Page Twenty-Six P H Y S I O T H E R A P Y July, 1954. VIII. Similarly this unit m ay be equally well employed in. giving leg exercises (D iagram IX ), the arm o r han d being th e anchorage an d the position o f the arm con­ trolling the angle o f pull an d tension o f the spring.. IX. In this article I have deliberately not specified conditions for which these exercises can be used; that is up to the physiotherapist to a d a p t the basic idea to th e needs of tier individual patient. These exercises are merely suggestions given in good faith, and I would m ost heartily appreciate other ideas and opinions o n Spring Gymnastics. I am sure there is trem endous scope fo r simple methods o f Re­ habilitation. Mrs.. G uthrie Smith has already blazed the trail, an d an interchange o f ideas is always a stimulus. M ay I hope th a t this is the first o f many articles on similar lines ? j AVALON A BRIEF A C C O U N T O F T H E W ORK D O N E AT TH E R EH A BILITATIO N CENTRE. * / B y SU SIE O O ST H U IZ E N , m .c .s .p ., Superintendent. IN 1952 the A valon Association fo r the reHabilitation o f the Physically H andicapped transferred its Centre from T ulbach in the C ape to “ Tussenkoppies” F a rm near Johannesburg. In th e beginning this new centre, which was ju s t a farm , h ad to be p u t into some sort o f shape in o rder to accom m odate 9 patients, and an old b arn was converted into a gym, etc. A t first it was doubtful w hether there w ould be a dem and fo r such a C entre. B ut soon, after some propaganda, it was discovereed th a t m ore accom ­ m odation would be necessary an d the total was then brought up to 20 beds, and now the dem and is so great th a t over 100 names are on the w aiting list. Cases are drafted from various organisations o r directly. A m ong th e organisations interested are : T he Cripple C are O rganisations, H ospitals, W elfare O rganisations, M ilitary Pensions D epartm ent, Social W elfare D ep art­ ments, W .C .A . an d L ab o u r D epartm ents an d D octors. A medical certificate is necessary in all cases applying for admission, which includes the history o f the case, suggested lines o f treatm ent, an d probable d uration o f stay a t the C entre. Close co-operation exists between all'these different departm ents an d th e Superintendent, an d th e services o f honarary doctors are available a t any time. T o quote examples o f how the C entre operates from the co-ordination with allied organisations a short history is given below o f Frankie W right. H ere was a boy who, a t th e age o f 9 years, h ad his right leg am putated above the knee, due to osteomyelitis, an d for th e following 30 years he h ad a recurrent osteomyelitis in the left hip. The picture then was th a t F rankie sat in a chair, n o t even a wheelchair, with an am putated leg, a withering left leg with hip contractures, an increase in girth size, loss o f muscle tone an d a m ental outlook which debarred him from any sort o f social life. So, F rankie h a d n o t w alked fo r 30 years. On- the 6th o f February, 1953 this patient entered AVA LO N with new hope o f walking again. . Sling exercises were comm enced an d although the bone in the hip was very osteoporosed, the risk o f attem pting to straighten the" leg in o rder to fit a weight bearing caliper was taken, an d active assisted exercises were begun. D uring thisjj period the Physiotherapy D epartm ent a t the Johannesburg^ G eneral H ospital very kindly assisted A valon by giving u ltra violet light w ith the K rom ayer to the hip twice weekly f o r a period o f three m onths. (It is interesting to n o te that the hip has been clear fo r 6 m onths). T he Social W elfare D epartm ent during this period, set to w ork to obtain th e approval o f the H ealth D ep art­ m ent fo r the m aking o f a prosthesis for the right leg and a caliper for th e left leg. Once this o rder was sanctioned, the G overnm ent Artificial Lim b Factory m ade the