SUMMER INTERNSHIP REPORT National Institute of Fashion Technology, Kannur.

RECOUP Neuromusculoskeletal Rehabilitation & Research Centre, Bangalore

MENTOR

Arun Mascarenhas

SUBMITTED BY Ashique Hydher Ali

KNR13MD23 M.DES, SEMESTER III

CERTIFICATE

NATIONAL INSTITUTE OF FASHION TECHNOLOGY

KANNUR

INTERNSHIP REPORT

Name ...................................... Class ...............................

Reg ............................... Roll no...............................

This is to certify that the internship training report of work done by the above student in RECOUP Neuromusculoskeletal Rehabilitation &Research Centre, Bangalore,during the

period of .......................... to ..........................

In particular fulfilment of the credit from the award of Master of Design Space

................................................... ...............................................

Signature of the staff In-charge Signature of head of the Design Space Department

PREFACE

Currently I’m doing Master of Design Space (M Des) degree at the National Institute

of Fashion Technology (NIFT), Kannur in Kerala. I am in my second semester and therefore I

have to conduct a 2 months internship for fulfilment of the semester. The reason I choose to

do my internship at RECOUP Bangalore is because I wanted to benefit from the experience.

After following 2 internships in the Kerala during my previous education, I wanted a new

challenge. I wanted to do my internship at Bangalore to experience the international world

of rehabilitation and to learning, improve and develop new sets of skills. One of my main

goals is to improve my language. Another goal is that I’m planning to do PhD and follow a

Master’s program. This is why I choose to follow my internship at RECOUP Bangalore; to

learn and develop new sets of skills and to experience working on another state or abroad.

The reason I choose RECOUP for my internship is because it is the one of the best

rehabilitation centre for Neuromusculoskeletal Disorders and RSI around the world. And I

can understand easily about the scope of designers in rehabilitation. It seemed convenient

for me knowing that, someone who can help me and guide me the way in while doing my

internship.

In this internship report I will describe my experiences during my internship period.

The internship report contains an overview of the organization, its hierarchy, functioning,

clients and tasks that I have worked on during my internship. Writing this report, I also will

describe and reflect my learning objects and personal goals that I have set during my

internship period.

For this opportunity, I thank:

First and foremost, praises and thanks to the Allah, the Almighty, for His showers of

blessings throughout to complete the internship successfully.

Dr. Deepak Sharan, who is the Medical Director of RECOUP Neuromusculoskeletal

Rehabilitation Centre. I want to thank him for giving me the opportunity to follow my

internship at his Rehabilitation Centre. He had the kindness to accept me in his

Rehabilitation Centre and guide me through my internship with advice, feedback and tips

despite her busy schedule.

Mr. Arun Mascarenhas, who is my faculty, mentor for my internship. He helped and

coached me during my internship by giving me feedback and tips on how to handle and

approach situations. He had always time to answer all my questions concerning my

internship.

Mr. Mohammed Ansar , Course Co-ordinator, Master of Design Space, NIFT Kannur, who in

spite of busy schedule has co-operated with me continuously and indeed, his valuable

contribution and guidance have been certainly indispensable for my internship.

Mr. Mathan Kumar M, Manager R&D Department and Mr. Ramesh Kumar R, Senior

Manager R&D Department, I would like to take the opportunity to thank and express my

deep sense of gratitude to my industry mentors. I am greatly indebted to both of them for

providing their valuable guidance at all stages of the internship, their advice, constructive

suggestions, positive and supportive attitude and continuous encouragement, without

which it would have not been possible to complete the internship.

Mr. Joshua Samuel (Manager, Paediatric Rehabilitation) without whose support and

guidance the internship couldn’t have been completed satisfactorily.

Ms. Hir Vyas, who is working for Asst Professor of Design Space Department, NIFT Kannur, I

want to thank her for helping me with the process of finding me a suitable internship.

I am also grateful to Dr. K. K. Sharan, Chief Operating Officer of RECOUP, for guiding me at

every stage and doing this internship a success.

