This volume describes those aspects of the process of rehabilitation applicable to people with disabling neurological disease. It has been directed towards a readership of neurologists, but calls on the expertise of authors from a variety of disciplines. It is hoped that the book will be of value to all professionals who work with patients suffering from neurological disorders. It assumes certain knowledge of neurological pathology and the diagnostic process in order to focus more sharply upon problem areas presented by the patient. The book is divided into three sections. The first describes the epidemiological, social, political and biological principles that underpin the practice of rehabilitation. The second describes the techniques necessary to this practice, including assessment and evaluation, and the characteristics and remediation of physical, cognitive, affective and behavioural disorders. The third highlights the use of these techniques in the context of specific diseases. The text emphasizes the fact that rehabilitation is an ongoing process involving problem-solving and education, in which assessment, goal-setting, intervention and reassessment are necessarily reiterative and require multi-disciplinary input. Where possible, evidence in support of the use of these techniques is described, but in many instances evidence of benefit, or otherwise, does not exist. This lack of evidence often does not represent the ineffectiveness of rehabilitation or absence of clear technique, but rather underlines the difficulties of researching into the area of multiple disability in contrast, for example, with trials of drugs or operations. Opportunities to rectify this situation are pointed out in the text. The book also emphasizes and contributes to the understanding of other aspects of practice in neurological rehabilitation, including: a perspective upon the icon of the randomized trial and a view which admits the usefulness of other group or single-case methodologies; some instances in which the needs of patients and their carers take precedence, in the end, over issues of cost containment, important though these are; the need for undergraduate or postgraduate training of doctors in neurological rehabilitation; and a breakdown of profssional barriers within rehabiliation to facilitate the use of combined treatment techniques.
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