught self care evaluation like wheelchair management and skills

Ample times we have heard about how one needs to heal not only the body but also the mind as well. But how many hospitals actually follow this principle? Come to think of it, hardly any. When it comes to words like 'healing', 'holistic', 'curative', you will find it difficult to associate these words with the concept of a 'hospital'. You may probably end up thinking about an Ayurvedic spa! Which is why, when New Delhi's Indian Spinal Injuries Centre (ISIC) comes up with a very holistic view of healing, you ought to sit up and take notice. Everyone claims to be 'different' but this one actually is.

ISIC provides 'innovative healing ways' and variety of treatments like no other hospital and worldwide patients flocking to this institute to get 'healed' are testimony to its services. It provides an array of rehabilitation treatments like hydrotherapy, dance therapy, aroma therapy apart from regular physio-therapy and counselling.

Rehabilitation Essentials

There are different components of rehabilitation but two most important ones, especially in the beginning, are medical rehabilitation and physical rehabilitation. During the process of medical rehabilitation, along with the stabilisation of the spine the patient is given ample knowledge about the morphology and physiology of the important systems like urinary, digestive, excretory etc. "That way one understands the reason and thus the importance behind intermittent catheterisation or tapping in bladder management and changing of position to relieve pressure regularly for prevention of pressure sores. Sexual rehabilitation too is covered under rehabilitation itself," adds Chitra Kataria, Head of Department- Rehabilitation Services, ISIC.

Psycho-social rehabilitation depends on the personality, education, status in the family, age, background and various other factors. This makes the way for the economic rehabilitation through vocational rehab leading to integration of the individual into the society.

Peer Counselling

"During medical rehabilitation, we give knowledge about morphology" - Chitra Kataria Head of Department Rehabilitation Services ISIC

"When a spinal shock patient is rehabilitated, the patient feels more positive" - Pragya Ghildial Yoga Therapist & Female Peer-Counsellor ISIC

To start with, apart from the regular counselling session, the rehabilitation centre provides a peer counsellor who is actually a rehabilitated spinal injured person, possessing good communicating skills, and has a fair knowledge about physiology and anatomy of the human body and psychological aspects of human behaviour. The peer counsellor provides ample psychological support to the patient and can help him/ her in coming out depression and can advise the patients about the coping mechanism from his personal experiences and also of those who have been counselled in the past. "The role of a peer counsellor along with psychologist becomes very crucial in deciding the time of breaking the news to the patient," says Kataria.

Says Pragya Ghildial, Yoga Therapist and Female Peer-Counsellor, ISIC, "When the patient enters the ward after Spinal Cord Injury (SCI), individual is not aware of what is in store for him/ her. After coming out of initial spinal shock, individual needs to know what has happened to him/ her. Things like when would they start walking again, why they do not have control over their bladder and bowel? When a person who as suffered all this and come out rehabilitated, the patients feel more comfortable and become positive after interacting with them."

Dance Therapy

One of the many innovative therapies is Dance Movement Therapy or DMT which is the therapeutic use of movement and dance for emotional, cognitive, social, behavioural and physical conditions. These dance classes take place every evening. DMT strengthens the body-and-mind connection through body movements to improve both the mental and physical well-being of individuals. "As a form of expressive therapy, DMT is founded on the basis that movement and emotion are directly related. The ultimate purpose of DMT is to find a healthy balance and sense of wholeness," opines Ghildial.

For patients with SCI, DMT helps in improving motor skills and body image while providing a way to communicate and express emotions. "Initially, every patient is shy to dance, they have the mental block that being on wheelchair they can't dance, but slowly, when they see us (peer counsellors) dancing, they open up and then even they dance in pairs," expresses Ghildial. ISIC has also arranged trainers from the institute of Shaimak Davar for training patients in DMT. Training of such kind help develop interest in this form of therapy. Patients along with therapists' participate in events such as annual day, etc. So far, ISIC is the only organisation in India that is providing DMT for its spinal injury patients.

Hippotherapy

Dance Movement Therapy uses movement and dance for emotional, cognitive, social, behavioural and physical conditions

ISIC has the largest solar heated hydrotherapy unit in Asia

Sports play a vital role in the rehabilitation of those with disabilities

Hippotherapy is derived from the word 'hippos', the Greek word for horse, the term 'hippotherapy' literally means treatment or therapy aided by a horse.