I owe my wholehearted thanks and appreciation to the entire staff of the RECOUP

Bangalore for their cooperation and assistance during the course of my internship. I hope

that I can build upon the experience and knowledge that I have gained and make a valuable

contribution towards this industry in coming future. I want to thank, Dr. Tomy Mampilly,

HOD PMR, Mr. Jerrish Jose , HOD Physiotherapy ,Ms. Arshiya Thakral, Manager HR, Mr.

Anoop, Mr. Jayakumar, (Ergonomists) and Physiotherapists , Mr. Mohan, Mr. Lokanathan ,

Mr. Avinash, Mr. Geeta, Mrs. Sarita, Ms. Kalpana, Mrs. Ruchi, Mrs. Sreelatha and Ms.

Revathy. Also I appreciated all the patients and Bystanders; I cooperated with and spent

good moments with during my internship.

Also I would like to thank my colleagues from the NIFT for their critical comments and

helpful suggestions. I wish to express my sincere gratitude to Mr. Saravanan

Sundarakrishnan, KARE Prosthetic and Orthotics CEO, Mrs. Ritu Ghosh, Deputy Director-

Training, Mobility India, Mr. Soikat Ghosh Moulic, Asst. Director- Technical, Mobility India,

Mr. SamaRaju, Programme Manager, Mobility India, Mr. Riyas, Physiotherapist, Mobility

India, Mr. Rajdeep, Programme Manager, Mobility India and all staff in Mobility India,

encouraged me to focus and to be more specific and spend much time providing technical

assistance.

Besides my internship, I really enjoyed my stay in Green House. It is a great experience and I

want to thank everybody for it.

Last but not the least; I would like to thank my family: my parents Hydher Ali and Shahida,

for giving birth to me at the first place and supporting me spiritually throughout my life and

my younger brother Fuzail Ahammed for daring to follow his dreams.

CONTENTS

INTRODUCTION.....................................................................................................................................

INTERNSHIP OBJECTIVES..........................................................................................................................

MY EXPECTATIONS...................................................................................................................................

INTRODUCTION TO THE ORGANISATION...............................................................................................

ORGANISATION....................................................................................................................................

ABOUT RECOUP.......................................................................................................................................

MISSION …………………………………………………………………………………………………………..

VALUES……………………………………………………………………………………….……………………

ORGANISATIONAL STRUCTURE...............................................................................................................

ABOUT RECOUP TEAM………………………………………………………………………………………….

ABOUT PATIENTS CLIENTS AND SERVICES………………………………………..………………………….

ACHIEVEMENTS........................................................................................................................................

TASKS AND ACTIVITIES..........................................................................................................................

DAILY TASKS AND ACTIVITIES..................................................................................................................

REFLECTION............................................................................................................................................

CONCLUSIONS.......................................................................................................................................

INTERNSHIP EXPERIENCE SUMMARY.......................................................................................................

RECOMMENDATIONS..............................................................................................................................

APPENDIX

...................................................................................................................................................................

EVIDENCE OF PERFORMED ACTIVITIES, TASKS AND DUTIES.................................................................

DESIGN SKETCHES AND PHOTOGRAPHS...............................................................................................

CONFIRMATION LETTERS........................................................................................................................

OVERVIEW OF PERFORMED ACTIVITIES AND DUTIES PER WEEK (WEEKLY REPORTS)..........................

COMMENCEMENT INTERNSHIP DOCUMENT.........................................................................................

INTERNSHIP ASSESEMENT FORM.............................................................................................................

INTERNSHIP OBJECTVIES

The reason I choose to RECOUP for internship is because I wanted to benefit from the

experience. I wanted a new challenge and to learn, improve and develop new sets of skills in

Rehabilitation. During my internship two major competencies are central: Working as a

Designer for Special Needs, analysing the needs from different perspectives and performing

duties and activities. And working as a Space and Interactive Designer, where I have to be

able to prepare a realistic and user friendly design. These are the two major competencies

that I have to conduct and focus on during my internship. Also I have to choose at least one

minor competency that needs to be executed and developed during my internship. And

finally I have to set up personal targets to develop and improve my skills.

During my two months of internship, I want to actively contribute to the RECOUP objectives

by applying the knowledge I obtained during my education such as the important aspects of

designing. As a Design Researcher, I want to come up with plans; new ideas, designs and

research on how to improve the rehabilitation in new phase.

