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Department of Physical Medicine & Rehabilitation Website


Rehabilitation Institute

Introduction

History

Admission to Rehab

Team Care

A Year in Rehab

Follow up

front of the new Rehab with 2 floors

The Rehab Institute, CMC, Vellore

Community care

Poor Patients

New Horizons

Would you like to help?

Links

Contact Us

Introduction

This page is dedicated to describing the Rehabilitation Institute at the Christian Medical College, Vellore. Rehab, as it tends to be called, is the inpatient or residential rehabilitation facility for the department of Physical Medicine and Rehabilitation.

The Rehabilitation Institute is based at the college campus site in Bagayam, 5 km from the main hospital site. 2005 saw the completion of the expansion of the Rehab facilities so there are now 82 inpatient beds here, which form the core of the rehabilitation beds. Patients can be transferred here from the hospital once they are medically stable and a bed is available.

2 men lying on their fronts and a lady sat in a wheelchair

Patients meeting informally
in front of the Rehab Institute.

The two men on the left are
on "prone trolleys"
- used to allow the patient
to get around but also to help
pressure sores on the back to heal.

The majority of inpatients have suffered a spinal cord injury e.g. by falling out of a tree, or from a road traffic accident.

With the increase in the number of beds, PMR has been able to dedicate 15 beds to form a service dedicated to treating brain injury.

These beds will be for inpatients who have had a stroke or head injury and need inpatient rehabilitation. The average length of stay for all inpatients is 6 weeks, but can range from one week up to six months.

There is also a Prosthetics & Orthotics (P&O) Laboratory at the Rehabilitation Institute. Prosthetics are artificial limbs and orthotics are devices to help support/protect the body like splints or crutches. The laboratory is used for the research of new prosthetics and orthotics and to make prosthetics and orthotics for inpatients in the Rehabilitation Institute. The International Committee for the Red Cross (ICRC) has been extremely supportive in helping us to equip this for the fabrication of ICRC prostheses (limbs) and for training P&O students. These limbs are plastic and modular i.e. the pieces are ready made and can be taken off a shelf and fitted together (except the socket). This makes them light, because of the plastic, and quick to make, because they are modular.

More details of life in the Rehabilitation Institute can be seen in the

Rehab Institute photo album

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Rehab History

black and white photo of a man with a spade, lady in wheelchair and others standing

Turning the first sod:

From left to right. Dr. Paul Brand,
Moyna Gordon (Parker),
Dr. Mary Verghese,
Daniel, Rehab Aid to Dr. Verghese,
& Alex S Talaiver, first in charge
of the Rehab Institute
physiotherapy services.

In the Annual Report for 1964-1965, Mary Verghese wrote: "February 18th was a memorable day since we were fortunate to get Dr. Paul Brand to turn the first sod of the Rehabilitation Institute at College Hill"

The Rehabilitation Institute was dedicated on the 29th of September 1966. Dr. Susheela Nayyar, Union Minister for Health and Family Planning officially opened it on the 26th of November, 1966. The first patient was admitted on the 2nd of January, 1967. To begin with the Institute had two rooms that would admit 16 general ward men patients and had two double and two single rooms to admit private patients. 5 beds for women were added to the Rehabilitation Institute the next year. A more detailed history of the Rehabilitation Institute can be found on the web page celebrating the 25th anniversary of the Rehabilitation Institute in 1991.

You can read some excerpts from the Silver Jubilee Publication printed to celebrate this in:

Silver Jubilee 1991: Rehabilitation - A Shared Vision

2005 saw the completion of the next major developments for Rehab as new patient facilities were completed. Two new units were dedicated

The Margaret and Paul Brand Spinal Injury Rehabilitation Centre

and the

Canon David Marriott Acquired Brain Injury Rehabilitation Centre

These were accompanied by more general and semi private beds plus new private beds. Kitchens are now available for patients and their families. Each ward area has a new bathroom and space to store wheelchairs and prone trolleys. A new theatre and theatre preparation (scrubbing room and sluice) allow the doctors to perform more complex surgery in Rehab. There are also more therapy treatment areas to treat the increased number of inpatients along with dedicated rooms for speech therapy, psychology and the doctors and more.

Some more information and pictures of the new rooms can be seen on New Improved Rehab Institute Facilities .

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Admission to the Rehabilitation Institute

Patients are admitted to the Rehabilitation Institute once they are medically stable. Admissions are after Outpatient Department assessments or transfers from the Physical Medicine and Rehabilitation beds in the hospital. Any body wishing to be assessed for admission should make an appointment to see the doctors in the Physical Medicine and Rehabilitation Outpatient Department at the hospital, registration is before 11am on Monday, Tuesday, Thursday and Friday.

