Department of Physiotherapy

Physiotherapy is a health care profession with an emphasis on the use of physical approaches for the promotion of health and the prevention, treatment and management of disease and disability. 

In NISH, the Department of Physiotherapy has been in existence, since 2013. The Department  consists of a  Paediatric Gymnasium and  an Adult Rehabilitation  area. Both  units are well equipped, sophisticated and modern equipment have been installed which are calibrated periodically.

Key features  

• • Excellent infrastructure

  • Speciality clinics

  • Multidisciplinary and Interdisciplinary  environment

Core competencies  

• • Highly qualified faculty, certified in Theratog fitting, Assistive Technology, Kinesiotaping and Oral Placement Therapy.

  • Multidisciplinary and Interdisciplinary team approach in rehabilitation.

  • Individual and Group intervention (enhances social and peer  interaction)

  • Oral Placement Therapy - Level 3

The Department provides comprehensive Physiotherapy services for a wide range of conditions for both 

• • Children with  Global Developmental Delay,Cerebral Palsy, Chromosomal Anomalies, Seizure Disorder, Myelomeningocele, and other Neurodevelopmental Disorders.

  • Adults with neuro motor disorders,RTA , Spinal cord injuries, orthopaedic conditions.

Procedure in the Department

An initial assessment will be performed by Physical therapist followed by listing out the impairments (problems). Goals and therapy will be planned according to the individual’s need. The Intervention programmes will be aimed at improving or restore the mobility by focusing on the following areas: 

• • Facilitation of developmental milestones

  • Strength and endurance training

  • Postural correction

  • Balance and coordination training

  • Improving Joint mobility

  • Training  gross and fine motor skills

  • Oromotor training

  • Gait training

  • Improving respiratory functions

 Programmes and Units under Department of Physiotherapy 

Individual Training Program

An individualized intervention program is established based on the  initial evaluation and aimed at achieving specific goals of each client. The therapist designs a customized treatment plan, provides training and assistance to parents, and monitors and modifies activities based on the progress.. Outcomes are largely dependent on a client’s adherence to a specific exercise  and home training. The sessions are carried out on a weekly and monthly basis.

Sensory Motor Unit

In the sensory motor unit, the Physiotherapist and Occupational therapist puts a combined effort in formulating the intervention plan and adapts an interdisciplinary approach. Sensory motor intervention is a personalised activity plan that helps children access the specific sensory inputs  incorporated with motor activities they need throughout the day. Therapists adopt  various methods to assist the child in generalizing the effects into play, activities of daily living, and school tasks.

 Cerebral Palsy Unit

The Cerebral Palsy Unit follows an integrative approach in assessment and intervention  of children with cerebral palsy and ensures long-term results. Physiotherapists and occupational therapists focus on encouraging a person’s day-to-day movement skills such as sitting, walking, playing, dressing and toileting. The unit helps to prevent impairments that might affect movement with a  range of specialist interventions such as neurodevelopmental treatment,dynamic compression system application, PNF techniques, timely prescription of assistive devices and training to use the various devices.. The duration of a rehabilitation training is about four to six months. One parent is allowed with the child for the entire duration of the rehabilitation program and is instrumental in assuring continuity of treatment at home.

Adult Rehabilitation (Rehab) Unit

A multidisciplinary team composed of  professionals from a range of disciplines (physiotherapy, occupational therapy, speech language pathology and psychology) work together to deliver comprehensive care that addresses as many of the patient's needs as possible.

The team combines their skill sets to tackle complex and challenging outcomes of neurological impairment. The multidisciplinary team meets regularly to discuss their work with individuals so that each patient has a care plan best suited to their individual needs.

Oral Sensory and Motor Unit

Oral Sensory and Motor Unit offers a comprehensive interdisciplinary service to children with feeding and speech difficulties. The team approach provides an extensive approach with in-depth assessments, interventions and recommendations. The team comprises of:

1. Physiotherapist: Works on postural management, proper respiration, muscle strengthening ,joint mobility and oro motor training.

2. Speech language pathologist: Supports the development of speech, language and communication skills in children.

3. Occupational Therapist: Assess the child's feeding skills, motor skills, sensory skills, strength, as well as the behaviour and environmental factors surrounding mealtime. Following this, the occupational designs a plan to ensure that  the child is reaching their full potential with self-feeding, independence and safety.

