Rehabilitation should be regarded as scientific challenge

EDITOR—Greenwood's editorial on the future of rehabilitation is a welcome sign that British neurologists have accepted restorative neurology as part of their discipline.1 But it suggests that their grasp of what rehabilitation is, and their understanding of the range of objectives that rehabilitation medicine seeks to achieve, are still uncertain.

For disabled people whose impairments cannot be reversed, rehabilitation involves processes that are clearly distinct from biological recovery, including learning, the acquisition of new skills, and the changing of behaviour. This is the case for the many non-neurological causes of impairment as well as the neurological ones.

Greenwood suggests that neurologists are far more disposed to accept published evidence that rehabilitation works now that they are able to view physical changes in the brain that might be taking place concurrently with it. If this is true they are seriously confusing two kinds of evidence.

Scientific study of the acquisition of skills and of the processes that enhance or obstruct it …