More details of how the hospital works will be on the CMC website when it is finished. We will give a more detailed link later. Here is the main site CMC Vellore - Hopsital website

Team Care: Multidisciplinary treatment

A multidisciplinary team provides care for the patients in the Rehabilitation Institute. A little about each of the team members activities within the Rehabilitation Institute is described below (in alphabetical order), with more detail available in the web pages dedicated to each section in the links provided.

Further details relating to patient practicalities can be found in Patient Information

Doctors: medical services

The doctors provide the medical services for the patients in the rehabilitation institute. When patients first arrive the doctors will see them, ask some questions about their disability and then examine them. Medicines and tablets are prescribed by the doctors who also order any tests or investigations needed such as blood tests.

Further information on the doctors activities and how to see them in outpatients on the Medical services page.

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Movement Analysis Laboratory

The movement analysis laboratory (often called the "gait lab") is also situated within the Rehabilitation Institute buildings. The staff supply services to inpatients and outpatients in the hospital and the RI. The gait lab have also benefitted from new rooms with a larger office and laboratory. The old lab was painted black but a new system has allowed this to be changed to white making it seem much light and bigger.

For more information see the MAL "Gait Lab".

Daisy sat at her desk in her white nurses sari

Sr Daisy in the
Nurses Station in Rehab

Nursing

The nurses are the only staff present in the unit 24hrs a day and 7 days a week. They are the staff that can ensure continuity for the patients. Initially, they train the patient"s carer in how to look after the patient and as the patient is able they then help the person to become as independent as possible. They also monitor the patients medical state eg measuring pulse and blood pressure, give out tablets/medicines and dress wounds.

For more information see Nursing

Occupational Therapy

The occupational therapists (OTs) work with most of the patients. For people with Spinal Cord Injury, the OTs teach them how to transfer from one place to another e.g. from a chair to the bed, or floor to standing. They also teach self caring skills such as dressing, washing, cleaning teeth, and extended Activities of Daily Living (ADL) such as cooking, shopping. Employment is an important part of most people"s lives and the occupational therapists will help to train people to return to their work whenever possible. The occupational therapists are also involved in making peoples homes and work places accessible e.g. by showing how adding a rail can help someone to climb stairs and giving instructions on how the rail can best be installed.

For more information see Occupational Therapy

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Pharmacy

Pharmacy services are provided within the Rehabilitation Institute for a limited period of time most days of the week. A new pharmacy and cash payment counter are now available. Mr. Ramesh has continued to work as the Pharmacist. During the year, 2,840 (2,612) prescriptions were dealt with and 8,028 (7,328) drugs were dispensed.

Young man lying on his front supported by the physio

Physiotherapists working
with this young man,
who has cerebral palsy.

Physiotherapy

The physiotherapists (PTs) work with most of the patients in the Rehabilitation Institute. They concentrate on improving balance and walking. Many people with low level Spinal Cord Injury e.g. below T10, can learn to walk with the help of long leg callipers (KAFO"s) and crutches. It takes a lot of training, hard work and dedication to do this but it can be done. Part of the training will include strengthening the muscles used and increasing the range of movement of the joints involved in walking.

When someone first has a Spinal Cord Injury from a broken back, they have to stay in bed until the bones are strong enough to allow sitting/standing. This takes about 3 months. When they first start to sit up patients often feel very dizzy. The tilt table, shown below, is used to allow the person to go slowly into the upright position. Some people with high-level lesions continue to use the tilt table for standing – to stretch out joints, and to help reduce spasticity.

More information here: Physiotherapy

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Prosthetics & Orthotics

prosthetist knelt by a patient who is stood in parallel bars with his artificial limb on

Prosthetist checking
the fit of a newly
made ICRC limb
in the P&O workshop.

The Prosthetics & Orthotics (artificial limbs and splints) workshop in the Rehabilitation Institute is much smaller than the one in the hospital and usually has about 3 prosthetists working in it. One of the aims of the Physical Medicine and Rehabilitation department is to develop Prosthetics & Orthotics (P&O) suitable for the Indian economy, which usually means adapting equipment available in the West so it is made with components readily and cheaply available in India.

The workshop is the Rehabilitation Institute is used for this development process and to make the International Committee for the Red Cross (ICRC) limbs. The workshop can also make Prosthetics & Orthotics for in-patients in the Rehabilitation Institute; this saves the patients and their families from travelling to the hospital for measurements and fitting. It also allows better communication between the Prosthetics & Orthotics staff and the rest of the team.

