Rehabilitation and Sports Medicine

We provide neuro rehabilitation services for patients with neurological illness or injury that has affected the ability to live and function independently. Patients may avail of rehabilitative services in an inpatient setting, inpatient rehabilitation unit, or in outpatient rehabilitation clinics.

• Stroke
• Traumatic brain injury
• Progressive neuromuscular diseases such as Parkinson’s
• Memory disorders such as Alzheimer’s
• Spine injuries and disorders
• Complex neuromedical conditions such as Multiple Sclerosis
• Vertigo, dizziness and balance disorders.

Cardiac rehabilitation is a structured program which is designed to help people with heart disease return to an active and satisfying life and to prevent recurrence of cardiac events.

Cardiac rehabilitation can benefit those who have had:

• Myocardial infarction (heart attack)
• Coronary Artery Bypass Surgery
• Angioplasty
• Angina
• Congestive Heart Failure
• Angiography showing blockages
• Valve surgery
• An individual who is at cardiac risk and who wants to prevent the occurrence of a cardiac event

Cardiac rehabilitation has Class I: Level A evidence in immediate post-surgical patients who have undergone CABG and recent angioplasty, which implies that all patients who have a cardiac history MUST enroll in a cardiac rehabilitation program.
The goals of cardiac rehabilitation at Sir H. N. Reliance Foundation Hospital are:

• To help cardiac patients get back to normal routine, as quickly and safely as possible.
• To institute lifestyle changes and regular monitoring to reduce future risk of cardiac events.
• To improve the psychological well-being of cardiac patients.

The program includes:

Aerobic exercises like treadmill walking, cycling, elliptical which are prescribed after assessing your baseline capacity. The baseline capacity is mainly assessed on the basis of the 6-minute walk test which is done on the day you enroll into the program.

Strength training helps to build up muscle strength of various muscle groups in the body. This is done with the help of different weight cuffs, dumbbells, elastic therabands and pneumatic machines.

Breathing exercises is a part of the warm-up and cool down exercises. This is to improve your overall lung capacity. It is of prime importance in those who have recently undergone a cardiac surgery with a view to prevent any respiratory complications.

You will be continuously monitored while you are exercising by a telemetry ECG monitoring system. In addition, your blood pressure and exertion levels will also be timely assessed by the therapist.

Yoga, in the form of various flexibility, breathing exercises and meditation, provides relaxation which will help you deal with the stress and improve your mental and spiritual well-being.

Diet is one of the important aspects of lifestyle modification which needs to be incorporated in all individuals with cardiac disease. Our team of dieticians will help you with a diet plan and all your queries pertaining to diet.

• Exercises- 3 days a week
• Yoga- once a week
• Diet- once a month

We offer comprehensive paediatric rehabilitation services, which include evaluation and medical treatment of underlying disorder by a paediatric neurologist and developmental paediatrician. The centre offers specialised testing for learning disabilities and their treatment.

• Cerebral palsy
• Mental retardation
• Autism
• Developmental delay
• Paediatric stroke, neuromuscular diseases, epilepsy
• Chromosomal and other genetic disorders
• ADHD (Attention deficit hyperactivity disorder)
• Learning Disabilities
• Speech and language delay
• Emotional, behavioural and Psychiatric disorders.

Most of us are able to communicate our needs without much effort. However, when due to some medical condition(s), these skills are partially / completely affected, it leads to a significant impact on an individual’s quality of life. Speech-language pathology services help in the diagnosis and treatment of swallowing (dysphagia), speech-language, and cognitive-communication disorders that result in communication disabilities.

