Introduction to Rehabilitation: Difference between revisions
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The proportion of the worldwide population over 60 will double in the next 30 years, the majority of whom will live with [[Chronic Disease|chronic diseases]], particularly non-communicable diseases. These changing health and demographic trends are contributing to rapid global increases in the number of people experiencing decline in functioning, resulting in enormous unmet rehabilitation needs. Much of these unmet needs are concentrated amongst the poorest and most vulnerable populations in low- and middle-income countries and conflict-affected settings, which are often ill-equipped to cope with these increasing needs for rehabilitation services.<ref name=":1">Shimizu Y. Rehabilitation. World Health Organization. 2020. Available from: https://www.who.int/news-room/fact-sheets/detail/rehabilitation. [Accessed on 8 January, 2020].</ref><ref>Cieza, Alarcos. "Rehabilitation the health strategy of the 21st century, really?." Archives of physical medicine and rehabilitation 100.11 (2019): 2212-2214.</ref> | The proportion of the worldwide population over 60 will double in the next 30 years, the majority of whom will live with [[Chronic Disease|chronic diseases]], particularly non-communicable diseases. These changing health and demographic trends are contributing to rapid global increases in the number of people experiencing decline in functioning, resulting in enormous unmet rehabilitation needs. Much of these unmet needs are concentrated amongst the poorest and most vulnerable populations in low- and middle-income countries and conflict-affected settings, which are often ill-equipped to cope with these increasing needs for rehabilitation services.<ref name=":1">Shimizu Y. Rehabilitation. World Health Organization. 2020. Available from: https://www.who.int/news-room/fact-sheets/detail/rehabilitation. [Accessed on 8 January, 2020].</ref><ref>Cieza, Alarcos. "Rehabilitation the health strategy of the 21st century, really?." Archives of physical medicine and rehabilitation 100.11 (2019): 2212-2214.</ref> | ||
According to the WHO, rehabilitation is one of the essential components of Universal Health Coverage (UHC), which features alongside “promotion of good health, prevention of diseases, treatment and [[Palliative Care Competence Framework for Physiotherapists|palliative care]]”.<ref name=":1" /> Thus, rehabilitation focuses on achieving functional independence in activities of daily living ([[ADLs|ADL]]), participation in work, recreation and | According to the World Health Organisation (WHO), rehabilitation is one of the essential components of Universal Health Coverage (UHC), which features alongside “promotion of good health, prevention of diseases, treatment and [[Palliative Care Competence Framework for Physiotherapists|palliative care]]”.<ref name=":1" /> Thus, rehabilitation focuses on achieving functional independence in activities of daily living ([[ADLs|ADL]]), participation in work, recreation and education, with individuals being able to achieve meaningful roles in daily life.<ref name=":1" /> Clearly, rehabilitation is pivotal in achieving not only individual health benefits, but an overall [[Universal Health Care|universal health]] goal that permits the building of a healthy and functional global population. | ||
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== Definition == | == Definition == | ||
Fundamentally, rehabilitation is founded on the philosophy that every individual has the inherent tendency and right to be expert in their own health care.<ref>Gender AR. Scope of rehabilitation and rehabilitation nursing. Chin P, Finocchiaro D. Rosebrough, A. Rehabilitation nursing practice. New york: McGraw-Hill,.1996.</ref> This, therefore, marks the distinction between [[Acute Care Assessment|acute care]] and rehabilitation, where acute care is concerned with an individual’s survival, while rehabilitation is concerned with the education and training of individuals to be able to carry out activities of daily living by themselves, thus promoting self-care and functional independence.<ref>Mauk KL. Overview of rehabilitation. Rehabilitation Nursing: A Contemporary Approach to Practice. 2011.</ref> | Fundamentally, rehabilitation is founded on the philosophy that every individual has the inherent tendency and right to be an expert in their own health care.<ref>Gender AR. Scope of rehabilitation and rehabilitation nursing. Chin P, Finocchiaro D. Rosebrough, A. Rehabilitation nursing practice. New york: McGraw-Hill,.1996.</ref> This, therefore, marks the distinction between [[Acute Care Assessment|acute care]] and rehabilitation, where acute care is concerned with an individual’s survival, while rehabilitation is concerned with the education and training of individuals to be able to carry out activities of daily living by themselves, thus promoting self-care and functional independence.<ref>Mauk KL. Overview of rehabilitation. Rehabilitation Nursing: A Contemporary Approach to Practice. 2011.</ref> Despite this there is currently no universal definition or understanding of rehabilitation, and it is portrayed in many ways depending on the context, including as a development issue, disability issue, health issue, human rights issue, substance abuse issue, and security issue, to name a few. As such there are a broad range of definitions for rehabilitation used by different authorities: | ||