During my two months internship, I want to improve my language especially English , Hindi,

Kannada and Tamil by working along with my colleagues and communicating with the

clients of RECOUP. I also want to practice and improve the different skills I developed during

my education such as:

Observing and researching different subjects.

Preparing New Designs.

Planning, organizing and communication activities.

EXPECTATIONS

Before my internship began my expectation where high, because I thought I can change the

strategies in rehabilitation suddenly. But this is an internship in a different state and with

different language and different culture, I faced some problems. Before my internship

began, I spoke with my mentors and they described what kind an internship it is going to be.

The organization is named RECOUP Neuromusculoskeletal Rehabilitation & Research Centre

and they specialise in extensive workplace assessments and design solutions,

musculoskeletal disorder assessment and specialized treatments, and Occupational health

and safety. It’s a Neuromusculoskeletal Rehabilitation Centre that is considered to be one of

the best in World. The description of my work, activities and assignments exist from;

observing and researching, developing new ideas and design strategies, updating contents.

Also I did some graphic design works for RECOUP and visited some orthotics and prosthetics

companies in Bangalore like KARE Prosthetics & Orthotics, and Mobility India for

understanding what kind of works they are doing based on design in Othotics and

prosthetics designing & making. With the knowledge I obtained, I knew I could learn much

and I knew I could achieve my learning objectives. I wanted to follow an internship where I

could work in the Orthotics and Prosthetics design field, because I always had an interest in

that area. The process of observing, researching and planning has always interested me.

That is why I choose for my elective Design for Special Needs and Space & Interactive

Design. I wanted to learn and specialize in how to attract people easily by designing cost

effective special needs. That is why I choose RECOUP, It is suitable and I knew could achieve

my learning goals.

INTRODUCTON TO THE RECOUP

On my first day I was surprised when I was brought to the Internship at RECOUP. It was a

Building having 4 floors with a small garden. I remember a security asked me Where are you

from? What do you want? I honestly thought why he was asking the whole details.

At the beginning I definitely had to get used to the idea of working in RECOUP, with all the

smalls spaces and the environment. But after a while I got used to it and felt comfortable.

The colleagues that I have worked with were very nice and helpful. RECOUP staff mostly

exists of Physiotherapists. The trainees are from different studies and have different

specialties. Some of them are also international students. This is very useful because this

way we can learn and share the knowledge with each other. The tasks that I was assigned to

were very interesting. At the beginning, I noticed that the Physiotherapy treatment was very

fast and advanced. I also noticed the different Physiotherapy tools they were using with

such as bobath table, chair during gait training, suspension therapy gait training,

manipulation and mobilization techniques. This was a great opportunity for me to learn

because I had little knowledge of these types of treatment techniques. Overall my

introduction with my institution went really well. The work fits my education and I felt I

could learn a lot. I felt really accepted in the institution.

ABOUT INSTITUTION

RECOUP is one of the largest Neuromusculoskeletal Rehabilitation and Research Centre in

the world, treating over 1000 patients daily. It has a multidisciplinary team of over 150

highly skilled, qualified, experienced and reputed Multispecialty Physicians and

Rehabilitation Professionals. RECOUP was established in 2001 and is located in Banagalore,

India, and has a hospital and 6 clinics in Bangalore (Jayanagar, Indiranagar, Sarjapur Road,

HSR Layout, Vijayanagar, ITPL), and 1 each in New Delhi, Ghaziabad (NCR/UP), Patna (Bihar),

Hyderabad (AP), Thrissur, Kozhikode and Thiruvanathapuram (Kerala) Jodhpur (Rajasthan).

Mission

The mission of RECOUP is to improve health and reduce the burden of

Neuromusculoskeletal disorders, Cerebral Palsy and other Childhood Disabilities,

Understanding Pain and its management, Ergonomics and Occupational health and

Geriatrics Disorders in society by Identification, Dissemination and Application of scientific

knowledge in a cost effective manner.

Values

Their values are patient centric approach, Focus on functional restoration and improving

quality of life. Single minded and uncompromising in pursuit of clinical excellence through

research, hands on training and innovation. Ethical work practices and professionalism.

