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This multiauthor book aims to provide physicians with an approach to the management of patients with chronic neurological disease.
The first part of the book describes a general approach to the management of neurologically disabling conditions, with three chapters entitled Nature of the problem,Character of the solution andMeasurement of effectiveness. The first describes the prevalence of disability with particular reference to the United States and then goes on to describe the nature of the disease, impairment, disability, and handicap, with an interesting discussion of the meaning of illness. The second chapter provides a good overview of a particular approach to rehabilitation. It describes a specific framework that encompasses many of the ideas and concepts that are common to rehabilitation throughout the world. The final chapter considers issues surrounding measurement of outcome.
The second part of the book applies this approach to specific diagnostic groups. The book has been well edited with each of the chapters following the same standard format with the nature of the problems being covered with sections reviewing the epidemiology of the disorder, the nature of the disease, and the associated impairments, disabilities and handicaps followed by sections on the character of the solution discussing management techniques and outcome measurement. A particularly good chapter is on spinal cord injury by Pamela Ballard with very specific descriptions of the impairments, disabilities, handicaps, and quality of life issues associated with spinal cord injury and their management. Other chapters are less coherent which may reflect the fact that for some disorders (spinal injury, multiple sclerosis) rehabilitation approaches are better established than for others. Each of the chapters illustrates the approach using clinical anecdotes. These emphasise the importance of the physician taking a patient centred approach.
Overall this book is worth reading for its description of a rehabilitation approach. The second section is less likely to appeal to neurologists but may have wider appeal to non-neurologically trained physicians working with patients with chronic neurological disease.
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