F- CLINICAL ASPECTS OF SPINAL CORD INJURIES
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added to the variety of skills. The work is graded and correlated to the physical improve
ment of the patient and, of course, his intellectual ability and personality. The medical
staff must take an interest in the progress of the patients, and regular reports given by the
instructors are most helpful in assessing progress. As in the case of early work therapy,
emphasis is laid on the patient's punctuality, dexterity and speed. Sometimes it has been
necessary to switch patients from one occupation to another.
FIG. 267.
For female paraplegics a kitchen equipped with furniture including a cooker, adjusted
to the easy reach of a wheelchair user is part of our O.T. department to enable female
paraplegics to adjust themselves to housework including cooking (Fig. 269).
Naturally, it was not to be expected that everyone would make full use of the various
facilities offered. In numerous cases, especially those who had long spells of sepsis and
those admitted in later stages from other units or hospitals, where they had been kept in
prolonged enforced inactivity, it took some time to arouse the patient from his state of
frustration, apathy and inertia to which he had resigned himself. Such patients needed
continuous guidance and encouragement from the medical officer and nursing staff
as well as the instructors to ensure steady progress. Moreover, other factors such as