Social responsibility: humane and compassionate approach towards patients and charity for

the socioeconomically disadvantaged.

The reasons for patients choosing RECOUP, they are credible with over 1, 50,000 success

stories since the year 2001. About 95% of cases was documented and published in a success

rate. Physician led, comprehensive, multidisciplinary approach under one roof is one of the

main strategies of RECOUP. Holistic and Evidence Based Treatment approach, incorporating

all available effective treatment modalities, both mainstream and alternative are also

available. They are focusing Individualised care on client satisfaction. Lasting recovery due

to attention towards predisposing factors (e.g., posture, stress, nutrition, habitual deep

muscle tension, medical co-morbidities) instead of just symptomatic relief. They are doing

proprietary and specific treatment protocol for each condition, scientifically validated by

International peers. It’s very cost effective and RECOUP Open 365 days from 6 am to 10 pm.

ORGANISATIONAL STRUCTURE

ABOUT RECOUP TEAM

RECOUP has a multi-disciplinary team of over 150 highly trained, qualified, experienced and

reputed Physicians and Rehabilitation Professionals.

Dr. Deepak Sharan, Consultant in Orthopaedics, Rehabilitation and Ergonomics, Heads RECOUP.

Dr. Deepak Sharan has supplemented 22 years of International clinical experience in

Musculoskeletal Rehabilitation with qualifications in Biomechanics, Ergonomics,

Orthopaedic Engineering, and Rehabilitation Technology. He described as a “cult figure in

the world of RSI” by the Wall Street Journal, is an advisor on RSI and Cerebral Palsy to the

Govt. of India.

Mr. Jerrish A Jose, Master in Physiotherapy with 11 years of experience as a Physiotherapist

and trainer in Manual therapy, Ergonomics and Paediatric Rehabilitation. Currently working

as the Head of Physiotherapy and Head of Corporate Services in RECOUP Bangalore.

Ms. Jeena Jose, Master in Physiotherapy with 6 years of experience as a researcher and

trainer in Manual therapy, Peadiatric Rehabilitation and Ergonomics. Currently working as

Manager- Training in RECOUP Bangalore.

Mr. Rameshkumar. R, Master in Physiotherapy with 7 years of experience as a researcher

and trainer in Manual therapy, Peadiatric Rehabilitation and Ergonomics. Currently working

as Senior Manager- Peadiatric Rehabilitation in RECOUP Bangalore.

Mr. Mathankumar. M, Bachelor in Physiotherapy with 7 years of experience as a researcher

and trainer in Manual therapy, Paediatric Rehabilitation and Ergonomics. Currently working

as an Manager- Research in RECOUP Bangalore.

The multidisciplinary team is trained in extensive workplace assessments and design

solutions, musculoskeletal disorder assessment and specialized treatments, and

Occupational health and safety. RECOUP’s staffs have received exclusive hands-on training

from Prof. Daniela Colombini, Dr. Natale Battevi, Ms. Lucia Pigini (Ergonomists from Milano,

Italy; inventors of OCRA and MAPO methods of Ergonomic Assessment), Prof. Arun Garg

(Ergonomist from Wisconsin, USA; inventor of Strain Index and Revised NIOSH Lifting

Equation), Dr. Steven Sanet (Founder, Osteopathic College of Ontario), Marilyn Lock

(Alexander Teacher, Pilates Trainer and Physiotherapist from Melbourne, Australia) and Ms.

Suparna Damany (RSI Therapist and Author from Pennsylvania, USA).

RECOUP multidisciplinary team consists of

Paediatric Orthopaedic Surgeon and Rehabilitation Specialist

Paediatrician

Paediatric Physical Therapists

Paediatric Occupational Therapists

Orthotist

Clinical Psychologist

Neurotherapist (LMNT)

Speech Therapist

Nutritionist

Paediatric Yoga Therapist

ABOUT PATIENTS, CLIENTS AND SERVICES

RECOUP is an acronym that represents: R - Repetitive Strain Injury

E - Ergonomics & Occupational Health

C - Childhood Disabilities

O - Orthopaedics & Neurological Disorders

U - Understanding Pain & Disabilities

P - Professionals & Patients Training

REPETITIVE STRAIN INJURY

“RECOUP philosophy is that RSI is primarily a structural problem that can be completely treated, even in advanced stages.”