Occupational therapy is a health profession concerned with promoting health and well-being through engagement in occupation. Occupational therapists use careful analysis of physical, environmental, psychosocial, mental, spiritual and cultural factors to identify and remove barriers to participating in occupation.

At NISH, the Department of Occupational Therapy started functioning in the year 2015. Occupational therapy services are delivered as a part of the rehabilitation programme which provide services for individuals from early childhood to the elderly population.

Conditions that benefit from Occupational Therapy include:

• • Autism Spectrum Disorders

  • Learning Disorders

  • Neurodevelopmental Disorders

  • Intellectual Disability

  • Chromosomal Anomalies

  • Cerebral Palsy

  • Feeding and Swallowing disorders

  • Stroke

  • Traumatic Brain Injury

 Occupational therapy goals are set to enhance the following skills and activity participation:

• • Activities of Daily Living

  • School readiness skills

  • Handwriting skills

  • Sensory integration

  • Motor planning and praxis

  • Bilateral Integration skills 

  • Balance and coordination skills

  • Visual motor and visual perceptual skills

  • Facilitation of developmental motor milestones

  • Fine motor skills.

  • Play skills

  • Community re-integration

Speciality clinics - Occupational Therapy Outpatient Department (OTOPD) 

• • Paediatrics Occupational therapy OPD (including Sensory integration unit) 

  • Orthopaedics Occupational Therapy unit  

  • Neurological Occupational Therapy unit 

  • Mental Health Occupational Therapy unit (Group therapy for De Addiction & Vocational & Pre-Vocational Rehabilitation for Psychiatric patients) 

  • OT Dysphagia unit 

  • OT Hand/Splinting unit

  • OT Seating & mobility unit 

Occupational therapy services include:

1. A detailed evaluation carried out using standardised and non-standardised tools and clinical observations to determine a baseline of the client’s functional performance.

2. Interventions tailored specifically to the individual, which incorporate therapy programmes, recommendations and strategies. All these are provided involving the family members.

3. Recommendation of adaptive aids, Assistive Technology and orthosis.

4. An outcome-based re-evaluation carried out in regular intervals.

Occupational therapy Intervention focuses on enabling people to participate in their activities of everyday life. Occupational Therapists help them improve their ability to engage in activities they want to, need to or are expected to, through remedial activities or by modifying the activity or the environment to better support their engagement (WFOT,2012)

Highlights

• • Interdisciplinary model

  • Client-centred and family-oriented

  • Positive outcomes for children and families.

  • High parent satisfaction and engagement

  • Positive outcomes for staff

Intervention programs provided at the OT department:

Individual Training Program

The therapist designs a customized treatment plan, provides training and assistance to parents during the handling of children by therapist, and monitors and modifies activities based on the progress. The sessions are carried out on a weekly and monthly basis.

Sensory Integration Unit

Sensory integration therapy aims to help children with sensory processing disorder.  After assessment using standard tools, a plan is designed involving therapeutic play which is multi-sensory to help the child gain appropriate adaptive responses and skills. Therapy is carried out as an individual session until the child is ready to mingle in a group. Parents are also accompanied so as to train them to cater the needs of the child.  A multi-sensory room is built at NISH with specialised sensory equipment such as various swings, a ball pool, textured mats, Audio-visual unit and toys. 

Cerebral Palsy unit

Cerebral Palsy Unit follows an integrative approach in assessment and intervention of children with cerebral palsy and ensures long-term results. An initial assessment is carried out involving a team of Occupational therapists, Physiotherapists, Psychologists and Speech Therapists. 

Children are then moved to various groups (Toddler unit, Intensive Training Program, CP unit) based on the needs of the child and feasibility of family members.

Group training is focused on training parents to handle the child through exercises, positioning and assistance in Activities of Daily Living.

Whenever needed, therapists help prescribe orthotic and adaptive devices for the child.

Recent advancements are implemented such as Thera togs, Kinesiotaping, Headpods and Virtual-reality games. One parent is allowed with the child for the entire duration of the rehabilitation program and is instrumental in assuring continuity of treatment at home. 

