An Overview of Rehabilitation for Doctors

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Original Editor - Daphne Xuan

Top Contributors - Daphne Xuan, Ewa Jaraczewska, Tarina van der Stockt, Kim Jackson and Jess Bell  

What Is Rehabilitation?[edit | edit source]

A Global Need

A study in 2019 found that there were 2.4 billion people worldwide who were living with a health condition that would benefit from rehabilitation at some point in the course of their illness or injury, which equates to about one in three people in the world.[1] This was equivalent to 310 million years of life lived with disability.[1] These numbers have already increased by 63% since about 30 years ago and are expected to continue to increase significantly as the global population grows, ages, and lives longer, many with chronic conditions and non-communicable diseases.[1][2] The three largest groups of health conditions found to contribute to disability were musculoskeletal disorders, sensory impairments, and neurological disorders.[1]

Unfortunately, many people who require rehabilitation are not receiving it. More than half of the people who need rehabilitation in some low- and middle-income countries do not receive it.[2] By 2050, low- and middle-income countries will be home to 80% of the global population aged 60 and up.[3] Rehabilitation in many countries is often under-resourced and seen as a backup for when other interventions fail. [1] The World Health Organization (WHO) has identified that, among other factors, one of the barriers we face is ineffective and under-utilised referral pathways to rehabilitation.[2] Cieza and colleagues suggest that rehabilitation services need better integration into the health system at the primary care level.[1]

Misconceptions exist about who needs rehabilitation services: that it is only for people with certain long-term impairments or disabilities, that it's a luxury service, or that it's only for when other interventions fail. In reality, anyone can require rehabilitation at some point in the course of their lives and it is a core healthcare service that should be available to all who need it.[2]

Definition

The WHO defines rehabilitation as the following:

"A set of interventions designed to optimise functioning and reduce disability in individuals with health conditions in interaction with their environment... rehabilitation helps a child, adult, or older person to be as independent as possible in everyday activities and enables participation in education, work, recreation, and meaningful life roles such as taking care of family." [2]

Rehabilitation is accomplished through selecting evidence-based and person-centred interventions to address conditions and limitations, improve function, and provide support. It can play a big role in health promotion, maintenance, and prevention. Specific goals will differ person to person depending on their goals and preferences. [2]

Rehabilitation professionals will typically go through a process that includes some or all of the following:

  • Assessment
  • Diagnosis
  • Planning
  • Education
  • Intervention
  • Evaluation/re-evaluation
  • Collaboration


Where Does Rehabilitation Occur?

  • Hospitals (inpatient/outpatient)
  • Private clinics
  • Institutions (e.g. schools, prisons)
  • Rehabilitation centres
  • Community settings (e.g. an individual's home)
  • Long-term care
  • Workplaces
  • And more[2]


Benefits of Rehabilitation

On an individual level, rehabilitation can reduce the impact of health conditions; minimise or delay the effects of chronic conditions; increase independence; enable participation in work, school, and other life activities; and improve quality of life.[1][2][4] For example, if everyone who had hearing loss who required a hearing aid used one, the associated disability would be decreased by 59%.[5]

On a system and societal level, rehabilitation can reduce hospitalisation and length of stays, prevent readmissions, and subsequently reduce overall costs.[2] In addition, it allows individuals to continue to contribute to and participate in society as fully as possible for as long as possible.[4]

The Rehabilitation Team[edit | edit source]

The Role of Doctors on the Interdisciplinary Rehabilitation Team[edit | edit source]

Resources[edit | edit source]

  • bulleted list
  • x

or

  1. numbered list
  2. x

References[edit | edit source]

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Cieza A, Causey K, Kamenov K, Hanson SW, Chatterji S, Vos T. Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet [Internet]. 2020 Dec [cited 2022 May 16];396(10267):2006–17. Available from: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32340-0/fulltext ‌
  2. ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 World. Rehabilitation [Internet]. Who.int. World Health Organization: WHO; 2021 [cited 2022 May 16]. Available from: https://www.who.int/news-room/fact-sheets/detail/rehabilitation ‌
  3. ↑ Chatterji S, Byles J, Cutler D, Seeman T, Verdes E. Health, functioning, and disability in older adults—present status and future implications. The Lancet [Internet]. 2015 Feb [cited 2022 May 16];385(9967):563–75. Available from: https://pubmed.ncbi.nlm.nih.gov/25468158/ ‌
  4. ↑ 4.0 4.1 Stucki G, Bickenbach J, Gutenbrunner C, Melvin J. Rehabilitation: The health strategy of the 21st century. Journal of Rehabilitation Medicine [Internet]. 2018 [cited 2022 May 16];50(4):309–16. Available from: https://pubmed.ncbi.nlm.nih.gov/28140419/ ‌
  5. ↑ Global and regional needs, unmet needs and access to hearing aids [Internet]. International Journal of Audiology. 2020 [cited 2022 May 16]. Available from: https://www.tandfonline.com/doi/abs/10.1080/14992027.2020.1721577?journalCode=iija20 ‌
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