edited by STEPHEN MATTINGLY TO, MB, FRCP, O.PHVS.MEO Consultant Rheumatologist, The Middlesex Hospital, London UPDATE BOOKS Published by

Transcription

1 RIHABlllTATloN TODAY edited by STEPHEN MATTINGLY TO, MB, FRCP, O.PHVS.MEO Consultant Rheumatologist, The Middlesex Hospital, London UPDATE BOOKS Published by UPDATE PUBLICATIONS LIMITED 33/34 Alfred Place, London We1 E 7DP

2 ACKNOWLEDGEMENT Chapter 24 is published with kind permission of the Director General Medical Services RAF Update Publications Ltd, 1977 ISBN-13: : / e-isbn-13: All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical. photocopying, recording or otherwise without the prior permission of the copyright owner.

3 Contents 1. Introduction Stephen Mattingly 1 2. The Need for Rehabilitation Michael D. Warren 6 3. Hospital Services Stephen Mattingly Medical Rehabilitation Centres Stephen Mattingly Community Services A. P. H. Randle Resettlement in the Community M. Broome and J. J. McMullan Voluntary Organisations Concerned with James G. Sommerville 36 Disabled People 8. Employment and Training Services Stephen Mattingly Special Centres Stephen Mattingly Demonstration Centres George Cochrane and Hugh Glanville Designing for the Disabled C. Wycliffe Noble Aids and Appliances P. J. R. Nichols and E. Williams Wheelchairs and Powered Vehicles C. J. Goodwill The Handicapped Child K. S. Holt The Young Amputee Ann Hamilton, E. Williams and 98 P. J. R. Nichols 16. Rehabilitation of the Elderly A. N. Exton-Smith The Elderly Lower Limb Amputee Ann Hamilton, E. Williams and P. J. R. Nichols The Severely Disabled P. J. R. Nichols and E. Williams The Mentally III D. H. Bennett 119

4 20. The Neurological Patient E. B. Casey and A. D. Tupper The Newly Blind Tony Aston Deafness D. Garfield Davies The Arthritic Patient M. A. Chamberlain and V. Wright Helping the Injured M. G. Molloy and C. B. Wynn Parry Paraplegia J. R. Silver 161 Appendices 168 Index 179

5 List of Contributors Aston, Tony Head, Employment and Assistance Department, Royal National Institute for the Blind, London. Goodwill, C. J., MB, FRCP, D.PHYS.MED Consultant Physician, Department of Rheumatology and Rehabilitation, King's College Hospital, London. Bennett, D. H., MD, FRC.PSYCH Consultant Psychiatrist Bethlem Royal and the Maudsley Hospital, London. Broome, M. Medical Social Worker, Garston Manor Medical Rehabilitation Centre, Watford, Herts. Casey, E. B., B.SC, MD, MRCP, MRCPI Consultant Rheumatologist, St. James's Hospital, Dublin, Eire. Formerly Consultant to the Department of Rheumatology and Rehabilitation, St George's Hospital, London, and Director of the Wolfson Medical Rehabilitation Centre, Wimbledon. Chamberlain, M. A., B.SC, MRCP Consultant Physician in Rehabilitation Medicine, the General Infirmary, Leeds. Cochrane, George, MA, MB, FRCP, D.PHYS.MED Consultant in Rheumatology and Rehabilitation, Royal Infirmary, Derby; Medical Adviser to the Institute of Consumer Ergonomics, Loughborough University; Medical Adviser on research into equipment for the disabled sponsored by the DHSS. Exton-Smith, A.N., MD, FRCP Professor of Geriatric Medicine, University College Hospital Medical School, London. Hamilton, Ann, MB, B.CH, D.PHYS.MED Clinical Assistant, Mary Marlborough Lodge, Nuffield Orthopaedic Centre, Oxford; Assistant Medical Officer, Artificial Limb Appliance Centre, Oxford. Holt, K. S., MD, FRCP, DPH Director of the Wolfson Centre; Professor of Developmental Paediatrics, Institute of Child Health, London. Mattingly, Stephen, TD, MB, FRCP, D.PHYS.MED Deputy Director, Department of Rheumatology, The Middlesex Hospital, London; Medical Director, Garston Manor Rehabilitation Centre, Watford, Herts; Honorary Consultant in Rheumatology and Rehabilitation to the Army. Formerly Regional Medical Consultant to the Department of Employment. McMullan, J. J., MD, DIH, MRCGP General Practitioner, Chesham, Bucks. Molloy, M. G., MB, B.CH, BAO, D.PHYS.MED Captain, RAMC; Specialist in Rheumatology and Rehabilitation Nichols, P. J. R., MA, DM, FRCP, D.PHYS.MED Consultant in Rehabilitation Medicine, Nuffield Orthopaedic Centre, Oxford and Consultant Adviser in Rehabilitation Medicine to the DHSS. Garfield Davies, D., MB, BS, FRCS Consultant Otolaryngologist, Middlesex Hospital, London; Consultant Surgeon, Royal National Throat, Nose and Ear Hospital, London; Lecturer, Institute of Laryngology and Otology. Randle, A. P. H., MB, FRCPI, D.PHYS.MED Consultant in Rheumatology and Rehabilitation at Addenbrooke's Hospital, Cambridge; Consultant in Rehabilitation to the National Hospitals for Nervous Diseases. Glanville, Hugh, FRCP, D.PHYS.MED Europe Professor of Rehabilitation, University of Southampton; Consultant in Rheumatology and Rehabilitation, Salisbury. Silver, J. R., MB, BS, MRCPE Consultant in Spinal Injuries at the National Spinal Injuries Centre, Stoke Mandeville Hospital, Buckinghamshire.