More information on the P&O page

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Social Work

There are several social workers in the Physical Medicine and Rehabilitation department and they all work in the Rehabilitation Institute. They are involved with the inpatients; helping them to adjust to the disability they have newly acquired and helping them look to the future and consider suitable employment. The social workers are also involved in community work, visiting former patients of the institute, who live within a hundred mile radius, to see how they are doing. They always go on the monthly community visits but also sometimes they go on their own. The social workers also co-ordinate the training of people with disabilities in the Mary Verghese Trust.

The philosophy of rehabilitation is to help people fulfil their normal roles in society; to be involved in family activities and decision making; to be active within the community; to give to society rather than be a passive recipient. Patient participation is one way that people can experience this within the Rehabilitation Institute. The social workers play a key role in facilitating such participation.

Follow these links for more information on the Social Work and Vocational Rehab

front cover of a magazine with a picture of deer and tamil writing.

The Rehab Murasu,
a newsletter in Tamil

Patient participation and education

The "REHAB MURASU", a free newsletter in Tamil, was circulated to the rehabilitated patients who are in the follow-up network. We owe a debt of gratitude to Mr. Suresh, our volunteer artist, who is himself physically challenged by Muscular Dystrophy, who assisted in the publication of this issue by organising the printing of greetings cards drawn by patients. The patients are also encouraged to help organise celebrations within the Rehabilitation Institute by manning stalls at the Divali Fete, or selling entrance tickets to visitors to the Pongal Festival.

Our video patient-education unit has continued to enhance our ability to teach rehabilitation concepts and skills to our patients who come from different language backgrounds, from all over the country. This resource, however, needs to be expanded and improved.

The PATIENT"S LIBRARY in Rehab has been functioning regularly and we are grateful to Mr. Charles, Volunteer Librarian, who makes this service possible.

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Speech Therapy

Not all of the patients in the Rehabilitation Institute need to see a speech and language therapist so the therapists work both in the Rehabilitation Institute and the hospital. They work with children with cerebral palsy who have problems pronouncing words and finding the right words to say. They can also work with adults who have acquired speech problems. This can happen after various forms of brain injury, so there are likely to be more patients requiring speech and language therapist once the second floor of the institute is built and more patients who have had a stroke (cerebrovascular accidents) or traumatic head injury are admitted.

Speech and language therapists (SALT) also work with people who have difficulty swallowing their food. If food is not swallowed properly there is a risk that food may go into the lungs. This can cause choking and sometimes severe chest infections. They are able to assess what is the safest type of food to eat and teach ways to swallow that are safer. For example food of mixed consistency e.g. soups that are liquid with solid bits in it are very hard to swallow. Also thin liquid is harder to control and swallow safely than thick liquids. So the speech and language therapists will advise avoiding some consistencies and instead taking thick liquids such as thick kunjee ("porridge" made out of rice or wheat).

For more information see: Speech Therapy

Supporting staff

There are many other staff working in the Rehabilitation Institute who constitute the support staff. They include attenders, the Rehabilitation Institute van driver, multipurpose workers, security guards, stenographers and sweepers.

Together they ensure the smooth running of the Institute by keeping it clean, transporting staff to and from the hospital, keeping the patient bills up to date and supplying discharge summaries for those ready to go home.

Read more about them here: Supporting Staff

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Staff in the Rehabilitation Institute

The details of staff working in the rehab Institute are now available on a separate web page: Staff in PMR

A Years Activity in Rehab

Dr. Jacob George, Lecturer, has been in-charge of the Rehabilitation Institute for the past year. Sr. Daisy, Sr. Margaret and her team of Nurses and supporting staff have been efficiently caring for and enthusing the patients in the Rehab Institute.

>lady doctor standing and preparing surgical equipment

Dr Raji Preparing
for a Cystoscopy

During the year, 208 (223) cysto-urethroscopic evaluations (cystoscopies) of patients with neuropathic bladders and 332 (389) diagnostic ultrasound examinations of the urinary tract were performed on our patients. Joint urodynamic studies with Dr. Sudipta Sen, Paediatrics surgery, are conducted every Saturday and 163(232) Urodynamic assessments of neuropathic bladder were performed.

A cystoscopy is a minor operation which can be done in the Rehabilitation Institute without the need for a general anaesthetic, as the paralysed patients have no sensation. These are done weekly at the Rehabilitation Institute and also during the Mela.

Follow up after Rehabilitation

Follow up for patients who have completed their rehabilitation programmes is provided in several ways. Medical follow up is provided through the PMR Medical outpatient services. People from all over India attend here for review and to plan any further investigations or treatments that are needed. Patients within 100km of the Rehabilitation Institute are able to attend the Rehab Mela. This annual event provides medical, therapy and social follow up – and a whole lot more! The Social Work and multidisciplinary team also provide some follow up in the local community.

