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August 3, 1957


Author Affiliations

New York

From the Department of Physical Medicine and Rehabilitation of the New York University—Bellevue Medical Center. While engaged in this study, Dr. Berns was a Fellow supported by the Allen P. and Josephine B. Green Fund.

JAMA. 1957;164(14):1551-1558. doi:10.1001/jama.1957.02980140027005

• Patients with paraplegia resulting from peacetime accidents are aided by the same programs of rehabilitation that were developed for the management of wartime cases. A group of 31 patients with severe paralyses in the lower extremities after spinal cord injuries were admitted to a course of training in selfcare and mobility, bowel and bladder control, and psychosocial and vocational adjustment. Complications arising in 20 of the 31 patients necessitated additional surgical or medical care during the training period. Each patient was studied again not less than one year after returning home. At this time 13 were employed full time in jobs and 10 others were in vocational training programs preparatory to employment, as contrasted with 24 who had been unemployed and economically dependent before admission to the rehabilitation program. The follow-up study demonstrated the sustained effectiveness of the physical and vocational rehabilitation for most of the patients. The costs of the total program, including transportation to and from the rehabilitation center, have been computed and demonstrate its economic advantages. To these economic considerations must be added many intangibles, especially the psychological gains to the patient and to the people in his immediate environment.