6 Sommerville, James G., MD, MRCP Consultant in charge of the Department of Rheumatology'and Rehabilitation, University College Hospital, London; Medical Director. Medical Rehabilitation Centre, London NW1 ; Honorary Consultant in Medical Rehabilitation. St George's Hospital, London; Honorary Senior Lecturer in Medical Rehabilitation, University of London. Williams, E., MB, MRCP Consultant Physician in Rheumatology and Rehabilitation, Fazakerley Hospital, Liverpool. Formerly at the Nuffield Orthopaedic Centre, Oxford. Wright, V., MD, FRCP Professor of Rheumatology, University of Leeds, Tupper, A. D., MB, BS, D.PHYS,MED Consultant in Rehabilitation, University College Hospital, London; Formerly Deputy Director, Wolfson Medical Rehabilitation Centre; Consultant to Banstead Place, Queen Elizabeth's Foundation, Surrey. Warren, Michael D., MD. FRCP. FFCM Professor and Director of the Health Services Research Unit, University of Kent, Canterbury. Wycliffe Noble, C., FRIBA, FRSA Consultant Architect to the Central Council for the Disabled. Wynn Parry, C. B., MBE, MA. OM. F.RCP, D,PHYS.M ED Director of Rehabilitation, Royal National Orthopaedic Hospital, London; Civilian Consultant in Rehabilitation to the Royal Air Force. Formerly, Group Captain RAF Medical Services and Consultant Adviser in Rheumatology and Rehabilitation

7 Preface THIS book is based on a series of papers first published in Update during 1974 and When they originally appeared they attracted attention from workers in many fields connected with rehabilitation, and it was clear that their appeal stretched far beyond the usual readership of Update. The papers present a unique collection of information on aspects of rehabilitation, and their publication as a single volume has been requested by many. Since their original publication the papers have been revised. There have been many changes in the organisation of government and voluntary services, including, for example, changes in the law relating to the mobility allowance. These changes have been incorporated in the revision, and the book now presents an up-to-date account of the various aspects of rehabilitation including the services provided by government and voluntary organisations, relevant legislation, the provision of aids and appliances and problems affecting particular disability groups. If it is concerned principally with the physically disabled this is because they appear numerically to be the most important. It is difficult, if not impossible, to define the scope of rehabilitation because it encompasses so many aspects of a patient's care and involves so many people and organisations. It is too important a subject to remain the interest only of specialists in rehabilitation medicine. All doctors must be responsible for the rehabilitation of their patients. Of course, the successful rehabilitation of a patient after illness or injury is not solely a medical problem and I hope that this book will be read not only by doctors, medical students, nurses and remedial therapists, but also by disablement resettlement officers, social workers and others working in the community. I am indebted to my fellow contributors for their help in presenting a comprehensive account of rehabilitation in Great Britain today and to Update Publications for making this book possible. Stephen Mattingly