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CHAPTER 33
of a 10 m swimming pool for the Stoke Mandeville Centre in 1952-53. The pool has an
electric hoist to which a stretcher can be attached to lower tetraplegics into the bay of the
pool, where the physiotherapist, standing within the encroachment of the bay, in the
form of a Hubbard tank, can give passive movements to spastic or contracted legs and
arms. There is, in addition, another hoist to which patients can be transferred from the
wheelchair and hoisted into the water. Paraplegics, more progressed in their rehabilitation,
can hoist themselves from their chair into the water with the aid of handles attached to a
chain. Moreover, the pool is also provided with steps and double rails for paraplegics, who
are able to walk into the water. The temperature of the chlorinated water of the pool,
which is circulating continuously, varies between 82-85°F, and regular bacteriological
tests are made to ensure sterility of the water. This pool is still used every day with great
satisfaction to all concerned, but, naturally, spinal centres set up in recent years in various
parts of the world, have more or less modified this pool according to their purposes.
Emphasis is laid in paraplegics on active hydrotherapy to utilize and mobilize all that
is left in the sensory-motor system. Therefore, passive procedures, such as the so-called
under-water therapy by douches and other elaborate forms of jets, which is so popular
in countries of the European continent, should not be used as hydrotherapy for the para
lysed. Swimming represents one of the most natural forms of remedial exercise and has
proved invaluable in restoring the paraplegic's co-ordination, strength, speed, endurance
and self-confidence and also in counteracting spasticity. In the contest with himself
to improve his performance, the paraplegic and tetraplegic learns to overcome fatigue—
a predominant symptom in the early stage of rehabilitation. Moreover, swimming has
FIG. 235.