You may have heard of pet-therapy and at ISIC it is the horses who become doctors/ healers. Last year, ISIC introduced therapeutic riding as one of the modes of treatment. "Several studies have reported the positive impact of hippotherapy on muscle tone, posture, balance and pain, as well as its psychosomatic influence on patients. Studies have also documented the effect of hippotherapy on spasticity in children with cerebral palsy and in adults with multiple sclerosis," informs Kataria. Spasticity is a common sequel of SCI and can restrict the functional independence of persons with SCI.

Hippotherapy uses rhythmic movement of the horse to treat mainly patients with neurological impairments. The horse, at a walking pace, is used as a facilitator, led by a horse master and a specially trained physiotherapist who walks beside the horse and is in close contact with the patient. The patient does not actively influence the horse, but is passively influenced by the horse's movement.

Wheelchair Sports

Sports play a vital role in the rehabilitation of those with disabilities and can often be a catalyst to increase confidence, self esteem and a positive outlook. Sports is more than just a way to recreate or compete - they are a documented means to healthy minds and bodies. Various activities such as quad rugby, wheelchair basketball, table-tennis, etc is included in the sports routine. These are even open to patients outside ISIC.

The physical, mental and social values and benefits derived from participation in sport and physical activity are widely accepted. "These values are even of greater importance for those with physical disability for whom the opportunity for participation in an active lifestyle has not been available through an organised delivery system at the community level," opines Kataria.

Complimentary Alternative Medicine

ISIC, in collaboration with Palms, Netherlands has introduced an herbal aromatherapy technique which is the right blend of mild massage and application of medical oils, pastes, creams and powders for all kind of pain relief-back, neck, knees, arthritic and joint pains, headaches, stress, stiffness and spasticity.

Hydrotherapy

Introduced in 2001, this is unique to ISIC. ISIC has the largest solar heated hydrotherapy unit in Asia, with a 350 square metre temperature controlled pool. Special equipment for floatation, cervical supporters, foam bars, aqua dynamic balance rings and resistance gloves are used to help the patients with exercises.

What's hydrotherapy? Kataria explains, "Water has an effect similar to that of a soothing massage on muscles by bringing more oxygen to the injured area. Movements those are extremely painful outside water, can be conducted in water with minimum pain." Running, walking and floating in water have been found to be more beneficial than most other activities. She elaborates, "Buoyancy of water reduces the pressure effect of the gravity on the skeleton structure, weight bearing joints, spinal column and ligaments. It helps in relieving pain, mobilising joints, promoting relaxation, increasing the range of motion, improving general fitness and in strengthening muscles and enhancing muscle coordination and balance."

Conditions treated with hydrotherapy include neck pain, head injuries, SCI, rheumatology, post-operative orthopaedics, multiple sclerosis, sports injuries, trauma, stroke, arthritis and even ante-pre and post-natal exercises.

Wheelchair Skills Training

Since most SCI patients use wheelchairs as their sole method of locomotion, they are equipped with a wheelchair that fits and is adjusted properly as soon as they begin out-of-bed activities. ISIC trains all its patients, be quadriplegics or paraplegics, to efficiently use the wheelchair once out of the hospital.

The various skills trained are-wheelchair propulsion on even surfaces, over obstacles, ramps and uneven terrain, curbs, stairs, narrow doorways, wheelchair falls, slope and wheelie strategies, curb/ uneven terrain strategies, stair strategies, narrow doorway strategies and fall safely. A peer counsellor (a person who is wheelchair bound) teaches these activities to other wheelchair patients.

Since, ISIC is one of the few centres that provide this service, many physiotherapy students flock at ISIC to learn these skills to impart to their students. Rajeev Virat, peer wheelchair and sports instructor says, "The idea is to facilitate the patient to get back to the normal lifestyle and not be dependent on anyone."

Occupational Therapy

After a spinal cord injury, many ordinary day-to-day activities such as writing, feeding, combing hair, wearing clothes, drinking on one's own become difficult tasks. The patients relearn these activities to learn more independent lives. The patients are taught self care evaluation and training, acquisition and training in assistive devices, use of adaptive clothing, wheelchair management and skills, home evaluation and adaptation, transportation to architectural adaptation.

"In essence, our occupational therapists play a vital role in making sure that the individual is able to lead a productive life with a high quality of living as per the capacity of the individual," shares Kataria. There are exercises aimed at upper limb strengthening, increasing muscle strength as well as the range of motion of the joints. This unique healing therapy instils the patient with confidence to move out, at par with the society.

Future Plans

The future plans include outings for patients. Right now, the outings for patients are restricted to Delhi. Soon, the patients will be encouraged to participate in adventure sports like river-rafting. They will also be encouraged to do rock climbing and other difficult activities. "This will be implemented within the next one year," concludes Kataria positively.

sonal.vij@expressindia.com