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Department of Physical Medicine & Rehabilitation Website

PMR Department

Physical Medicine & Rehabilitation
Christian Medical College, Vellore

Introduction

PMR opd building with link to a larger picture of the same

PMR Outpatient
Department
at the Hospital

Welcome to the Department of Physical Medicine and Rehabilitation (PMR). The department helps people with disabilities. People come from the nearby towns and villages, and from as far away as North India, Nepal and Bangladesh.

In case you do not recognise the name, in other countries the department may be called Rehabilitation Medicine. In the USA, the doctors may be called Physiatrists.

For many people who have a disability life is hard, and the future can seem bleak. Some people are able to adapt and so to fulfill their full potential but many need help to do this. In most countries of the world, people with disabilities are poor and marginalised (excluded) from the rest of society. The two go hand in hand. If society marginalises you, and will not include you fully, then it is hard to work. If you cannot work you are poor, if you are poor you are often marginalised.

Darkness into Light?

Mural showing people moving from shadowed area ie the dark, into light area
"Out of Darkness Into Light"

As you go into the PMR outpatients there is a picture above the door. This shows people in the dark - in a grey area. The other side of the picture is people in the light - a white area. The mural is a picture of how people move from darkness into the light with rehabilitation. The PMR dept works to help people to fulfil their full potential - to do as much as possible. For many people, the process of fulfilling that potential is like the mural. It is like moving from darkness, into the light.

People with disabilities can have many needs. So they often need many different people to meet these needs. The PMR dept is a large multidisciplinary team. The team has many different people on it. They each have different skills that can help you. They work together to try to help patients who come to the department. These web pages will explain, a little, about what the different people do. We are slowly adding more information so please come back to see what we have added.

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Our Heritage

picture of Dr mary verghese in her wheelchair getting the award from Indhira Gandhi

Dr. Mary Verghese
greets the President of India,
Sri Sarvapalli Radhakishnan,
at the opening of the PMR Dept.

This year, in 2016, we celebrate 50 years since the Rehabilitation Institute was started in 1966. The actual Physical Medicine and Rehabilitation department was started in 1962-3 by Dr. Mary Verghese. Dr Mary studied at CMC, Vellore. She became paralysed from the waist down following a bus accident. She could not walk so she used a wheelchair after the accident. But she was still able to train and work as a surgeon.

Dr. Paul Brand, also worked in the department as a consultant. Dr Brand is known for his leading work in Hansens Disease (Leprosy).

The PMR department was opened on the 5th of January 1963 by the President of India, Sri Sarvapalli Radhakishnan.

Services

The PMR department has both inpatient and outpatient services. People come with many forms of disability. Patients come from all over India and beyond. Rehabilitation services are not widely available in the Indian Subcontinent so people often have to travel a long way.

Most of the inpatient work used to be with people who have Spinal Cord Injuries. But now we see people with different types of brain injury as well as children with disabilities. See below for more information Who we can help

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Newer Services

We added over 40 new beds in 2005. Patients were waiting many months to be admitted. Unfortunately, patients still have to wait, despite having many more beds. We have plans to add more beds soon. A third floor will be built giving more beds and more therapy areas. Please contact the development office if you would like to help with this dev.office@cmcvellore.ac.in.

Dedicated Services

There is now a dedicated Spinal Injury Centre:

The Margaret and Paul Brand Spinal Injury Rehabilitation Unit.

We offer comprehensive rehabilitation. This will enable people to do as much as possible - despite their spinal cord damage and disabilities.

We also look after things like pressure sores (sometimes called bed sores) - including surgery if needed. We can help with urological management (urinary incontinence) and other complications that often occur after a Spinal Cord Injury.

We also have services for people with brain injury. This unit is called the :

The Canon David Marriott Acquired Brain Injury Rehabilitation Suite.

Traumatic brain injury is often called the "silent epidemic". It is far more common than Spinal Cord Injury (SCI) in most countries. And it affects young working people. But it often goes unnoticed.

