Chapter 53 Rehabilitation therapies

This chapter retraces the history and evolution of rehabilitative efforts by physicians and other health professionals to alleviate the symptoms and disabilities associated with neurological disorders. Rehabilitation therapies often provide interventions that go beyond traditional medical treatment aimed at treating impairments, and help those with neurological injuries and illness to re-establish themselves as productive and socially-integrated citizens by reducing their functional disabilities. The chapter considers the early history of practical treatments developed in Greek and Roman times, reviews the scattered attempts at treatment during the Middle Ages and Renaissance, examines the more recent development of specific rehabilitative techniques and disciplines in the 20th century, and also provides discussion of the contemporary application of empirically validated rehabilitation strategies and techniques that emphasize treatment efficacy. The evolution of medical and physical rehabilitation, occupational and vocational rehabilitation, aphasia and cognitive rehabilitation, are all discussed, with additional review of the influence of some of the military conflicts and wars in history that have stimulated the advancement of the clinical practice of rehabilitation. A critique of the benefits of comprehensive rehabilitative programs for traumatic brain injury and stroke is specifically included. The varied skepticism and optimism of treating neurological disorders throughout history is also highlighted.