PROBLEMS IN REHABILITATION OF THE HEMIPLEGIC PATIENT

The new philosophy of the treatment of hemiplegia emphasizes attention to the portions of the body that remain functional. But it must be recognized that brain damage limits the goals of rehabilitation. Among the 122 patients here studied, there were 23 judged to be physically able to return to work, but of the 11 with right-sided hemiplegia, 6 are now employed, while of the 12 with left-sided hemiplegia, only 2 are now employed. Vocational rehabilitation was thus more likely in patients with involvement of the dominant hemisphere. Much can be done for the patient during the first 7 to 10 days of flaccidity, during the ensuing period of spasticity, and finally during the period of retraining in ambulation and self-care By early and persistent use of what is available, especially in the choice of assistive devices, many hemiplegic patients can be made self-sufficient, thus relieving their families and friends of much of the burden of their care.