Children's Therapy Area

Our new room for the Children's unit was dedicated in November 2015. We generally have 6 children under 10 years old here. Older children are treated with the adults (until we have a separate unit for them). Children are now seen in their own unit. The therapists specialise in working with children. There is also an outside play area that children with disabilities can use.

Play is an important part of how a child learns. Play can also treat a child if the right activities are used. We are trying to find ways for children to do their therapy through play.

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Services in Physical Medicine and Rehabilitation

Patients we can help

Medical & Nursing Services

Therapy Services

Services for people
in the Community

Academic Activities

Working in PMR

Who we can help

The PMR department can help people with many types of disabilities and medical problems. We have both Inpatient and Outpatient Services. Some of the problems we can help with include:

The Patient Information page may be useful if you wish to know more about how we can help patients and their families.

If you wish to know more about services for people who have cerebral palsy, a stroke/CVA or head injury then the "services for people with brain injury" page will help: Brain Injury.

Medical Services

Outpatients

Investigations
Done by PMR

Inpatients

Nursing

Medical and Nursing Services

Medical Services

The doctors see patients in the PMR outpatients in the main hospital. This is a separate builing and not the general outpatient builing. Here they will see new and returning patients. They ask questions to find out what is going on and examine the patients. Sometimes blood tests, xrays and other tests need to be done. All this helps them give a diagnosis to the problems you may have. Then they can decide what treatments are needed. Some people may need therapy, some need medicines and some may need surgery. Some need all of these.

Many of our patients will go to see our therapists: we have physiotherapists, occupational therapists, speech therapists plus psychologists. Patients will go back to see the doctors after having therapy so the doctor can see how the treatment is working. We also have nurses in the outpatient rooms who will see some patients.

The doctors provide the medical services. You can read more about the medical services here Medical Services.

Outpatients

Outpatient (OPD) services are held in the PMR department of the main hospital campus on Mondays, Tuesdays, Thursdays and Fridays.

There are also several Joint Clinics where the PMR staff do clinics with other departments. The different doctors work together and "share the care" of some people with disabilities. This gives the expertise of several different doctors in one clinic.

Investigations and Tests Done by PMR

PMR doctors operating in the main hospital

PMR doctors,
anaesthetist
& nurse in the
hospital theatre

The PMR doctors also do several tests themselves. These tests all have long names! They are

These tests can be done for both inpatients and outpatients. These are explained in more detail here: Investigations and Tests in PMR

Inpatient Medical Services

Most people will be seen as outpatients but some need to be admitted as inpatients. The doctors look after patients in the main hospital - about 70 patients and those in the Rehabilitation Institute - over 80 patients.

Patients needing acute care are admitted into the main hospital. Those needing comprehensive rehabilitation are admitted into the Rehabilitation Institute.

Surgical operations are done in the main hospital on Wednesdays. These activities are described in more detail in the Medical Section.

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Nursing

The Nursing staff of PMR work with the inpatients in the Hospital and in the Rehabilitation Institute, College Campus, Bagayam. They do the same things many other nurses do but also help with the rehabilitation of the patients.

The job of nurses in India is slightly different to that in other countries. Patients are admitted to the hospital or Rehabilitation Institute with a female carer. This carer will give the personal care that the patient needs eg washing, shaving, feeding, preparing food. They also learn how to care for the person once they are at home, if complete independence is not possible.

The nurses will do tests like the temperature, pulse and blood pressure. They give out medicines and change dressings etc. The Rehabilitation Nurse also help to teach the person with a disability. This is crucial, especially in learning to diagnose and treat early problems related to skin, bladder and bowel management.

Therapy Services

Occupational Therapy

Physiotherapy

Social Work

Speech Therapy

Splints and other things

Prosthetics & Orthotics
(Splints &
Artificial Limbs)

Movement Analysis
Laboratory

(inc Gait Lab)

Rehabilitation Institute

Therapy Services

Occupational Therapy

The Occupational Therapists teach the patients how to do things in new ways now they are disabled. We hope to allow them to be as independent as possible. This will include learning to dress, wash, transfer from one place to another, cook, write etc.

