ABSTRACT
Assessment of disability and of handicap begins with an appraisal of the patient, in a hospital bed, in an out-patient department, or at home. It may be clarified or confirmed in those with communication disorders or cognitive impairment, by an interview with an immediate carer or next of kin. Other members of the rehabilitation team will contribute more detailed information. Assessment demands a knowledge of the tools available for the job but, more fundamentally, requires a recognition of disability and handicap. The diagnostic approach to disease militates against the careful functional analysis required in neurorehabilitation. It is difficult to remember that the patient dying with a paraneoplastic peripheral neuropathy may have independent upper limb function extended for weeks or months by the use of mobile arm supports or elbow coasters, when most medical enthusiasm is directed towards finding the primary lesion or considering the merits of cancer therapy.