In the last decade, millions of otherwise healthy individuals have developed a painful,

debilitating and sometimes disabling condition known as Repetitive Strain Injury (RSI). RSI is

a diffuse disorder of different body structures which leads either to impairment or to

participation problems. RSI is also known as Work Related Musculoskeletal Disorder

(WRMSD), Cumulative Trauma Disorder (CTD), Computer Related Injury (CRI), Work Related

Upper Limb Disorder (WRULD), and Occupational Overuse Syndrome (OOS).

ERGONOMICS & OCCUPATIONAL HEALTH

Ergonomic friendly workplace can save pennies from their employees’ workers

compensation claims. Not only that, it increases the productivity too. All we think is the

benefit and profit. RECOUP has been providing corporate wellness solutions to some of the

top corporate of the country for many years. They plan and customize tailor made flexible

packages to suit the client’s requirements at a highly competitive rate. Their occupational

Physicians and nurses are highly experienced at industry standards and competent to

provide a support to day to day on-site medical needs and employee wellness. The most

important and unique feature of their different health check-up packages are they are done

at the clients place i.e. the offices where the employee actually works. So a great deal of

hazard and time are saved on going to any distant clinic in a particular time and waiting in a

long queue.

RECOUP – EPM International School of Ergonomics

RECOUP has started the EPM International Ergonomics School in association with

Ergonomics for Posture and Movement, Milano (Italy), the World’s foremost

Ergonomics and Occupational Health Institution.

RECOUP is the only authorised Institution at present in all the English speaking

countries to conduct certified training in Revised NIOSH Lifting Equation and OCRA

Methods, under the aegis of the International Ergonomics School. These are

considered gold standard tools for assessing the Ergonomic risk factors involved in

manual material handling and biomechanical overload due to repetitive activities

according to the current ISO standards for Ergonomics.

An International Online Certification Course in Ergonomics is likely to be offered in

2013 by RECOUP under the aegis of the International Ergonomics School.

Dr. Deepak Sharan is the Founder Director of EPM International Ergonomics School

and the President of the Indian Ergonomics School, affiliated to the EPM

International Ergonomics School.

RECOUP’s Ergonomists have over 12 years of experience in job risk analysis, macro

and micro ergonomics, cognitive ergonomics and applied physical rehabilitation

methods.

RECOUP’s Ergonomists are currently collaborating with several International

Ergonomics research groups to develop new risk assessment tools.

RECOUP’s Corporate Services

Awareness Talks and Camps

Ergonomic Workplace Analysis

Job & Risk Factor Analysis

Ergonomic Appraisal of Workplace

On site RSI Clinic

E-Fitness Training Programme

Health Check ups

Corporate Training Programmes

Industrial Consulting

Return of Investment (ROI)

RECOUP has been providing Ergonomic Workplace solutions to its broad spectrum of

corporate clients ranging from the big players in IT industry to top notch Biotechnology or

Oil Manufacturing companies. Since 2001 Recoup has provided ergonomics and corporate

wellness services to Fortune 500 companies across India. They have a vast variety of

Services to address every corporate need starting from basic employee wellness program to

extensive ergonomic intervention throughout the organization.

CHILDHOOD DISABILITIES

Most of the patients in RECOUP are suffering

from common types of childhood disabilities

include

Cerebral Palsy

Developmental Delay

Spina Bifida

Birth deformities

Learning and behavioural disabilities

Speech and language impairments

There are many families who are still not able to figure out what their child is suffering from

and run from pillar to post looking for specialised medical care. At RECOUP, the team of

Paediatric Rehabilitation professionals is skilled in assessment and treatment of various

childhood disabilities. They offer world class, evidence based, multidisciplinary and cost

effective treatment with excellent documented results.

Under one roof the child will get a Physician directed and a customised and methodical

rehabilitation programme with a designated therapist-in-charge. The child’s progress will be

monitored and documented by both objective and subjective outcome measures.