Occupational therapy is able to offer a service for patients

Clients can be assessed for Occupational Therapy by seeing a doctor in outpatiens. these clinics often refer patients:

The Occupational Therapist will see the client and then plan further treatment.

tricycle transfer photo

Learning to do a
transfer in OT
using calipers made
in the P&O workshops

The Occupational Therapy Unit was started by Miss Chandra Manuel in 1962 and is now involved in the rehabilitation of both inpatients and outpatients.

Education in Occupational Therapy

The Bachelor in Occupational Therapy course, under the Tamil Nadu Dr. MGR Medical University, is offered to 10 students every year; most of whom are sponsored by mission hospitals. It was lengthened to a four year course, plus a six month internship at Christian Medical College and Hospital, Vellore, in 1997. There is also an ongoing in-service training programme.

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Physiotherapy

Physiotherapy can help people with musculoskeletal problems such as pain, weakness or problems with co-ordination. A major part of the therapists work with people with disabilities consists of helping them to walk and teaching home programmes to prevent deterioration. The Physiotherapy Unit was started in 1952 and now runs daily Outpatient clinics and provide in-patient services to Physical Medicine and Rehabilitation, Neurology, Orthopaedics and Cardiothoracic patients in the main hospital and to PMR inpatients in the Rehabilitation Institute. More details available on the Physio page PhysioTherapy.

Education in Physiotherapy

A Bachelor of PhysioTherapy(BPT) programme, registered under the Tamil Nadu Dr. MGR Medical University, is offered to 10 students each year. This is a four year course, plus a six month internship at Christian Medical College and Hospital, Vellore. Many of these students are sponsored by mission hospitals which require their services. There is also an ongoing in-service training programme.

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Social Work

In the Rehabilitation Institute we have two Social Work who help with the evaluation of the socio-vocational resources of patients using interviews and home visits. This information is used to help the patient and his/her family with planning for a future vocation and suitable vocational training. Several income generating schemes are organised by the Social Worker to enable patients and their relatives to earn while they are undergoing treatment. The vocational training project based in the Mary Verghese Trust, just down the road from the Rehabilitation Institute, is also managed by the social worker.

Speech Therapy

It is thought that the Speech Therapy and Language Therapy section was re-started in 1991, although we are unsure when it originally started or who the first head was (we would be delighted to hear from you if you know anything about this). There are now posts for three speech therapists in the PMR Department who help adults and children with communication and/or swallowing problems. They treat patients in the Outpatient Clinic, in the hospital wards, at the Rehabilitation Institute and in the residential centre for children with cerebral palsy.

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Prosthetics and Orthotics (Splints and Artificial Limbs)

We have a P&O (P&O) Workshop in the main hospital, which fabricates calipers (splints), crutches, upper and lower limb artificial limbs (prostheses), spinal braces, special footwear and thermo-plastic appliances for patients. In the Rehabilitation Institute we have a workshop, which makes plastic modular artificial limbs plus splints for the Rehabilitation Institute inpatients and also attempts to find innovative solutions for difficult orthotic & prosthetic problems.

Education in Prosthetics and Orthotics

There is a 2yr diploma in Prosthetics & Orthotics which teaches the students to make splints, callipers, artificial limbs, spinal braces and specialist footwear. The training is followed by a six month internship in the PMR department.


Movement Analysis Laboratory (including the Gait Lab.)

The motion analysis laboratory (MAL) is in the rehab Institute but is a test/investigation lab. It is used to look in detail at the way movement occurs for inpatients and outpatients. The two main areas looked at are walking and eating with fingers. The laboratory is also involved in making equipment such as simple electrical nerve stimulators, to improve hand use for people with tetraplegia (paralysis of the arms and legs) and cerebral palsy. They also adapt computer mice to make it easier for people with limited finger movement to use computers. The MAL also write and maintain the PMR department's general software for patient booking, billing etc. Follow this link for more information MAL - the "Gait Lab".

Photo of a child sat by her mother who is the patient

Mother and child
in OT in the
Rehab Institute.

