Aids for daily living: the problems of the severely disabled

This paper is a description of the nature of different forms of disability and their incidence in the general population. It deals with the problems of management and rehabilitation of the disabled, and emphasises the importance of taking consideration of the behavioural and social factors in assessing individual needs. It describes the role of equipment, mainly special equipment, in the rehabilitation process, and points out the difficulties arising from architectural barriers.

Access by general practitioners to physiotherapy department of a district general hospital

There has been much opposition, voiced most notably in the Tunbridge Report, to general-practitioner access to hospital rehabilitation services. Co-operation between general practitioners, physiotherapists, and the consultant with responsibility for the physiotherapy department at a general district hospital has provided an efficient open-access service. This service has been welcomed by the general practitioners because it supplies prompt treatment for their patients and by the physiotherapists because it enables them to minimise disability by treating musculoskeletal problems at an early stage.

A radiological assessment of osteoarthrosis of the knee: experiments in observer error

In a trial to determine the best palliative physiotherapy for the painful osteoarthrosic knee, radiological assessment was suggested as a measure for testing homogeneity of treatment groups. Preliminary observer error experiments showed that an accepted standard grading scheme was unsatisfactory. A different system was designed in which all three knee compartments were graded separately (medial, lateral and patello femoral), based on a comparison of supine and erect films. The two systems have been compared in use on the same set of radiographs, and the observer error results are presented. The advantages of grading each compartment separately are discussed.

Preliminary studies in measuring range of motion in normal and painful stiff shoulders

This study has been prompted by the need to provide basic data for prospective studies in the management of the painful stiff shoulder. We have used a hydrogoniometric technique of proven accuracy to measure passive movement at the gleno-humeral joint in a normal population, patients currently attending with a painful stiff shoulder, and a retrospective group. We have shown that there are significant age and sex differences in the range of motion of normal and affected groups. A significant number (42 per cent) of patients had persisting limitation of range of the gleno-humeral joint six years after the onset of the disability. The study indicates the importance of matching patients for age and sex, and the need for long-term follow-up for meaningful results.