This therapy team includes licensed speech therapists who assess and treat adults and children of all ages. Speech Language Swallowing therapists can treat a variety of communication and swallowing disorders caused by a number of conditions, including but not limited to:

• Autism
• Learning Disability
• Cleft lip and palate
• Down’s syndrome
• Hearing impairment
• Head and neck cancer
• Parkinson’s disease and other movement disorders
• Stroke
• Pediatric developmental disorder
• Dementia
• Traumatic brain injury
• Vocal cord dysfunction

The programs for Speech Language and Swallowing therapy at Sir H. N. Reliance Foundation Hospital & Research Centre are:

1. Pediatric:

Speech-language pathologists work with children of all ages. For example,

• Infants and toddlers may receive speech therapy if they have feeding and swallowing problems or need assistance in developing verbal communication.
• Preschool children may also require extra help to learn basic skills, such as communicating wants and needs.
• School-age children can learn to correct articulation errors and improve language / reading skills.
• Also children with stuttering require early intervention to help them develop fluent speech.

The therapy program includes a detailed evaluation followed by an individualized and multidisciplinary intervention to support their overall development. Therapy is conducted in a child friendly environment with the use of various play based activities. Group therapy is also conducted to promote development of social skills.

2. NeuroRehabilitation:

Speech Language Swallowing therapist diagnose and treat a variety of disorders resulting from stroke, brain injury or other neurological conditions. Therapist address the needs of patients diagnosed with a wide range of disorders like,

• Aphasia: Impairment of comprehension/expression of spoken language
• Apraxia: Inability to execute purposeful & coordinated muscle movements
• Dysarthria: Difficulty articulating words & voice-resonance changes (Slurred Speech)
• Orofacial Myofunctional Disorders: Difficulty in Speech- Swallowing due to facial& laryngeal muscle weakness

Therapy usually entails individual therapy training, multi modality stimulation and education to help an individual overcome or compensate for any of their difficulties. Specialized Voice Treatment for patients with Parkinson’s disease and other neurological impairments is also done.

3. Voice Clinic:

At our specialized voice clinic, patients with voice complaints like harsh/breathy voice, strained voice, and reduced loudness/pitch range are evaluated and treated with state of art technology.
Voice therapy also helps professional voice users (singers, teachers and actors) to meet their vocal demands and prevent voice disorders.
Our therapist work closely with the ENT specialist to holistically assess patient voice., using Laryngoscopy, Stroboscopy and Acoustic analysis software.
Therapy includes various exercise protocols, voice training and education on voice care and lifestyle modification to improve patient’s voice quality.

4. Oncology Rehabilitation

Most patients with head and neck cancer have difficulty with Speech and/or Swallowing which may be temporary or permanent in nature.
Some of the important roles of a speech language therapist are:

• Rehabilitation during and post-radiation treatment (focused on speech, voice and swallowing).
• Post-laryngectomy voice restoration: Tracheosesophageal voice, Artificial larynx and Esophageal speech.
• Post Glossectomy articulation and swallowing rehabilitation.
• Swallowing evaluation and treatment to prevent aspiration & facilitate oral food intake.
• Family education and counseling.

A multi disciplinary team approach involving Oncosurgeon, Radiation oncologist, ENT specialist, Dietician and Physical therapists, is used to deliver best care to patients.

5. Stuttering Therapy:

Stuttering affects the fluency of speech. It begins during childhood and, in some cases, lasts throughout life. The program includes breathing exercises, fluency shaping strategies and counseling to bring about behavioral changes needed to achieve improvement that will be generalized into daily living. Devices like Delayed Auditory feedback are also used to facilitate fluent speech production. Group therapy and Support group for Stammering are conducted to assist in generalization of therapy.

6. Swallowing Rehabilitation:

Swallowing disorder also called as dysphagia is difficulty in eating food. This can occur in patients with stroke, brain injury, Parkinson’s, head-neck cancer etc. It can also occur in children with cleft palate, oral sensory disorder, cerebral palsy etc.
At Sir H.N. Reliance Hospital state of the art assessment procedures like Video fluoroscopic swallowing evaluation (Modified barium Swallow) and Fiber optic Endoscopic Evaluation of Swallowing (FEES) are used to diagnose swallowing disorders.
Swallowing therapy includes exercises to improve muscle movement, positions or strategies to help the individual swallow more effectively and diet modification to ensure safe swallow. Electrical stimulation to stimulate muscle activity necessary for phonation/swallowing is also used.