Proposed for Ability Regional Rehabilitation center

(Centre for Spine & Head Injuries and Other Orthopaedic conditions)

 

There is an increasing population with complex rehabilitation needs which needs a Consultant led Multidisciplinary team with different skill sets to address various aspects of patient care includes:

  • Rehabilitation Consultant
  • Nurses
  • Physiotherapist
  • Occupational therapist
  • Speech and language therapist
  • Psychologist
  • Orthotics and assistive technology/ Seating
  • Gait scientists
  • Dietician
  • Social worker
  • Charity organisations
  • Neurologists/ Neuro surgeons /plastic and Orthopaedic surgeons, Urologists

 

The type of patients needing complex rehabilitation typically include:

  1. Spinal cord injuries- Trauma, infections, tumors leading to paralysis of lower+/- upper limbs.
  2. Complex neck and low back pain management
  3. Acquired brain injury- Stroke, Trauma, Infections, tumors, neuro degenerative conditions, Hypoxic brain injury.
  4. Complex multi trauma patients with Musculoskeletal +/- spinal +/- brain injury.
  5. Single or multiple Limb Amputations, Congenital limb deficiencies in children.
  6. Cerebral palsy, Polio, Learning disabilities.
  7. Severe Heart and Lung conditions needing rehab.

 

Problems with the above patients usually include a varied combination of:

  1. Complex pain issues – Musculoskeletal/ Neuropathic pain
  2. Spasticity (Tightness) and contractures of limbs
  3. Bowel problems
  4. Bladder problems
  5. Bed sores
  6. Depression, anxiety, loss of self-esteem and confidence
  7. Social isolation and Loss of job/ earnings
  8. Loss of mobility – wheel chair or bed bound
  9. Loss of independence with daily activities like dressing, washing , feeding
  10. Sleep problems
  11. Swallowing and speech problems with communication issues
  12. Increased risk of falls leading to further injuries
  13. Cognitive deficits – learning, behaviour, memory problems
  14. Burden on carers / family for care and livelihood
  15. Being Vulnerable to physical and mental abuse

 

What the service can offer to people:

  1. Complex chronic back pain management – Physiotherapy, Caudal Epidural injections, facet joint injections, Medial branch blocks, Functional rehabilitation programs and adjunctive therapies like Acupuncture, TENS, Ultrasound therapy, Massage, Osteopathy.
  2. Spasticity (Muscle tightness) management – Physiotherapy, Pharmacological agents and therapeutic titration, Botulinum toxin injections, Phenol injections, Intrathecal Baclofen pumps and Orthotics, FES (Functional electrical stimulation) and Assistive technology/ Environmental controls. Surgery for soft tissue contractures causing deformity/ pain, mobility problems.
  3. Bowel incontinence – Bowel regimes, Bowel irrigation systems, Colostomy procedures.
  4. Bladder incontinence – Intermittent self catheters, Urodynamics, Ultrasound KUB, Suprapubic catheters, Bladder wall Botox injections, Urology input.
  5. Bedsores – Skin and wound care, nursing, plastic surgery procedures.
  6. Depression and anxiety – Counselling, Cognitive behavioural therapy, Pharmacotherapy, family counselling.
  7. Loss of mobility – Physiotherapy, wheel chair and complex seating, electric scooters, stair lifts, transfer aids, wheel chair friendly vehicles.
  8. Swallowing and speech problems – Swallowing assessments, diet consistency, PEG Tubes, speech training, assistive devices for speech impairment.
  9. Cognitive/ behaviour problems – Psychology, cognitive therapy, risk assessments.
  10. Vocational rehabilitation- Finding alternative ways of employment / livelihood to sustain family and earnings in collaboration with other support agencies.
  11. Congenital limb deficiency in children – Prosthetic solutions and rehabilitation, school and home support.
  12. Cerebral palsy/ Learning disability – Surgery, Orthotics, seating and wheel chairs, Physiotherapy, Occupational therapy, Family support and counselling, Special schooling.
  13. Amputations- upper and lower limbs – Prosthetic solutions, Physiotherapy Rehabilitation, Revision surgeries as needed – Plastic surgeons/ orthopaedics.

 

How we can achieve this?

  1. Inpatient service with a purpose built building with wheel chair and lift access
  2. Space for 50 beds with separate wards for men, women and children
  3. Clinic and admin/office rooms
  4. Gym Equipment for physiotherapist/OT
  5. Basic medical equipment
  6. Space for 20 lower therapy beds for Active Rehabilitation Unit.
  7. Accessible Swimming Pool for Hydrotherapy services.
  8. Open Space for wheelchair Basketball, Rugby, Other sports and Games.
  9. Closed Space for Indoor activities like Wheelchair skill training, dance, etc.
  10. Garden space for outdoor rehabilitation activities.
  11. Transit House (Temporary house setup before discharge)
  12. Dormitory for patient’s attender night stay.
  13. Community kitchen for cooking their own food by the caretakers.
  14. PMR Specialist, Physiotherapists, Occupational therapists, Speech and language therapists, 1 Psychologist, Nursing staff, Peer counsellor, Active Rehab Consultant, Health care workers and management /admin support.
  15. Artificial Limbs and Appliances Fitting Centre-Prosthetist & Orthotist
  16. Assistive Technology Centre- Rehabilitation Engineer Technologist (RET)
  17. Wheel chair accessible vehicle and driver
  18. Accessible Canteen
  19. Vocational Training Institute
  20. Social workers-for networking & Advocacy
  21. Teaching and Training material to train health personnel and community workers.
  22. Audio-Visual aids / equipment for community awareness.
  23. Close working links with charities, Government, Hospitals.