<blockquote>“Refers to services, and programmes designed to assist individuals who have experienced trauma or illness that results in an impairment that creates a loss of function (physical, psychological, social or vocational).” <ref>Lubkin IM, Larsen PD, editors. Chronic illness: Impact and interventions. Jones & Bartlett Learning; 2006.</ref></blockquote><blockquote>“Aims to restore, compensate, prevent or slow deterioration in functioning (sensory, physical, intellectual, mental, cognitive, or social) to help individuals to reach their optimal levels.” <ref name=":0" /></blockquote><blockquote>“A process to restore mental and/or physical abilities lost to injury or disease in order to function in a normal or near-normal way” <ref>National Cancer Institute. Rehabilitation. 2007. Available at: https://www.cancer.gov/search/results?swKeyword=rehabilitation. [Accessed on 8 January, 2020].</ref></blockquote> | <blockquote>“Refers to services, and programmes designed to assist individuals who have experienced trauma or illness that results in an impairment that creates a loss of function (physical, psychological, social or vocational).” <ref>Lubkin IM, Larsen PD, editors. Chronic illness: Impact and interventions. Jones & Bartlett Learning; 2006.</ref></blockquote><blockquote>“Aims to restore, compensate, prevent or slow deterioration in functioning (sensory, physical, intellectual, mental, cognitive, or social) to help individuals to reach their optimal levels.” <ref name=":0" /></blockquote><blockquote>“A process to restore mental and/or physical abilities lost to injury or disease in order to function in a normal or near-normal way” <ref>National Cancer Institute. Rehabilitation. 2007. Available at: https://www.cancer.gov/search/results?swKeyword=rehabilitation. [Accessed on 8 January, 2020].</ref></blockquote> | ||
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"a set of measures that assist individuals who experience, or are likely to experience, disability to achieve and maintain optimal functioning in interaction with their environments.” <ref name=":2">World Health Organization. World Report on Disability 2011. Geneva: World Health Organization, 2011. Rehabilitation.</ref></blockquote> | "a set of measures that assist individuals who experience, or are likely to experience, disability to achieve and maintain optimal functioning in interaction with their environments.” <ref name=":2">World Health Organization. World Report on Disability 2011. Geneva: World Health Organization, 2011. Rehabilitation.</ref></blockquote> | ||
<br> | <br> | ||
Rehabilitation is then a set of interventions designed to | Rehabilitation is then a set of interventions designed to optimise functioning in individuals with health conditions in interaction with their environment. Health conditions can refer to disease (acute or chronic), injury or trauma, which may also include other circumstances such as pregnancy, ageing, stress, congenital anomaly, or genetic predisposition. Anyone with a health condition who experiences some form of limitation in functioning, such as mobility, vision, or cognition, may need rehabilitation. As such rehabilitation should is best characterised using the biopsychosocial model through the use of interventions that address impairments, activity limitations and participation restrictions, considering contextual factors both personal and environmental, including assistive technology that impact functioning. | ||
Rehabilitation | Rehabilitation should be seen as an essential service offered across all levels of the health care system. Many people without long-term impairments will need rehabilitation services at some point in their lives. Similarly, many people with long-term impairments do not constantly need rehabilitation services e.g., a person with a spinal cord injury may need intensive rehabilitation in the months following their initial spinal cord injury, but once they have received enough therapy to function to their maximum capabilities and have been provided with the assistive devices, they need to enable them to continue to function well in their community and home environment, then they may not need to access more rehabilitation services. Some people with long-term impairments may also need episodic rehabilitation services, such as persons with depression or degenerative conditions. | ||
Rehabilitation is a highly person-centered health strategy where treatment caters to the underlying health conditions as well as the goals and preferences of the user. Information on functioning is essential to decision-making in rehabilitation at all levels of the health system since the goal of rehabilitation is to optimize functioning in light of impairments, injuries, & acute or chronic diseases:<ref>World Health Organization. [https://cdn.who.int/media/docs/default-source/documents/health-topics/rehabilitation/call-for-action/healthinformationsystemsandrehaboctober17.pdf?sfvrsn=a0461dd9_5 Health information systems and rehabilitation.] Rehabilitation. 2017;2030. </ref> | Rehabilitation is a highly person-centered health strategy where treatment caters to the underlying health conditions as well as the goals and preferences of the user. Information on functioning is essential to decision-making in rehabilitation at all levels of the health system since the goal of rehabilitation is to optimize functioning in light of impairments, injuries, & acute or chronic diseases:<ref>World Health Organization. [https://cdn.who.int/media/docs/default-source/documents/health-topics/rehabilitation/call-for-action/healthinformationsystemsandrehaboctober17.pdf?sfvrsn=a0461dd9_5 Health information systems and rehabilitation.] Rehabilitation. 2017;2030. </ref> | ||
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Rehabilitation objectives include: | Rehabilitation objectives include: | ||
* Prevention of the loss of function | * Prevention of the loss of function | ||
* Slowing the rate of loss of function | * Slowing the rate of loss of function | ||
