الفهرس 
THE SPINAL CORDOnly 14 pages are availabe for public view
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Abstract
l’ht r•rH tlr, !l1uhit~’,1l ul JJll}’Sjca1 Jj,c;abj}jty, \-Jilich Ita:-; bevl! (’);-
pt•,·1·.·d t,, diminj::-;li v.rjt!J improv(’d mcdic3-l can·, l1as~ pnradnxicaJly,
p_vt~afJlidl·d to alat-minf!, m:~g11ituJe.
V.,Tjt)J bcttt’r prL·vr·ntion~ Jefjnitive c:arc ;md sav1ng of life, survlva1
and Jmq;cvity have increased to the point, where the annual lncremcnt
of the physical handicapped is constantly mounting. Rusk
(Arch. lndusL.Hyg. Apri I l95l) has referred to rchahiliLation as the
11 3rd phase” of medical care and has he]pcd to engender wide spread
recognition of its significance and effectiveness in our complicated
medical-social-economic structure. The philosophy of rehabilitation
springs not only from human emotions, but is integral in the medical
responsibility of all physicians. Success in rehabilitation is only
as good as the medical planning behind it. Knudson (Arch.Phys.Med.,
March 1953) points out that the hospital beds are becoming filled with
chronically ill patients at an increasing rate and tt1at is why the number
of beds available for the acutely ill is inadequate. The statistlCS
alone tell only a small parl of tl1c story. The long term toll of
chronic ilJness in : suffering, anxiety and distrupted homes, constitutes
the real tragedy of the situation. Moreover, the staggering cost
of chronic disease to the community and to the nation depletes the resources
of manpower and money, and the Joss of oarning power <Jf tl1c· iilrapacitated
increases the cost.
RPhrtbilitation 1s one of the most expons1ve types ilf medic,1l (·,-trc· :irid
:it j s 1-ikey tn rema111 su sjnce the costs involvC’d are not dept.:·ndl·nt llll
the economic ratio uf :oupply and dcnund h11t up11r1 the’ hc~sic f~ll’ tlut
large numbers of h-ighJy trained pC’rsonncJ and a great deal of tim() :lf<’
rcquil’f’d for the optimal lrt·atment of most of these patients.
H.ehabilit,·:ltion as a branch of mcdicjnc· includes both the [cq-muJ:ttiun
and the attainment (if the maximum re_a]istic goals of tota1 functiun f(’r
tllllSl’ disabled by injury or discasP. l. Evaluation of the patient as a whole.
2. Physical medicine.
3. Psychological supportive therapy.
4. Vocation a] training
l) EVALUATION OF THE PATIENT must inclttdc a detailed survey of his disability,
his reaction to it and his remaining potentialities on which
he can base his fuLure. Accurate diagnosis forms the basis for estimating
the duration and degree of disability and as a sequel for
planning preventive meaStires. ~rhen an established permanent disability
exits, an analysis of its scope must be made, that is, a
functional diagnosis.
Pain must be eliminated or minimised before a patier1t can participatp
in any kind of rehabilitation procedure. Every surgical, pharmacnlogical
and physical means shouJd bP usc:d to overcome p;lin, ancl
thcrelYy obtain the coopc:ration ancl confidcncC’ nf the’ pat it’ll!. ~L!l\’
patients arc drprivcd ofanopportunity for r(~hnbilit:HiclJl i<’r a L-kk
of successful cClntroJ of pain, hccaust’ of limitatit)ll pf their p;lrtici
pation in an adcquale prngr;1m.
intcrferen< t’ ”h’ith the function (lf
the muscles may be brought dboul by trauma, disusP, i.mmobilisnti(lJi,
pPripllera1 nerve injuries or upper motor neurone lesions, c11n.it’a1lY
~1 v..’idc variety of muscular impairmC”nts are SQCn, including the nn:;-;-
p;tralysis or paresis associat0d \Vitll JW]i(llllV(’]Jti~; :1nd a v..’idl:’ \”,lt-it’IY
of nther neurological conJiticlils.