The centres has experienced Paediatric Therapists and innovative technology for treatment

including Virtual Reality Based Therapy, Hippo therapy, Whole Body Vibration Therapy, EMG

Biofeedback, Aquatic Therapy in a temperature controlled swimming pool, Body Weight

Supported Treadmill Training, Swiss Ball Exercises, Sensory Integration, Constraint Induced

Movement Therapy, Mirror Therapy, Play Therapy, Music Therapy, etc.

ORTHOPEDIC & NEUROLOGICAL DISORDERS

They are also treating Orthopedic and Neurological disorders consist of conditions involving

muscle, bone, joints, ligaments, nerves, spinal cord and brain. They provide rehabilitation

for all the conditions coming under NEURO MUSCULO SKELETAL system. And a Specialist

Orthopedic Physician, Dr. Deepak Sharan who is highly experienced and skilled at assessing

and treating individuals with complex orthopedic and neurological disorders. Conditions

treated under these disorders are Pain involving any part of the body like head, neck, upper

extremity, lower extremity, trunk and pelvis. He follow an internationally acclaimed

SHARAN’s protocol for each condition which has given 95% documented success rate even

in conditions where people have lost hope with life, had lost job and regained their life back

with ease. The wings of RECOUP spreads all over India and still expanding to reach to any

disability and regain your functional life back. Their approach is more of manual rather than

electrotherapy. They have specialized Myotherapy units where there skilled therapist looks

for and treats the main cause of pain.

UNDERSTAND PAIN AND DISABILITIES

RECOUP has been recognized as a Centre of Excellence for RSI, Ergonomics and Cerebral

Palsy by several authorities both nationally and internationally. It is the world’s topmost

research organization in the fields of RSI, Chronic Pain and Ergonomics, with over 400 major

publications / conference presentations. More than 20 cutting edge research projects have

recently been published in top peer-reviewed and indexed International journals, leading to

the validation of RECOUP’s treatment approach, recognition of new MSD conditions, risk

factors, assessment and treatment methods. Experts from RECOUP presented 15 research

papers, special sessions and symposia at the World Ergonomics Congress

(www.iea2012.org) at Recife, Brazil in February 2012- a new world record for the maximum

number of presentations from a single organisation at an International Conference dealing

with Ergonomics / RSI.

PROFESSIONALS & PATIENTS TRAINING

RECOUP Research & Training Centre offers a variety of educational and training

programmes for patients including Back School, Ergonomics, Musculoskeletal Disorders. It

has been a constant endeavour of RECOUP to reach patients as well as professionals to

improve health and reduce the burden of Neuromusculoskeletal Disorders in society by

discovering, disseminating, and applying scientific knowledge in a cost effective manner.

The Health and Safety Executive and the Department of Health (Govt. of UK) have proposed

to fund a research study in 2010 to document RECOUP’s extraordinary results with RSI as

compared to the poor outcomes routinely robtained in the NHS and private clinics in UK.

They provide continued education program for patients as well as professionals in the form

of awareness talks, camps, seminars, conferences, symposium, online courses, etc.

ACHIEVEMENTS

RECOUP is one of the largest Occupational Health and Ergonomics Consultancies in the

world, with over 60 Fortune 500 and other prominent long-term and repeat clients, catering

to over 2,00,000 employees daily. RECOUP’s Ergonomists have received exclusive hands-on

training from Prof. Daniela Colombini, Prof. Enrico Occhipinti, Dr. Natale Battevi, Ms. Lucia

Pigini (Ergonomists from Milano, Italy; inventors of Revised NIOSH Lifting Equation, OCRA

and MAPO methods of Ergonomic Assessment), Prof. Arun Garg (Ergonomist from

Wisconsin, USA; inventor of Strain Index and NIOSH Lifting Equation), Dr. Kazutaka Kogi

(President, International Commission for Occupational Health and developer of

Participatory Ergonomics), Dr. Enrique Alvarez-Casado (President, Catalan Ergonomics

Association, Spain and co-developer of Revised NIOSH Lifting Equation), Dr. Steven Sanet

(Founder, Osteopathic College of Ontario), Marilyn Lock (Alexander Teacher, Pilates Trainer

and Physiotherapist from Melbourne, Australia) and Ms. Suparna Damany (RSI Therapist

and Author from Pennsylvania, USA).

