New Approaches to Physiotherapy

What made the spinal injuries unit at Stoke Mandeville truly distinctive was the introduction by Guttmann of sport as a means of rehabilitation. Guttmann recognised the value of games and sport in encouraging fitness, introducing competition and providing pleasure. Once spinal patients were up and into wheelchairs then they could take part in games like darts, billiards and skittles. Then there was an indefinable point at which some of the gym and physiotherapy activities – like using a punch ball or throwing a medicine ball – could move across and turn into a sort of competitive sport.

Dot Tussler, one of the longest serving physiotherapists at Stoke describes it thus. “Sport was used as an integral component to the rehabilitation programme and provided the means to develop strength, balance and coordination for newly injured patients. The added benefit of socialising and competition through the medium of sport was an opportunity for both staff and patients to learn and develop new skills.”

The presence of a weekly sports club in the spinal centre attended by both staff and patients enhanced the interaction and use of sport and confidence building.

The Sports Movement by Guttmann

“Guttmann knew that exercise could be boring, but that archery, for example, would make maximum use of upper body muscles; so the patients would do archery. All patients were encouraged to learn to swim – and most of them enjoyed feeling less disabled because of their weightlessness in water. The pool was built by 1954. It became a very programmed approach to exercise.

Physiotherapy in the pool at Stoke Mandeville

A patient having physiotherapy in the pool at Stoke Mandeville in 1956. NSIC

Competition at Stoke Mandeville pool 1955

Swimmers competiting in the Stoke Mandeville pool in 1955.

Patients were expected to get up and dress themselves and then do archery, swimming, table tennis, physio and occupational therapy during the day. It had a lot to recommend it; it encouraged discipline and self-belief and competitiveness.” – Brom, physiotherapist

“The sports movement was hugely important to Guttmann; he knew that sport can make an amazing difference to the life of a person with a spinal cord injury. It aids rehabilitation. It decreases the need for long term healthcare and medical treatment because of the healthy lifestyle.

Sport restores independence enabling people to undertake everyday tasks more easily including dressing, transferring in and out of their wheelchairs to the car, bath and bed.

Finally, it motivates disabled people by giving them new goals and increases confidence and self belief.” – Doctor John Silver