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Community based care

Mr. Guru Nagarajan, Social Work, and his team, work with the Rehabilitation Institute team to enable us to serve the poor effectively. During the year, they visited 93 (98) severely disabled patients" homes to do a preliminary assessment of their home environment for appropriate planning of their rehabilitation. In addition to 114 (116) follow-up visits, which they did on their own, they organised the monthly follow-up by the rehabilitation team when the patients" health and social conditions were re-evaluated in detail.

The World Health Organisation funded a project on Community based rehabilitation (CBR) for 2001-2, which is being conducted along with the Low Cost Effective Care Unit of this hospital. The initial work went well and further funding from WHO and the department has allowed the project to continue. The social workers in the Rehabilitation Institute play a pivotal role in this new service: Two Social workers, one Psychologist and One Prosthetist/Orthotist were appointed for a two period which has now been completed. Nine urban slums of Vellore town were identified to implement this CBR project. One volunteer, who is called a Local Supervisor and is committed to working with people with disabilities, has been identified from each of these nine slums. The volunteers received training and now work with disabled people in their community. The CBR project is continuing with financial support from within the PMR department and donations from outside.

Details can be found here: CBR.

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tariff

The cost of treatment in the Rehab Institute can be seen by going to the CMC hospital information pages: PMR inpatient service tariff.

Support for poor patients

36 (42) patients were rehabilitated with the assistance of the Person-to-Person scheme and we wish to place on record our gratitude and appreciation to the PTP committee for their generous assistance. We also express our gratitude to all our friends from far corners of the world that help us by sending used stamps, which are cleaned and arranged in packets by the patients. The Table below summarizes the details of the various economic assistance programmes carried out this year.The Social Work page has a table depicting the income generation provided for Rehab patients.

The project entitled "Vocational Rehabilitation of Severely Disabled Adults" is continuing, thanks to Mrs. Susy Koshi and the MVT:
Mary Verghese Trust
for allowing us to use their premises for housing the trainees on this project and for providing funds for their food, training and equipment. 7 (17)  persons with severe disability were trained in Tailoring and 7 (10) in Bicycle repair. Following that they were provided with equipment to continue their vocation in their village.

Training for Book binding, Stove repair, Umbrella repair, Repainting of cycles, Embroidery picture work have been offered to the interested candidates along with their main trades. When possible, further training is offered to ex-trainees when the need is identified.

More details here: Vocational Rehab.

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New Horizons for the Rehabilitation Institute.

We wanted to double the number of beds available at the Rehabilitation Institute. There were not enough beds available to treat patients who needed to be admitted for inpatient rehabilitation. We have now finished the expansion and increased the beds to 82. Sadly they are now full and a waiting list has started to form again, for which we are very sorry. Patients have to wait at home or in other hospitals until a bed becomes available. During this time, some develop complications which then require surgery, lengthen their period of rehabilitation or may even cause their death.

If you would like to read more about these plans for development please see the page New Horizons.

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Would you like to help?

The extension for the Rehabilitation Institute was/will be funded by charitable contributions, a loan was taken to allow it to be built and over 50% has already been paid off. If you would like to support this you can donate money through any of the following organisations: (Please state that the donation is for PMR and what, if anything, you would like the funds used for. The Rehabilitation Institute Extension fund is 13R110.)

Within India

Bankers Drafts can be made payable to "The Treasurer, CMC, Vellore"
and sent to:

Dr. Suranjan Bhattacharji
Professor & Head, PMR. Department
Christian Medical College, Ida Scudder Rd, Vellore. 632004. India.

Email: pmrcmcv@gmail.com

Elsewhere in the World

Addresses for Friends of Vellore organisations around the world
can be found on this page: Friends of Vellore Addresses

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Job Opportunities in PMR

Vacancies arise within 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.

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 - double click on the page you want.

Contact Us

How to Book Appointments and Register

You can phone, post or visit the hospital to book an appointment. See PMR Contacts 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 phone the Appointments Call Center any day, at the time shown below.
Please note:You need to PAY by CREDIT CARD when you book the appointment by phone. All credit cards with the VISA emblem are now accepted.

Day Time Telephone

Monday - Friday

7 am to 9.30 pm

0416 228 8000

Saturday

7 am to 7 pm

Sunday

10am to 2pm

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

Eg Ringing Physical Medicine and Rehabilitation office from India:

0 416 228 2158

More detailed contact information can be found at Contact Us


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 Sept 2010

Department of Physical Medicine & Rehabilitation Website

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