RECOUP’s Professionals have conducted over 1500 training sessions or workshops on

different aspects of Occupational Health, have produced over 300 scientific publications or

presentations and are on the editorial panel of major International Sub-specialty journals.

The Health and Safety Executive and the Department of Health (Govt of UK) have proposed

to fund a research study in 2010 to document RECOUP’s extraordinary results with RSI as

compared to the poor outcomes obtained in NHS and private clinics in the UK. RECOUP’s

Ergonomists has successfully treated over 150,000 RSI patients from 25 countries with a

success rate of over 95%. RECOUP conducts over 25 International and National Level

Conferences and Courses on RSI and Ergonomics every year.

A Revolutionary Surgery for Cerebral Palsy – SEMLARASS

A revolutionary surgery conceptualized by Dr. Deepak Sharan, Director of RECOUP

Neuromusculoskeletal Rehabilitation Centre is named SEMLARASS at Bangalore, India in

2001. SEMLARASS is an acronym for Single Event Multilevel Lever Arm Restoration

and Anti Spasticity Surgery. SEMLARASS refers to a new and path breaking multi-level

rehabilitative surgery to correct lever arm dysfunction and spasticity.

SEMLARASS includes the following components:

Single event: all surgeries are usually completed under a single anaesthetic,

requiring only one hospital admission and one period of rehabilitation.

Multilevel: all the affected regions and all orthopaedic deformities (soft tissue and

bony) are corrected simultaneously in view of interdependence of joints.

Lever arm restoration: simultaneous correction of hip subluxation, femoral

anteversion, tibial torsion, hindfoot valgus to improve the direction of pull of

muscles.

Anti spasticity: myofascial surgical releases to reduce spasticity.

A major advantage of SEMLARASS that has been noted is an all-round acceleration of other

functions thereafter, e.g., learning, speech, behaviour etc. Decreased spasticity allows the

child to have greater range of motion, less spastic response to stretch, and better potential

to develop and use voluntary activity during gait. Physical therapy for strengthening muscles

is more effective once spasticity is reduced. Functional strength training (Suspended

treadmill training, suspended bicycle training, therapeutic swimming and horseback riding

(hippotherapy) are useful modalities in this situation (all are available exclusively in

Bangalore). The traditional view was that muscle strengthening was neither possible nor

desirable in CP because it might increase spasticity. Recent research has shown that muscle

strength can be reliably measured in children with CP and that those who participate in

strengthening programmes demonstrate increases in muscle power and improvements in

function.

The postoperative rehabilitation following SEMLARASS is intensive and protocol based, and

requires dedicated and skilled physical therapy for at least 2 years. Functional improvement

is slow and steady and can continue for 2 years or more.

SEMLARASS avoids most of the problems associated with Botulinum Toxin, Selective Dorsal

Rhizotomy (SDR) and Intrathecal Baclofen Therapy (ITB).

RECOUP International Patient Services

RECOUP is visited by hundreds of patients from around the world for specialized

rehabilitation care. The travel and stay is made easy by their staff and patients will feel at

their home. They try their level best to reach clients requirements. Their services are

complimentary, from providing well equipped room, a cafeteria with appealing diet,

newspapers, arranging the rehabilitation sessions, Pharmacy, Wi-Fi, escorting them to their

appointments, everything they did was intended to made client comfortable. Clients will

feel at home even when they are far from their home.

DAILY TASK & ACTIVITIES

During my internship, I have worked on multiple tasks, projects and activities. RECOUP

projects and activities can be divided into daily tasks that involve office work, and the on-

site activities that have to be conducted at the corporate clinics.

Daily tasks and activities

Observing Patient Flow

Assessment > Evaluation > Treatment > Discussion > Follow up.

Observing Situations

Doing the treatment what all the situations are facing by Therapists, Parents,

Etc.

Identifying Problems

Making Solutions

Making Sketches for the solutions.

Assisting Office Works

Working this way helped me a lot become aware of the process and the activities around it.