Adult Rehab Unit

The Adult Rehab unit caters to the needs of individuals above the age of 18 who survived cerebro-vascular accident (stroke), traumatic injury. Various activities to improve their hand function, functional abilities and maximise their independence in both basic and instrumental ADL are provided under the guidance of both Occupational and Physiotherapist.

SCORE (Sensory, Cognitive and Rehabilitation Unit)

Sensory, Cognitive and Rehabilitation Unit adapts an interdisciplinary group therapy approach, combining the expertise of the Physiotherapist, Occupational Therapist and the Psychologist. Group aims to improve the cognitive skills, adaptive responses, motor skills and socio-emotional skills through the use of various activities and therapeutic play. Group meets every week.

Oral Sensory and Motor Unit

Oral Sensory and Motor Unit offers a comprehensive interdisciplinary service by the Occupational, Physio and Speech Therapists to children with feeding and speech difficulties. The team approach provides an extensive service with in-depth assessments, interventions and recommendations. 

Occupational Therapists in the team assess the child's feeding skills, motor skills, sensory skills, strength, as well as the behaviour and environmental factors surrounding mealtime. Following this, the Occupational Therapist designs a plan to ensure that the child is reaching his/her full potential with self-feeding, independence and safety.

Mental Health Unit

Mental Health Unit focuses on enabling individuals to re-engage in meaningful occupations through a variety of skill sets such as skills development, establishing positive habits and routines, setting therapy goals, using MOHO (Model of Human occupation).

OTs work with clients and their loved ones to improve these and other life management skills:

• • Creating and following a productive daily schedule

  • Taking care of personal hygiene

  • Managing one’s own health

  • Navigating the community and using public transportation

  • Organizing and following a medication regimen

  • Interacting appropriately in work or social situations

  • Working or volunteering

  • Planning and cooking healthy meals

  • Managing budget and finances

A variety of techniques for a diversity of issues have been employed in mental health occupational therapy. These include as follows:

• • Behaviour therapy,

  • Cognitive behaviour therapy,

  • Psychoanalytical,

  • Motivational enhancement therapy

  • Group therapy

  • Humanistic and client-cantered therapies

Group Therapy

Specific for children with difficulties in specific areas of development and adults with impairments in various areas. After assessment using standardised tools, clients are enrolled into the appropriate groups. Various therapeutic activities targeting a range of goals are implemented. 

Adaptive and positioning aids are recommended whenever necessary.

Various groups at Occupational Therapy:

• • Handwriting / Visual motor Group

  • Sensory Motor Group

  • Play Group

  • Visual Perceptual Group 

  • Evaluation Group

  • Thematic group

  • Topical Group

  • Task Oriented Group

  • Developmental Group

  • Social Skills Group

  • Assertiveness Group

ENT Services

An ENT doctor is an essential team member in the identification and rehabilitation of speech and hearing disorders. The department of ENT offers medical intervention for otological as well as speech problems, helps to identify candidates for hearing aid fitting and cochlear implantation and provides appropriate referrals if needed. ENT department extends services in conducting Stroboscopy and Vestibular evaluations. Interdepartmental projects and academics for the ASLP students are also carried out at the department. Various Certificates for availing medical reimbursement, driving licenses for the hard of hearing candidates and other medical certificates are also issued by the ENT doctor.

• ENT consultation time is from 9.30 to 12.00 from Monday to Friday.

• Consultations are based on prior appointments.

• Individuals who want to procure a certificate for license purposes have to:

1. Undergo a  complete audiological evaluation at NISH.

2. Undergo Hearing aid trial and fitting if not eligible for license without getting aided.

3. 2 passport sized photos, age and address proof ( SSLC or equivalent certificate, disability certificate), should be brought by the desired candidate.

• For other certificates, the candidates have to bring the appropriate documents.

Nursing services

Full time nursing services are available for staff, students and patients. The nursing personnel ensures health promotion, prevention of diseases by conducting health awareness programs, screening camps, providing health education, etc. First aid for various medical emergencies, sedation dose administration for children undergoing various hearing tests are included in the nursing services. The nurses work together with the ENT doctor in the patient care services.