National Spinal Injury Centre at Stoke Mandeville Hospital

"...it seemed impossible that a man who had lost the use of more than half his body could ever be anything but a hopeless cripple. It seemed almost ridiculous to imagine that he would ever be able to go home and take his place in any kind of normal life again.  But at the hospital at Stoke Mandeville miracles were worked." (Charles Rowe, The People)

Dr. Guttmann used a holistic team approach, with all medical staff working together. His pioneering treatment included frequent turning of patients to avoid bedsores, special diets, transfusions, penicillin, and sports therapy.  He strongly believed sports and exercise played an essential part in a patient's physical and mental rehabilitation. 

​​​​​​​​​​​​​​"It [rehabilitation] is a very complex process and includes a long series of activities, which can be divided into three stages: (1) First aid and early treatment; (2) Physical and psychological readjustment; and (3) Permanent settlement on employment."

"Repeated blood transfusions, special diets rich in protein, vitamins and glucose, scrupulous cleanliness of the patient, ... are essential measures in improving the patient's general condition. Intervening infections are combated by courses of sulphonamides ... and penicillin." 

"The two cardinal methods of local treatment of pressure sores are frequent change of posture and redistribution of pressure."

"The whole unit must be impregnated with enthusiasm, and this inspires the patient to cooperate to the full."

"Active exercises play a cardinal part in the rehabilitation of spinal injured, and these should be started early."

"Games play an important part in the physical and psychological readjustment of paraplegics....Darts and snooker [pool] are two examples of games...wheel-chair polo distract(s) the patient's attention from his disability, to keep the man's intelligence and concentration lively, to promote a good blood circulation, to keep his healthy limbs supple, and invigorate the body." (Ludwig Guttmann, Medical Times)

"Among the techniques that that he established arguably the most important was his multi-disciplinary approach that recognised that a combination of all disciplines – medical, nursing, physiotherapy, occupational therapy, social work - was needed to simultaneously address a patient’s needs." (Prof Wagih El-Masri, Mandeville Legacy)

"What was distinctive about Guttmann’s treatment regime at Stoke Mandeville? Essentially if they went anywhere else for care, the spinal injuries patients died. He exerted a total, obsessive control over all aspects of care at the hospital, whether it was him coming round in the middle of the night to make sure that the nurses had turned patients, or checking on the quality of the cleaners’ work or that of the food served on the wards. Everything was his responsibility. This was such an enormous contrast with the approach of consultants in most other hospitals who would do a ward round once a week and expected to leave everything else to junior doctors or nursing staff." (Dr. John Silver, National Paralympic HeritageTrust)

The first games were darts, pool, punch-ball and bowling. These led to more organized sports like wheelchair basketball. Archery became popular and it relied on upper body strength. Therefore the disabled could compete with the non-disabled, which broke barriers between paraplegics and society.​​​​​​​ 

"There was no question of whether the patient wanted to undertake sport-like work, Sir Ludwig introduced it into the dynamic treatment programme of spinal cord injuries with the same importance as that of bladder or skin care. As a result, the majority of our patients came to like sport and to recognise not only its physical but also its social advantages.​​​​​​​" (Joan Scruton - secretary Stoke Mandeville Hospital, Paraplegia)

"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... and confidence building.​​​​​​​" (Dot Tussler - physiotherapist, Mandeville Legacy)

Skeptics

There were people who questioned Dr. Guttman early in his work at Stoke Mandeville.  But, as paraplegics reintegrated into society, doubters were converted.

"Radical changes in the medical and psychological approach to the problem of spinal paraplegia as a whole were introduced, and as in any pioneer work in medicine, dogmas and many prejudices had to be overcome. I still recall the question that was put to me with almost monotonous regularity by visitors in the first two year of our work: 'Is it really worth while?' It was quite unorthodox in those days to reject the conventional methods of recumbancy and immobilisation... and replacing them with new methods of mobilising of the natural forces of repair and readjustment. It was a new approach to both medical and nursing staff."

"It was quite revolutionary to teach and impress on the authorities of medical and social services, that the mere fact that a person ws a paraplegic did not justify care in one of the institutions for 'incurables', but that in spite of his severe physical handicap, rehabilation to a useful life and employment was possible in the great majority of cases." (Ludwig Guttmann, Paraplegia)

The Mandeville Legacy - Paralympics Documentary, Mandeville Legacy