Rehabilitation Institute

The Rehab Institute, often called the "Rehab Institute", was dedicated on 29th of September 1966. The first patient was admitted on the 2nd of January, 1967. It is in the College campus in Bagayam. This is 6km from the main hospital. Patients requiring comprehensive inpatient rehabilitation are admitted here. many patients will need about 3 months of rehab. There are now 85 bed in the Institute. Until 2005 there were 39 inpatient beds for which there was a long waiting list. But a major building project made more beds and therapy areas. Most of our work used to be with patients with Spinal Cord Injury. But, the extra building means we now have beds for people who have suffered brain injury from trauma or a stroke.

If you would like to help us pay for this building and treat people with disabilities: please write to the dev.office@cmcvellore.ac.in .



Services for people
in the Community

Community Outreach

Mela

Vocational Rehabilitation

Services for people in the Community

Community Outreach

Currently we have a community outreach programme and we have a small Community Based Rehabilitation programme. The existing community outreach is extended to patients discharged from the Rehabilitation Institute, who live in a 100 kilometre radius of Vellore. They are followed up in a monthly multidisciplinary home (CHAD) Hospital also provides Occupational Therapy services to some visit programme and invited to the annual Rehabilitation Mela. The Community Health Departments Community Hospital and Development of the surrounding villages.

The World Health Organisation recommends Community Based Rehabilitation (CBR) as

"a system for change for improving service delivery in order to reach all in need, for providing equal opportunities and for promoting and protecting the human rights of disabled people" (from Prejudice and Dignity, by E Helander).

Funding to start a CBR programme to the urban community in Vellore town was provided by the World Health Organisation (WHO) for 2002. This project is run jointly with the Low Cost Effective Care Unit (LCECU). The funding has now ceased but a project remains working with people in Vellore town. PMR and lcecu continue to work together on this project. PMR is now designated by WHO as a centre for community based rehabilitation. This includes training others who wish to work in CBR.

Community Based Rehabilitation is an integral part of the vision for the future of the PMR department, and has been for a long time. We would like to provide a CBR Programme to the surrounding village areas. Research from the vellore town project will help shape these services. In order to provide CBR to the villages we will need some funding to launch such a programme. We would hope that it can be self-sustaining once fully established. If you would like to help us set up such a programme please see our section New Horizons.

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Mela - follow-up with a difference

The Mela is not a separate section in the PMR department. But it forms an big part of the annual activity of the department. The Mela occurs in February each year. More than 100 patients return to Vellore each year. There is a programme including a medical check up, social activities, sports, self-help groups and a chance to renew friendships. This is a very successful way to provide holistic follow up for local patients.

There are two events. One on a Saturday for those who had a traumatic brain injury or stroke. One (usually) the following weekend from the Friday to the Monday for people with spinal cord injury.

You can read more about the mela here: Rehab mela

Photo of man mending a bicycle

Learning to
repair cycles;
a sustainable
vocation.

Vocational Rehabilitation

Having a job is much more than just earning money. It gives people a sense of self worth and a role in their community. Vocational rehabilitation is not "the icing on the cake" when planning rehabilitation programmes. ,It is an essential part of any holistic rehabilitation programme. This was recognised early on by the team working in the Rehabilitation Institute. As a result, all patients will explore their employment potential with the team during their inpatient stay.

Suitable employment options will be very influenced by the culture of the community. Some need specific training programmes to learn the skills needed. With this in mind, research was done to explore the best options for people with physical disabilities. A residential programme was started close to the Rehabilitation Institute. A separate charity called the Mary Verghese Trust helps to run this.


Academic Activities

Education

Research

Academic Activities

Education

The Physical Medicine and Rehabilitation department offers a range of undergraduate and post-graduate training programmes. PMR also run many in-service training programmes.

Currently the following University accredited courses are offered:

You can learn more about these and other courses at CMC here: Education at CMC.

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Research

Research has been included in the activities of the PMR department from the early days. Initially the research activities looked at the comprehensive rehabilitation of paraplegics. In 1974-5 Dr Mary Verghese was awarded the P.N Raju Oration award by the Indian Council for Medical Research. This was for outstanding research in rehabilitation. She also got the Padma Shree, the first time this award was made for outstanding work in Rehabilitation of persons with spinal cord injury.

