In-Patient Therapy
Physiotherapy and Rehabilitation are major requirements for safe and swift recovery after any surgical intervention in spinal disorders. In fact, therapy and training should ideally start before the planned date of operation.
Physiotherapist’s Role:
Preoperative Education, which includes reasons for surgery, associated risks, restrictions following surgery, as well as pain expectation. A few basic exercises of the spinal and related areas are demonstrated. Respiratory exercises and control of smoking in smokers are also initiated at this stage.
Preoperative assessment and recording of basic parameters required for various outcome scales in order to plan and execute individualised therapy and rehabilitation programme for each patient. This allows the patient to derive maximum benefit from the surgical treatment with major reductions in the time of recovery and hospital stay.
Post operative care begins immediately after the patient leaves the operation theatre, and is actually a continuation of the pre-operative therapy. Transfer from post-operative room to the ward or ICU and positioning the patient in bed are of the utmost importance in spinal surgery, and are ideally controlled and supervised by the physiotherapist under the guidance of the anaesthesiology team.
Controlling pain is an important first step in allowing patients to recover, as it is impossible for a patient in severe pain to participate in any physiotherapy or rehabilitation activity. There are several means that are available to the physical therapist for helping minimize post-operative pain such as cold/heat application, positioning of the patient or his/her limbs, controlled and guided movements, use of electrical devices (e.g. TENS, US, IFT), etc.
One on one training session which is typically developed and tailored for the individual patient, taking into account the specific surgery, body type and different co-morbidities. Therapist focuses on muscle facilitation particularly in areas where the muscles need special re-training to gain strength and provide stability. Individualized approach also helps with areas where the patient’s mobility and flexibility are limited. Therapeutic exercise therapy focuses on:
- Muscles in the incision area
- Muscles that may have been weakened by nerve problems before the surgery
- Small muscles that work around each vertebra and help stabilize the spine (segmental stabilization)
This session also includes different mobilization techniques for functional transitions and movement restoration, improvement in gross and fine motor skills, strength and endurance training, sensory and cognitive integration, balance and coordination training, walking pattern improvement training (Gait training), pulmonary rehabilitation in order to reduce fatigue and keeping the lungs clear, etc.
Logistic help for different training programmes are available in our unit. These include time honoured classic devices as well as modern, state of the art equipment. A representative (by no means exhaustive) list of apparatus used by our unit is appended below. We also provide custom splinting and bracing facility as and when prescribed by the spinal surgeons under supervision of a specialist in Orthotics.
Domiciliary physiotherapy may be essential for patients with major disabilities and also for those undergoing very major spinal surgical procedures. Spinal Cord Injury patients may require special considerations depending on the location and severity of injury. The Spine Foundation organises home services within the city limits of Kolkata, and also in some suburban areas. Typically, the service also includes family education and attendant training.
Out Patient Therapy
This section caters to the needs of patients referred from the Outpatient clinics of the spinal surgery and anaesthesiology consultants, pre-admission patients being prepared for surgery and post discharge patients who do not require domiciliary care.
- Goals are achieved through comprehensive assessment with individualized treatment combining education, continuous support, home exercise programs and advice using knowledge from our extensive computerised database. Our physiotherapists use only the latest research and evidence-based methods. Interactions with the clinicians are a regular routine for every case.
- Treatment focuses on reduction of pain and swelling, improvement in range of motion, healing of soft tissue structures, soft tissue relaxation, improvement in gross and fine motor skills, gait training, reduction in post-operative stiffness, balance and co-ordination training, strength and endurance training, sensory and cognitive integration training, with effective utilization of different advanced therapy like manual therapy, mobilization techniques, dry needling, cupping, taping and electrical modalities.
Some of our Equipments: Parallel bar with mirror, standing frame, tilt table, wobble board, bosu ball, stability disc, foam roll, therapeutic resistive devices (dumbbells, resistant bands, tubes, kettle bell), walking assistive devices (walkers, crutches), body weight supported treadmill trainer, IFT, TENS, LASER, Functional electrical stimulation, Ultrasonic therapy, short wave diathermy, biofeedback unit, etc.
