Neuro rehab
Unit 1
Intro to NR, Historical background
INTRO
o Rehab is a process of active change by which a disabled person acquires and uses
the knowledge and skills necessary for ideal physical, psychological and social
functions. It is an active process in which at least 2 people are involved- person with
disability and helper or therapist who is there to help them to regain some lost skills
or abilities what he had earlier.
o Rehabilitation is a widely accepted means of treatment of chronic physical illnesses,
neurological disorders, intellectual impairment and psychiatric illnesses.
o Neuropsychological rehabilitation can be defined as a therapeutic approach which
aims to address cognitive, emotional, and behavioural deficits which result from
central nervous system injuries or disorders.
o It involves a multidisciplinary effort to restore or compensate for impairments in
various cognitive functions such as attention, memory, language, executive
functions, and social skills.
o Neuropsychological rehabilitation typically includes assessment, intervention, and
support tailored to individual needs, and
o goal is to improve everyday functioning, promoting independence, and enhancing
quality of life for individuals affected by neurological conditions.
o Contemporary neuropsychological rehabilitation is concerned with helping people
with cognitive, emotional or behavioural difficulties after brain injury to achieve their
maximum potential in various domains like psychological, social, leisure, vocational
and everyday functioning, (Wilson, 2009). This definition emphasises that NR
concerned with how people live their life after brain injury.
TYPES OF REHABILITATION
Rehabilitation in psychiatry has been classified in following types:
1) Depending on the areas of concern: (MSPVC)
Medical - involving restoration of function
Vocational- involving restoration of the capacity to earn a livelihood
Social - involving restoration of family and social relationships,
Psychosocial - involving restoration of personal dignity and confidence.
Cognitive - involving restoration of cognitive functions like attention and memory.
2) Settings of Rehabilitation Activities:
o Inpatient: This setting typically involves treatment within a hospital or
residential facility, focusing on stabilization, acute care, and initial
, rehabilitation efforts. It often includes pharmacotherapy (medication
management) and psychoeducation.
o Outpatient: Patients receive treatment while living at home and visit
healthcare facilities for therapy sessions or appointments. It includes
individual therapy, family therapy, pharmacotherapy, and psychotherapy. It
also emphasizes functional family intervention and education.
o Community: This setting involves rehabilitation services delivered within the
community, such as community care centers, day care centers, and sheltered
workshops. Community-based rehabilitation aims to integrate individuals
back into society and promote independence within their local environments.
3) Parallel Rehabilitation 'Ladders':
o Domestic: Describes a path of rehabilitation that starts in a hospital or
residential setting and progresses through different stages, such as hostel
wards, hospital hostels, halfway houses, group homes, and finally
independent living. It focuses on moving from institutional care to living in
the community step by step.
o Occupational: Similar to vocational rehabilitation, this ladder focuses on
preparing individuals to re-enter the workforce. aimed at enhancing
employment skills, job training, job placement.
HISTORY
1. Early History: The earliest known description of brain injury treatment dates back
2500-3000 years ago in an Egyptian document discovered by Edwin Smith in Luxor
in 1862. It describes the treatment of various injuries, including brain trauma,
demonstrating an advanced level of medical knowledge for its time. Notably, it
contains the first known descriptions of cranial structures, the meninges, the
external surface of the brain, cerebrospinal fluid, and intracranial pulsations.
Hippocrates said no head injury is too severe to despair or nor too trivial to ignore.
In 19th century more and more survived brain injury even gunshots to brain. After
this cognitive impairment were discussed. Two types of rehabs were worked on-
visuospatial and speech.
2. Kurt Goldstein's Contributions: Kurt Goldstein, a German neurologist and
psychiatrist, is a pioneer in modern neuropsychology. He said don’t believe in short
term but in long term treatment. Goldstein's work involved treating soldiers with
brain injuries during wartime, followed by rehabilitation efforts in a therapeutic
setting in Frankfurt. He gave the term “catastrophic reaction” that means severe
condition or consequences.
3. Zangwill said in 1947- “we wish to know in particular how much the brain injured
patient can overcome for his disabilities and the extent to which the brain is capable
of re-education. He gave 3 terms: CSD
Compensation: Adjusting to minimize a disability.
Substitution: Using new methods to replace lost functions.
Direct retraining: Improving brain functions with extra help.
