GPAtlas🧭 When to suspect a rehabilitation need
Rehabilitation should be on the agenda for anyone recovering from a traumatic injury – defined by NICE as any major or minor injury requiring hospital admission at the time of injury, including musculoskeletal, soft tissue, nerve and visceral injuries, spinal cord injury, limb reconstruction and limb loss. Survival after major trauma has improved, so the limiting factor for many patients is no longer survival but regaining function, independence and participation.
NICE NG211 specifically addresses complex rehabilitation needs – multiple needs (often polytrauma) requiring coordinated input from two or more allied health professional disciplines. Most general practitioner (GP) involvement comes after discharge: recognising unmet needs, coordinating community rehabilitation, managing pain and mental health, watching for complications, and supporting return to work. The two clinical skills are to assess recovery across every domain (not just the injured part) and to never miss a red-flag complication.
| Domain to assess | Ongoing problems to look for |
|---|---|
| Physical | Pain, weakness, stiffness, reduced range of movement, poor balance, reduced mobility, fatigue, deconditioning. |
| Cognitive | Memory and concentration difficulty, "brain fog" – common even without a brain injury. |
| Psychological | Anxiety, low mood, fear of movement, adjustment difficulty, post-traumatic stress disorder (PTSD). |
| Communication / sensory | Speech, language and swallowing problems; hearing or visual impairment. |
| Participation | Self-care and activities of daily living (ADLs), return to work or education, relationships, driving, leisure. |
Source: NICE NG211 · NICE NG252
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