Seminar - January-February 1952 - The Treatment of Residual Defects

Sep 29, 2026

Seminar material from January–February 1952 addresses chronic disease and disability in an aging population, focusing on hemiplegia as a major clinical and rehabilitation challenge. It argues that medical management must be frontal, dynamic, and total, noting large numbers of hemiplegic patients and the long-term impact of stroke. The text outlines a motivational, training-based rehabilitation approach, including emotional rehabilitation grounded in assessing capacities and shifting psychological investment. It also examines sensorial changes such as orientation, memory, and calculation, and emphasizes psychological testing for evaluation.

LanguageEnglish

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Pages24

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The Treatment of Residual Defects

Sensorial Changes

白 VE LEGE OL了POBT,MCHICA A Do NOTREMVE Seminar SHARP &DOHME,JANUARY-FEBRUARY 1952 TRACINETS. BACITRACIN-TYROTHRICIN TROCHES EDITED BY THE MEDICAL DIVISION OF SHARP&DOHME Original articles contributed by foremost authoritiesin their respective fields of medicine ContentsRehabilitation of the Hemiplegic PAGE 5 MEDICAL ILLUSTRATIONS BYFRANK NETTER,M.D. A CHALLENGE Today,the United States is faced with a groweing tide of chronic diseaseeith its concomitant disability,which threatens to engulf our nationallife medically,socially,and economically.Paradoxically,we in medicinehave caused much of this inundation through the scientific advances madein reducing the incidence of death from infectious and communicablediseases,through a reduction in infant mortality,and through improvedpublic health measures,thereby producing an aging population. .Two thousand years ago,the average length of life was 25 years;at the turn of the century,49,and today it is 67.In 1900,oneperson in 25 was 65 years of age or older;it is estimated that in 1980,the ratio will be 1:10.The chances are now 2 out of 3 that a youngman starting his working life at the age of 18 will live to his retirementage of 65.A 45 year old man today has 70 chances in 100 of reachingthe age of 65,and the chances for a 55 year old man are 78 in 100.White males aged 65 can expect to live an additional twelve years pluson the average,and wehite females fourteen plus years. As people become older,their medical needs change,and theyrequire more medical service.In 1940,the 26.5 per cent of the nation's population over 45 required over half the nation's medical services.By1980,it is expected that the number of persons over 45 will constitutenearly half the population. Not only do older persons require more medical services,but inaddition their medical needs differ from those of the younger age groups.Today,more and more of a physician's practice consists of the manage-ment of physical disabilities resulting from chronic disease,and of thisgroup there is no single clinical entity of the magnitude of hemiplegia.Today,on the basis of earlier statistics,it is estimated there are wellover 1,000,000 hemiplegic patients in the United States. Some idea of the extent of the problem may be obtained from thefact that the"stroke"is listed as the third major cause of death,rankingbehind only heart disease and cancer.The majority of patients who dosustain a stroke of apoplexy do not die during the initial state;insteadthey improve to a greater or lesser degree and often live a number ofyears despite their residual disabilities.Because of the numbers involved,as zwell as the severity of the disability,the problem of the medicalmanagement,as zwell as the rehabilitation of the hemiplegic,becomesone of great proportions.The attack on this problem must be frontal,dynamic,and total. # The Treatment of Residual Defects Unfortunately in the past,the medical attitude to-opportunity.Motivation is not difficult if there is adequate opportunity afforded the patient. ward the hemiplegic has been one of hopelessnessand passive acceptance.Hemiplegics have filled theback beds of our medical wards,the back bedroomsof our homes,and have crowded the few availablenursing homes and institutions for custodial care.With a dynamic approach,the hemiplegic is not alost cause.Recent spot checks on the results ofdynamic rehabilitation programs have shown that90 per cent of all hemiplegics can be taught ambula-tion,self-care and urinary and fecal continence,and30 per cent can be taught to do gainful vork.Further,it has been shown recently in a well-controlled objec-tive study that such programs can result in an incre-ment of over 125 per cent gain in ability to performactivities of daily living over nontreated subjectswith smaller but significant gains in muscle strengthand range of motion as vell.17 For a program to beeffective it must provide motivation and training Grayson in a s

FAQs

Why is rehabilitation of hemiplegia considered a major medical problem?

Hemiplegia arises after stroke and often leaves patients with long-term residual disabilities. The large number of affected individuals and the severity of disability make medical management and rehabilitation a major undertaking.

What makes a rehabilitation program effective for hemiplegic patients?

The program must provide motivation and training. Evidence cited in the text indicates that dynamic rehabilitation can teach ambulation, self-care, continence, and can improve activities of daily living.

How should sensorial changes be assessed in hemiplegia?

Sensorial changes require guarded prognosis, and assessment can involve orientation, memory, and the ability to do simple calculations. Psychological testing is described as the most informative method to evaluate remaining assets and cerebral deterioration.

Sep 29, 2026

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