[Current aspects of neurologic and neurosurgical rehabilitation in ambulatory medicine].

Abstract

Nearly all neurological and neurosurgical diseases can cause lasting disabilities. Therefore, neurorehabilitation is needed. The German Pension Insurance Association has developed a concept of phases working as a chain of treatment, rehabilitation and care. This was confirmed as the one official system by the German Federal Society for Rehabilitation consisting of all social insurances and wellfare sponsors. The goals and tasks of each phase are defined by the functional status of the patients and their requirements for recovery. The costs are mostly determined by the social health or the social pension insurances. Different professions (physicians, nurses, physiotherapists, occupational therapists, speech therapists, (neuro-)psychologists, social workers) have to cooperate as a "therapeutic team" to improve the patient's impairments, disabilities and handicaps and to make full use of their individual resources of recovery. Only this can be the basis for valid prognostic decisions. In the long term treatment and care of the general practitioner, stroke patients are the most important group. Special problems are seen after traumatic brain injuries. Other relevant diagnoses are Parkinson's syndrome, multiple sclerosis, diseases and injuries of the spinal cord or the peripheral nervous system. In many patients, special aids have to be prescribed for several aspects of human living.