[Integrated physical therapy in psychiatry, neuro-rehabilitation and rehabilitation of the aged]. / Integrierte Physiotherapie in Psychiatrie, Neurorehabilitation und Altersrehabilitation.

Physiotherapy forms a main part of modern therapy, however it only can be optimal in full integration with pharmacotherapy, psychotherapy and sociotherapy. Gerontopsychiatry offers a large field for physiotherapists. Besides highly specialised physiotherapy the dimension of recreation, fun-giving and amelioration of life quality must not be forgotten in physiotherapy. These possibilities from an important function within a human and humanitarian medicine. A further main condition for amelioration is to involve relatives fully in the therapeutical concept. Our experience has shown that within the domestic surrounding rehabilitative progress can well arrive; however, only if systematically prepared and uninterrupted stimulated.

[Ten years neurologic follow up--part of the "Vorarlberg Rehabilitation Model"]. / 10 Jahre nachgehender neurologischer Rehabilitationsdienst--Teil des "Rehabilitationsmodells Vorarlberg".

Within our framework of "comprehensive and permanent" rehabilitation, the follow-up neurological rehabilitation service is an important element. Based on the findings of an anterospective computerized documentation, a ten year survey is given concerning more than 600 patients and over 15,000 home visits. Aside general epidemiologic data, such as age, gender distribution, etc., our findings above all show that improvements in rehabilitation profiles can be achieved even after prolonged periods of time (i.e., 12 months and over) after onset. This, for one thing, may help in countering a widespread rehabilitation pessimism and, for another, serve in motivating the responsible cost-carrying agencies to pay increased attention to the field of neuro-rehabilitation. Literature concerning systematic assessment of long-term rehabilitation outcomes is sparse and fragmental. Available data to a large extent are in line with our findings. Further accompanying rehabilitation research into these respects is urgently needed. A number of important service delivery/organizational aspects have in addition been traced, which we are already trying to implement within our Vorarlberg rehabilitation model.

[Clinical and biochemical follow up of Refsum's disease (author's transl)]. / Klinisch-biochemische Verlaufsuntersuchungen bei Heredopathia atactica polyneuritiformis (Morbus Refsum).

Within a family refered here, two sisters are presenting heredopathia atactica polyneuritiformis (Morbus Refsum) with the complete clinical, electromyographical and serological findings (increased phytanic acid level, accumulation of mono- and diphytanyl, triglycerides). In addition, some symptoms of Refsum's disease are clinically apparent in the eight year old daughter of one of the patients, but significant principal characteristics are absent (dissociation of the spinal fluid, retinopathia pigmentosa, increased phytanic acid level). The phytanic acid level in the serum of ten clinically normal blood relations (three of which are also obligatory heterozygotes) is normal. In both patients with manifest illness we found not only the usual spinal fluid changes with highly increased protein levels (gammaglobulin, IgA- and IgG-fraction) but also a remarkably large number of macrophages with vacuoles. Within almost two years of keeping to a strict diet with low phytanic acid and phytol content, both patients showed a distinct clinical improvement in parallel with a decrease of the phytanic acid level. Even a temporary increase of the phytanic acid level in one of the patients did not cause clinical relapse. Regarding the biochemical control of the course of the disease, the phytanic acid containing triglycerides proved to be a highly sensitive parameter.