Posts in this category are not easily categorised! They will cover any aspect of rehabilitation and a range of topics peripheral to rehabilitation, matters that should be discussed and considered but may not be – yet.
I am asked to provide second opinions when the local team has difficulty, usually when the patient and family disagree with the rehabilitation team, or there are disputes about funding more rehabilitation. I enjoy the challenge and typically find a way forward. This post is my reflection on how I approach challenging and complex cases. […]
Resolving complex clinical cases. Read More »
Virtual reality is frequently used to describe rehabilitation treatment and occasionally assessments. But what does the term mean, or, more accurately, what does the user mean by it? Was ‘Return of the [space] Invaders’, released in 1984, virtual reality? It certainly engrossed thousands of people, including me! Knowing what the term means is crucial when
Virtual Reality rehabilitation Read More »
Over 44 years of interest and research in rehabilitation, I have scarcely considered hope except as something likely to cause distress when it is not realised. My interest started on 9 June 2024 when I wrote a page on “goals and hope in rehabilitation,” now published. I only added hope to contrast it with goal
Hope in rehabilitation: an overlooked asset? Read More »
Community rehabilitation is rehabilitation delivered to a patient outside a hospital setting by a multi-professional team managed as a unit with a single budget, whose members have shared resources and meet regularly in their base to discuss cases, policies, and quality improvement. Community rehabilitation sounds good to politicians (it saves money on buildings), patients (they
What is community rehabilitation? Read More »
First published: April 6, 2024 Last updated: November 23, 2025 In healthcare, a diagnosis is a label assigned to a health condition. The Oxford English Dictionary defines diagnosis as: “the identification of the nature of an illness or other problem by examination of the symptoms,” and the Cambridge Dictionary as: “a judgment about what a
What is a diagnosis? Part 1 Read More »
The title of this post is deliberately ambiguous. It contains both the issue – how should you make a challenging clinical decision – and the answer – challenge each decision to check that it is sound and justified. Using four recent legal judgments, I will argue that the best way to make a difficult decision
Challenging clinical decisions Read More »
Neural plasticity is “the ability of the central nervous system (CNS) to adapt in response to changes in the environment or lesions”. It has been recognised since 1912. Publications about rehabilitation have increasingly referred to neural plasticity as central to rehabilitation’s success; for example, Zuha Warraich and Jeffrey Kleim said, “an understanding of neural plasticity
Two recent judgements from the Court of Protection have concerned the conflict between a person’s deep-held beliefs and what the clinical team judged to be in the person’s best interests. One case involved KT, a 53-year-old man in a prolonged disorder of consciousness where the clinical team considered it was no longer in his best
Beliefs, capacity, and best interests Read More »
First published: October 21, 2023 Last updated: March 22, 2025 Personal factors (WHO ICF) are an invalid construct. They cannot exist separate from the person as independent influential factors. The person has characteristics, which vary according to the person’s role at the time. The World Health Organisation’s International Classification of Impairment, Disability and Handicap, published
Personal factors in rehabilitation Read More »
A patient’s father recently asked me, “What is the usual rehabilitation curriculum for someone with problems like my son’s?”. Until then, I had only considered a rehabilitation curriculum in the context of educating and training healthcare professionals about rehabilitation. I had never thought of a patient’s rehabilitation curriculum. Although I have often said rehabilitation is
A patient’s rehabilitation curriculum? Read More »
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