September, 1957 P H Y S I O T H E R A P Y Page Thirteen

PHYSIOTHERAPY -  THE W ORM S EYE VIEW
By J. B. ODAMS

My  title is not m eant to  im ply th at in the hands o f a physiotherapist th e  patient feels like som ething that 
“crawled from  under a stone” , but rath er th at th e  writer is, 

a n d  has been, a patient undergoing physiotherapy. Eighteen 
months ago I married a physiotherapist, and six m onths ago 
I was attacked by polio, and so I am  no new convert to  the 
creed; and yet, w hat can any enthusiastic am ateur hope to 
be able to  tell th e professional physiotherapist about her 
occupation — probably nothing th a t she has not heard 
before. I thought, however, th at it might be useful to  talk 
about the psychological approach o f th e  physiotherapist to 
her patient, and the effect each type o f approach has on th e 
patient. I have no doubt th a t this subject crops up m ore than 
kjnce in th e physiotherapist’s training and it m ight be useful 
Tf my own experiences bear out what is taught during that 
training. I realise, o f course, th a t the physiotherapist’s 
approach must depend upon th e age and th e m ental equip­
ment of th e  patient w hom  she is attending. I  have seen a 
great deal o f success gained with children between the ages 
of two and six when the physiotherapist m akes o f their 
exercises a game; they are to  be a train. T he legs open wide 
like the carriage doors and all the people get in ; th e legs then 
start pumping slowly and the train pulls away from the 
platform ; faster and faster it goes until it reaches the next 
station where the sam e perform ance is repeated, as the 
people get out and th e doors close and th e train moves on to 
its destination. I have also heard experienced physiothera­
pists who claim th at children m ust be treated in an adult 
fashion, must be m ade to  realise th a t th e  exercises th a t they 
are doing are serious, and any elem ent o f play th a t is intro­
duced is nothing m ore than a relaxation. I do not, however, 
wish to discuss or criticise such points as these, for I feel that 
the only value th a t this article can have , comes from  its 
subjective approach, its account o f my own experiences.

Now I am  very glad to  say th a t I have never been bullied, 
but I am  told th at there are cases where th e patient has, 
perhaps, given up hope and where it is psychologically 
necessary th at they be bullied before any work at all can be 
extracted from them . M ay I be bold enough to  suggest th a t 
this should be a last resort for th e physiotherapist. T he 

-immediate result which it would have on m e — speaking 
jlersonally — is to  m ake m e “ dig my toes in” metaphorically, 
,and become extremely obstinate. It is a rather unfortunate 
fact that a patient, after some tim e in hospital, acquires a 
morbid enthusiasm for, and interest in his own symptoms 
and weaknesses. T he physiotherapist has my co-operation 
who makes capital out o f this hum an failing. I f  she explains 
precisely what muscle is making what m ovem ent and what 
each movement is designed to exercise, she im mediately has 
me contem plating my own body, a thing which I  have been 
doing for some weeks already while lying in bed. This, then, 
is my main thesis. Given a patient o f average m ental ability 
over the age o f six, co-operation can be coaxed from him, 
even against his own will, in this way.

W hen will this co-operation wear thin ? In  a p atient with 
only slight paralysis, or paresis he will be cured before his 
enthusiasm has w an ed ; but if paralysis o f one type or another 
has a firm grip, the p atien t’s co-operation and interest may 
begin to wane after sam e weeks, when m iraculous im prove­
ments which he had expected are not forthcoming. There 
seems to  com e now a period between the early enthusiasm 
and final realisation and resignm ent to a long, slow recupera­
tion, a rath er hopeless tim e when, as far as the patient can 
see, nothing is doing him any good. D uring this middle 
period three things especially helped me. First o f all my

attention was constantly being drawn by the physiotherapist 
to  all the small new achievements, which in th a t state o f 
mind would probably have gone unnoticed. Also, it was 
constantly impressed upon m e how slow a polio affected 
muscle is to  improve, until the idea finally settled with me 
and became p art o f my make-up. A nd finally, an elementary 
point perhaps, my exercises were changed at th a t stage and 
it was surprising how  this stim ulated my interest. Some of 
the changes were co-incidental, others were contrived by the 
physiotherapist; som e were m ade possible through my 
emergence from  th e iron lung on to  a bed; others were 
different exercises which moved the sam e muscles as had 
been w orked for the past twelve weeks; but this semblance 
o f a change was much better than a rest.

And now there is quite an adventure ahead until I can 
start working a g a in ; an adventure involving a new car with 
hand controls, the choosing o f a wheel chair, the building of 
a G uthrie-Sm ith bed fram e for our hom e, and m any other 
things which will assure my continued interest and co­
operation with the physiotherapist, even if she is my wife.

MISSING PERSONS
Miss Frere, formerly o f Jane F urze Hospital.
Mrs. K elfkens, form erly o f R oodepoort, Transvaal.
M rs. K itson, form erly o f Johannesburg.

Deliverance
/ro w  pain . . . .  the humanitarian function of 
of the practitioner . . . .  now accomplished 
with greater speed, more economy and with a 
higher degree of safety than ever before.

Full d e ta ils  and c lin ica l n o te s on 
th e  use of

R E N O T I N
in th e  tre a tm e n t o f M igra in e , 
N e u ritis, Lu m b a g o , S p ra in s and 
M y a lg ia  may b e  o b ta in e d  from

E x c lu siv e  D istr ib u to rs f o r  S o u th e rn  A fr ic a

P . O .  B O X  7 7 9 3

P H A R M A C E U T IC A L S  LTD .

J O H A N N E S B U R G

R
ep

ro
du

ce
d 

by
 S

ab
in

et
 G

at
ew

ay
 u

nd
er

 li
ce

nc
e 

gr
an

te
d 

by
 th

e 
P

ub
lis

he
r 

(d
at

ed
 2

01
3.

)