More recently our research has expanded to include work relating to

You can read about the projects done by our post-graduate students here: Post-graduate Research studies in PMR

So what stops us doing more research? The biggest challenge comes from the amount of clinical work to be undertaken. Patient care is important! Secondly, finance is usually needed to start major projects.


General Hospital Information

Booking Appointments etc

Details of how you can book an appointment, times and places for different tests, where the cash counters are etc is here: CMC Hospital Information Booklet.

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Other pages related to PMR

MVT: The Mary Verghese Trust

The Mary Verghese Trust is a charity based in Bagayam. It was set up by Dr. Mary Verghese, the founder of the Physical Medicine and Rehabilitation department. The trust provides training to people with a disability. It teaches people income-generating trades . So people learn how to do a job that will earn them money. The course is residential, so students stay at MVT while studying. There is a separate page relating to the MVT that you can visit, and it also features in the Vocational Rehab and Mela pages.

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Profile of PMR Department

Year Established

1962

First Head of Dept

Dr Mary Verghese


Paul Brand was the first consultant. He was also
the Head of Dept of Orthopaedics and
Principle of Christian Medical College, Vellore.

Present Head of Dept

Dr Raji Mathews

Doctors

15

Nurses in Rehab Institute

12

Allied Health Faculty

59 staff and up to 40 interns

Other staff inc.
social workers, clerks, attenders

35

No of Outpatients
appointments per year

over 60,000 (all units)

No of Inpatients
per year

over 650

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Working in PMR

Supporting Staff

In any organisation there are the people who everyone sees and recognises, but just as important are the people in the background who keep the organisation ticking smoothly over. In the PMR department these people include our attenders, secretaries, driver, medical record and you can see more of them on their page Supporting Staff

Current Staff

A list of the staff working in PMR is here: Staff In PMR - It is usually lagging behind as staff turnover is constant and so it is hard to keep up to date.

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Job Opportunities in PMR

Vacancies arise in the PMR department at regular intervals. Medical, OT, Physio, speech therapy, orthotics and prosthetic posts and internships are all handled by the principal's Office. Contact details below.

Contact Us

Contact PMR
Hospital Appointments

Contact Us

How to Book Appointments and Register

You can book online, post or visit the hospital to book an appointment. See Appointments for full details

Appointments and Registering by Phone

You can get most telephone extensions inside the hospital without the operators,

New and returning patients may book online.
Please note: You need to PAY by CREDIT CARD when you book the appointment online. All credit cards with the VISA emblem are now accepted.

Coming Back to CMC - Book Online

Patients coming back to CMC with a CMC hospital number can book appointments online. Payment is by credit card or the CHRIS card (CMC cash card).

Page: http://clin.cmcvellore.ac.in/index.asp#new

Job and internship enquiries

Enquiries about working as a doctor, therapist or nurse and internship enquires: please contact the principal's Office:

Email: princi@cmcvellore.ac.in

PMR Patient Enquiries

Patient care enquiries for PMR: please contact Dr. Debbie Skeil:

Email:

PMR Office Phones & Postal Addresses

The code for India is +91, the Vellore area code is (0)416. Simply dial 228 then the extension you need.
If you need operator assistance then dial 228 4000.

PMR Office Extension

Physical Medicine and Rehabilitation
Christian Medical College, Vellore. 632004. India

2158

Rehabilitation Institute
Christian Medical College, Bagayam. 632002. India


Main Office

4549

Nurses station ground floor

4302 / 4506

Nurses station, first floor

4580 / 4544

Eg Ringing Physical Medicine and Rehabilitation office from India:

0 416 228 2158

More detailed contact information is at Contact Us

Links

Links to the rest of the PMR web pages are in the column to the left. Hover over (mouse over / move the mouse over) the titles and see more information about the page . Then double click on the page you want.


We hope this information is accurate. If you have any information that may be useful or see any mistakes, please let us know.

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Last Edited Nov 2015

Department of Physical Medicine & Rehabilitation Website