The bigger picture

During my placement in India i realised that as Physios it is easy to get tunnel vision and only focus on specific aspects of a patients disorder without thinking about whether addressing thewse issues will really make a drastic improvement to the patients quality of life, or whether you are likely to be able to actually improve these issues. A lot of the children i worked with in India had such severe disabilities that i had to step back and decide what was really going to benefit them the most. Many of the children had extremely severe fixed contractures due to the poor managemnt of their spasticity. In these childrren it was easy to get fixated on trying to lengthen their short muscles however i realised that one i wasn't going to be able to make much diffenece on a fixed contracture ( although it is important to prevent any further loss of range) and two that these children would benefit the most from interventions that would allow them to play and interact with the other children. Whilst over there i was working with OT students which i found quite interesting as they seem to take a far more holistic approach to treating their patients. I found that many of my patients benefited more from structured games with other children where they could learn to socialise and interact, than from specific individual physiotherapy sessions. Having said this i found that many children benefited a great deal from individual physio sessions but i learnt that you have to look at the whole situation with each patient and realise that certain patients may not get as much benefit from typical physio interventions. With these patients i think it is necessary to take a more holistic approach and to recognise what it is, whether it be physio related or not, that would make the biggest difference to the patients life.