Vulnerability

Our ignorance in treating neurologic patients may be hidden by applying discretionary physical therapy concepts and techniques [1], using technologies, such as virtual reality and robotics [2], providing intensive physical therapy for hospitalized neurological patients [3] or importing entire neurorehabilitation models from other countries as rehabilitation strategies.

Neurorehabilitation protocols cannot be compared to those of orthopaedic rehabilitation where methodology is well established. We live in an era of important changes related to how we evaluate and rehabilitate neurological lesions, based on electrophysiological and functional brain image studies [4]. Treating a variety of neurological ailments with a wide range of symptoms has forced us to design unique and individual programmes.

Neurorehabilitation must be looked upon as a process in which people with a secondary disability to a neurological lesion or disease work together with a team of professionals, relatives and members of their community with the purpose of attaining the highest level of physical, vocational, psychological and social wellbeing. This editorial does not intend to analyse different medical strategies for neurological patients’ rehabilitation, rather it addresses the concept of neurorehabilitation in different cultural communities.

The birth and evolution of rehabilitation medicine in each of our countries has been driven by different needs. In Mexico, for example, the origin of rehabilitation dates back to 1861 when the government opened special schools for the blind, deaf and mute, a responsibility formerly assumed by the church as the primary caregiver for the handicapped. The Children's Hospital of Mexico began the modern era of medical rehabilitation in 1943, by focusing primarily on treating conditions that resulted from poliomyelitis, cerebral palsy, birth defects and traumatic and neurological ailments [5]. Development of neurorehabilitation strategies must not be left to chance, particularly because people now have access to the large amounts of information that are available through electronic media, which can confound those interested in the subject matter.

We must seek to educate and guide medical professionals and the community in regard to the old and new forms of treatment to ensure they are less vulnerable to the information that could impress them, despite the fact that it lacks scientific support. The essence of this development cannot be limited to patient treatments and must provide knowledge and information about a general consensus concerning treatment strategies in this field and about research and investigation trends worldwide. The work of medical specialists and paramedics should consist of analysing and taking the vital aspects of this information, according to their individual needs, to adjust and apply said information to their communities based on their social, cultural and financial environments [6].

One of the primary objectives advanced by the World Federation for Neurologic Rehabilitation (WFNR) consists precisely of educating people through its courses and congresses and providing support by means of international professors who participate in diverse events in countries around the world.

Participants at the second Pan-American Conference in Buenos Aires (September 2007) agreed to develop a Spanish-language webpage within the WFNR's website, to promote neurorehabilitation in Latin America. Since 1999 the WFNR has sponsored a Neurologic Rehabilitation Certification Course held in Newcastle Upon Tyne in the UK directed toward professionals in the field. A proposal was made to present a course in Spanish in a Latin American city, thus opening this educational opportunity to a larger number of people. The faculty for the course in Spanish includes a local and an international team.

Many Latin American countries belong to a network of paediatric neurorehabilitation centres called ‘Teleton’. I proposed at the 2007, Second Pan-American Conference that Teleton could help spread information and knowledge about neurorehabilitation. It can also serve as a liaison between communities with similar needs in Latin America. At the same time, smaller, locally established medical service networks can help form interest groups based on ongoing daily hospitalization and outpatient practices to identify areas that require stronger levels of attention. These interest groups can serve a similar function as Teleton in Latin America. Professional publications can add to this purpose.

These activities in Latin America will serve as a model for other geographic regions to form neurorehabilitation work teams. The specific objectives of which are as follows:

• Determine specific epidemiological aspects that are not well-known in Latin America.

• Bring together health professionals who work in the field of neurorehabilitation.

• Learn the current status of rehabilitation treatment for neurological patients.

• Establish evaluation and management guidelines and validate these guidelines in our communities.

• Promote education, support research activities and encourage publication in professional journals.

Improving professional communication is key to spreading an appropriate and ethical practice of neurorehabilitation. This will be aided by incorporating an interdisciplinary approach to serve a wide base of patients needs.

For more information please contact the World Federation for Neurologic Rehabilitation:

[email protected]

[email protected]