Unit 1
Intro to NR, Historical background
INTRO
o Rehab is a process of active change by which a disabled person acquires and uses
the knowledge and skills necessary for ideal physical, psychological and social
functions. It is an active process in which at least 2 people are involved- person with
disability and helper or therapist who is there to help them to regain some lost skills
or abilities what he had earlier.
o Rehabilitation is a widely accepted means of treatment of chronic physical illnesses,
neurological disorders, intellectual impairment and psychiatric illnesses.
o Neuropsychological rehabilitation can be defined as a therapeutic approach which
aims to address cognitive, emotional, and behavioural deficits which result from
central nervous system injuries or disorders.
o It involves a multidisciplinary effort to restore or compensate for impairments in
various cognitive functions such as attention, memory, language, executive
functions, and social skills.
o Neuropsychological rehabilitation typically includes assessment, intervention, and
support tailored to individual needs, and
o goal is to improve everyday functioning, promoting independence, and enhancing
quality of life for individuals affected by neurological conditions.
o Contemporary neuropsychological rehabilitation is concerned with helping people
with cognitive, emotional or behavioural difficulties after brain injury to achieve their
maximum potential in various domains like psychological, social, leisure, vocational
and everyday functioning, (Wilson, 2009). This definition emphasises that NR
concerned with how people live their life after brain injury.
TYPES OF REHABILITATION
Rehabilitation in psychiatry has been classified in following types:
1) Depending on the areas of concern: (MSPVC)
Medical - involving restoration of function
Vocational- involving restoration of the capacity to earn a livelihood
Social - involving restoration of family and social relationships,
Psychosocial - involving restoration of personal dignity and confidence.
Cognitive - involving restoration of cognitive functions like attention and memory.
2) Settings of Rehabilitation Activities:
o Inpatient: This setting typically involves treatment within a hospital or
residential facility, focusing on stabilization, acute care, and initial
, rehabilitation efforts. It often includes pharmacotherapy (medication
management) and psychoeducation.
o Outpatient: Patients receive treatment while living at home and visit
healthcare facilities for therapy sessions or appointments. It includes
individual therapy, family therapy, pharmacotherapy, and psychotherapy. It
also emphasizes functional family intervention and education.
o Community: This setting involves rehabilitation services delivered within the
community, such as community care centers, day care centers, and sheltered
workshops. Community-based rehabilitation aims to integrate individuals
back into society and promote independence within their local environments.
3) Parallel Rehabilitation 'Ladders':
o Domestic: Describes a path of rehabilitation that starts in a hospital or
residential setting and progresses through different stages, such as hostel
wards, hospital hostels, halfway houses, group homes, and finally
independent living. It focuses on moving from institutional care to living in
the community step by step.
o Occupational: Similar to vocational rehabilitation, this ladder focuses on
preparing individuals to re-enter the workforce. aimed at enhancing
employment skills, job training, job placement.
HISTORY
1. Early History: The earliest known description of brain injury treatment dates back
2500-3000 years ago in an Egyptian document discovered by Edwin Smith in Luxor
in 1862. It describes the treatment of various injuries, including brain trauma,
demonstrating an advanced level of medical knowledge for its time. Notably, it
contains the first known descriptions of cranial structures, the meninges, the
external surface of the brain, cerebrospinal fluid, and intracranial pulsations.
Hippocrates said no head injury is too severe to despair or nor too trivial to ignore.
In 19th century more and more survived brain injury even gunshots to brain. After
this cognitive impairment were discussed. Two types of rehabs were worked on-
visuospatial and speech.
2. Kurt Goldstein's Contributions: Kurt Goldstein, a German neurologist and
psychiatrist, is a pioneer in modern neuropsychology. He said don’t believe in short
term but in long term treatment. Goldstein's work involved treating soldiers with
brain injuries during wartime, followed by rehabilitation efforts in a therapeutic
setting in Frankfurt. He gave the term “catastrophic reaction” that means severe
condition or consequences.
3. Zangwill said in 1947- “we wish to know in particular how much the brain injured
patient can overcome for his disabilities and the extent to which the brain is capable
of re-education. He gave 3 terms: CSD
Compensation: Adjusting to minimize a disability.
Substitution: Using new methods to replace lost functions.
Direct retraining: Improving brain functions with extra help.