necessary appliances and then the teaching o f w alking started. F rom th e anti-social'view point, ways and means to break down a 30 year old barrier had to be brought into the program m e. This was started by introducing strangers to him , encouraging him to talk ab o u t his disability and encouraging him to attend places o f entertainm ent in public. O utings in the com pany o f o ther patients were constantly organized, various ■ public bodies visited th e C entre, and soon Frankie n o t only started to talk a b o u t himself, but actually enjoyed doing so. The final scene in his rehabilitation was when the Superintendent took him o n a holiday, which m ade him 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. ) July, 1954. P H Y S I O T H E R A P Y Page Twenty-Seven A g r ea t day fur F r a n k i e as he t a k e s his first st ep s in 30 year s. realize t h a t he c o u k l v e n t u r e a w a y to d i s t a n t p lac es j u s t a s well a s o t h e r p e o p l e c o u l d . T o - d a y F r a n k i e is a b l e to wa lk with t w o slicks, st a ir s w hi ch we re o n c e his bo gey me an n o t h i n g to hi m , a n d his o u t l o o k 011 life ha s c o m p l e t e l y ch an ge d . So at 39, life be g a n for F r a n k i e a f t e r a p e r i o d o f 6 m o n t h s at A v a l o n . A m p u t e e s f ro m all o v e r t h e c o u n t r y , as far as S o u t h West Africa, a r e sent to th e C e n t r e t h r o u g h S o cia l W e l f a r e D e p a r t m e n t s , whilst b e i n g fitted wit h p r o s t h e s e s at t he G o v e r n m e n t Artificial L im b F a c t o r y . D u r i n g t h e fitting stage these p at i e n t s a r e t a u g h t to walk o r h o w t o use a r t i ­ ficial ha n d s , w h i c h e v e r th e ca s e m a y be, so t h a t w h e n th e final stages o f t he m a k i n g o f th e a p p l i a n c e s is r e a c h e d , they a r e a l r e a d y c o n v e r s a n t wi ih t h e i r new' " g a d g e t s . " T he d u r a t i o n o f t h e i r st a y a t A v a l o n , d e p e n d i n g 011 the disability, is gene ra ll y 3 t o 6 w'eeks. P a r a p l e g i c s a r e lo ng t e r m cases a n d need very sp e ci al a t t e n t i o n . P re s s u re so r es a r e the gr eatest p r o b l e m a n d c o n s t a n t t u r n i n g d u r i n g the nigh t is necesasry. T h e s e ca se s a r e in cli n ed t o fits o f “ J o s e , " a n o t h e r Avalon ease. 25 y e a r s confined to a chai r, finding his feet for the first time. d e p r e s s i o n a n d g r ea t tact is n e c e s sa ry in t h e i r t r e a t m e n t . Pol io c a s e s a r c lo n g ca s es a n d s t a y at th e C e n t r e for m o n t h s . O n e i n t e r e s t i n g c as e, J o s e Bor ges , t o o k 4 t m o n t h s to m a s t e r th e a r t o f w a l k i n g wi th c a l i p e r s a n d c r u t c h e s . But J o s e h ad n o t w a l k e d fo r 25 y e a r s ’ A f t e r a n u m b e r o f o p e r a t i o n s , he w'as re fe rr e d to A v a l o n by a n o r t h o p a e d i c s u r g e o n , .lose, w h o w a s f r o m L o u r e n c o M a r q u e s , t o o . is g r a t e f u l to A V A L O N . F u n d s a r e very n ec es sa ry t o c a n y o n t h e w o r k at t h e C e n t r e . A t p r e s e n t t h e r e is n o S t a t e Aid a n d c o n s e q u e n t l y fu n d ra i si n g h as to be u n d e r t a k e n c o n t i n u o u s l y . S tr e et c o l l e c t i o n s a r e held in m a n y t o w n s all o v e r th e U n i o n . A s s i s t a n c e is given by C r i p p l e C a r e O r g a n i s a t i o n s , a n n u a l m e m b e r s h i p s u b s c r i p t i o n s , d o n a t i o n s f r o m m a n y o r g a n i s a ­ t i o n s i nt er es te d in W e l f a r e W o r k a n d firms a n d m e m b e r s o f t h e pub li c. A V A L O N , in sp it e o f m a n y difficulties, m a n a g e s to ho ld its h e a d a b o v e w a t e r a n d is even c o n t e m p l a t i n g e x ­ p a n s i o n . 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. )