During my internship, I have visited some companies to understand the Process of making

orthotics and prosthetics. Based on the result of the observing things, suggestions are going

to be made to improve the design process of those products. Also actions are going to be

described on how to improve the design. The purpose of this visit is to evaluate and to

improve the present designing process of assistive devices, and to provide the attendees

with the highest level of comfort.

REFLECTION

I will reflect how I worked as a Designer for Special Needs and Space & Interactive Designer.

I will use for my reflection on an approach, reflecting the situations, tasks, actions, results

that I have experienced during my internship.

Working as a Designer for Special Needs and Space and Interactive Designer for RECOUP R &

D department helped me develop and learn lots of things. As a Designer, I worked in

different areas where I did different work. I described in the previous chapters that the tasks

and projects that I have observed and worked on. The good thing is that these areas are all

aspects of the knowledge I obtained during my observation and evaluation. This knowledge

has helped me a lot with the tasks that I have done. I already studied the structure of

Prosthetics and Orthotics. I learned how to research the market, target group and how to

come up with strategies. The knowledge that I obtained of my education has really helped

me in this area. The only area where I didn’t have any knowledge of was the production

area. That is why the last weeks of my internship did at Mobility India, were a little bit

interesting. By working this I learned about the subjects on my own. I improved a lot

compared to the first weeks. Searching most of the things on my own have helped me a lot.

Also observing and listening a lot to discussion/brainstorming that were held in the office

has also helped me a lot. But the most effective way for me was working with the therapists.

Working and communicating with them and seeing how they approach things has help me

understand the problems. The areas that I feel the therapist and bystanders really helped

me the most with their design suggestions.

Before every rehab RECOUP organise a team meeting where we discuss the condition of

patient, selecting treatment and protocols etc. The first meetings I wasn’t aware of the

subjects. But the last meeting I attend, I was fully aware of the subjects of the meeting and I

was actively more involved in the meeting suggesting ideas and thinking with the team.

CONCLUSTION

The past two months of my internship have been very instructive for me. RECOUP has

offered me opportunities to learn and develop myself in many areas. I gained a lot of

experience, especially in the Prosthetics and Orthotics field. A lot of the tasks and activities

that I have worked on during my internship are familiar with what I’m studying at the

moment. I worked in different areas where I did different work. This gave me the chance to

find out which areas I want work in after my education. The area that I found most

interesting is design for special needs. By developing a design, I had to do lots of research

where I had to find the best way of marketing a product. I learned many things about

orthotics and prosthetics designing and production by visited different companies as part of

this internship.

Before my internship started my ideas did not match the experiences have gained during my

internship. There is a big difference in the college projects and the tasks and activities during

the actual work. In school and colleges we learn how to describe the work in projects, where

in work you learn how to implement them in reality. This internship was definitely an

introduction to the actual work field for me. I have learned to work in a business

organisation and apply my knowledge into practice.

My Industry mentor during my internship was Mathan Kumar who I have also learned a lot

from during my internship. He has lots knowledge in Research & Development of Assistive

devices. He has also lots of knowledge in the working area that I have described such as

Physiotherapy. He was very helpful and always willing to give me advice and feedback which

I appreciate. I have tried to learn as much as possible from him and the therapists worked

there during my internship. The conversation through email and facebook with my college

mentor Arun Mascarenhas is also an important learning moment for me during my

internship. He had always time to answer all my questions concerning my internship. And as

a teacher, he also helped me a lot by giving me feedback on how to use my English writing.

He had always time to answer all my questions concerning my internship. I appreciate all

the advice he gave me during my internship.

Interning at RECOUP was definitely a learning experience. The most interesting event that I

have attended during my internship was the DESIGN & INNOVAION organized by the

Bangalore Alpha Labs. During this event I got to network meeting a lot of entrepreneurs

from the different areas. Besides the English language, I got to use my other languages such

as Hindi and Tamil even the Malayalam language. This made the conversations easier and I

got to learn more from the entrepreneurs. I really enjoyed attending this event and was

definitely experience to remember.

This internship was definitely beneficial for me and I’m grateful and thankful that I got to

experience and learn many things.