Comprehensive rehabilitation of the severely disabled ventilator-assisted individual

The lives of many individuals with severe disability and paralytic/restrictive pulmonary conditions, which progress or worsen with time, can be significantly prolonged, and the quality of life greatly enhanced, by noninvasive or conservative rehabilitation interventions. These interventions are devised to maintain or improve the individual's orthopaedic, pulmonary, and functional status. The combination of orthopaedic surgery and rehabilitation can reverse or ameliorate musculotendinous contractures and scoliosis and, thereby, maintain optimal patient comfort, function, and the possibility for nursing or personal care. Recent advances in the use of computers, environmental control systems, robotics, etc., can increase upper extremity functional activities. Non-invasive methods of airway secretion evacuation and ventilatory support can permit individuals with little or no vital capacity to avoid acute pulmonary complications, intubation and tracheostomy indefinitely.