* Improvement or restoration of function | * Improvement or restoration of function | ||
* Compensation for loss of function | * Compensation for loss of function | ||
* Maintenance of current function | * Maintenance of current function | ||
== Rehabilitation Outcomes == | == Rehabilitation Outcomes == | ||
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* Increased independence | * Increased independence | ||
* Decreased burden of care | * Decreased burden of care | ||
* Return to role/occupation that is age, gender, and context-relevant ( | * Return to role/occupation that is age, gender, and context-relevant (e.g. home care, school, work) | ||
* Improved quality of life | * Improved quality of life | ||
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== Summary == | == Summary == | ||
Rehabilitation is, without doubt, a crucial aspect of health that is aimed at enhancing | Rehabilitation is, without doubt, a crucial aspect of health that is aimed at enhancing function and independence. As a field of health, it has evolved through different stages before arriving at its present model that incorporates different components of biological, societal and contextual factors that have effects on the health and function of individuals experiencing various health challenges. Regardless of who the beneficiary is, who delivers it, or the context in which rehabilitation is delivered, optimising function is the ultimate goal of rehabilitation and is instrumental to a patient's wellbeing, regardless of the underlying health condition. <ref>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. 2020 Dec 19;396(10267):2006-17.</ref> | ||
== Resources == | == Resources == | ||
Revision as of 00:01, 26 July 2021
Original Editors - Joseph Ayotunde Aderonmu and Naomi O'Reilly
Top Contributors - Naomi O'Reilly, Kim Jackson, Vidya Acharya, Lucinda hampton, Merinda Rodseth, Tarina van der Stockt, Ashmita Patrao, Aminat Abolade, Oyemi Sillo, Candace Goh, Rucha Gadgil and Wanda van Niekerk
Introduction[edit | edit source]
Rehabilitation is a concept that is widely discussed globally. This is by no means unexpected since over a billion people live with a form of disability, accounting for over 15% of the world population. Furthermore, according to a recent report, 2.41 billion individuals worldwide live with the conditions that impact their functions in daily life and would benefit from rehabilitation services, which equates to 1 in 3 individuals requiring rehabilitation services throughout the course of their illness or injury.[1]
The proportion of the worldwide population over 60 will double in the next 30 years, the majority of whom will live with chronic diseases, particularly non-communicable diseases. These changing health and demographic trends are contributing to rapid global increases in the number of people experiencing decline in functioning, resulting in enormous unmet rehabilitation needs. Much of these unmet needs are concentrated amongst the poorest and most vulnerable populations in low- and middle-income countries and conflict-affected settings, which are often ill-equipped to cope with these increasing needs for rehabilitation services.[2][3]
According to the World Health Organisation (WHO), rehabilitation is one of the essential components of Universal Health Coverage (UHC), which features alongside “promotion of good health, prevention of diseases, treatment and palliative care”.[2] Thus, rehabilitation focuses on achieving functional independence in activities of daily living (ADL), participation in work, recreation and education, with individuals being able to achieve meaningful roles in daily life.[2] Clearly, rehabilitation is pivotal in achieving not only individual health benefits, but an overall universal health goal that permits the building of a healthy and functional global population.
Definition[edit | edit source]
Fundamentally, rehabilitation is founded on the philosophy that every individual has the inherent tendency and right to be an expert in their own health care.[6] This, therefore, marks the distinction between acute care and rehabilitation, where acute care is concerned with an individual’s survival, while rehabilitation is concerned with the education and training of individuals to be able to carry out activities of daily living by themselves, thus promoting self-care and functional independence.[7] Despite this there is currently no universal definition or understanding of rehabilitation, and it is portrayed in many ways depending on the context, including as a development issue, disability issue, health issue, human rights issue, substance abuse issue, and security issue, to name a few. As such there are a broad range of definitions for rehabilitation used by different authorities:
“Refers to services, and programmes designed to assist individuals who have experienced trauma or illness that results in an impairment that creates a loss of function (physical, psychological, social or vocational).” [8]
“Aims to restore, compensate, prevent or slow deterioration in functioning (sensory, physical, intellectual, mental, cognitive, or social) to help individuals to reach their optimal levels.” [1]
“A process to restore mental and/or physical abilities lost to injury or disease in order to function in a normal or near-normal way” [9]
Rehabilitation is one of the core health strategies of the World Health Organisation, along with the promotion, prevention, treatment, and palliative care. WHO defines rehabilitation as
"a set of measures that assist individuals who experience, or are likely to experience, disability to achieve and maintain optimal functioning in interaction with their environments.” [10]
Rehabilitation is then a set of interventions designed to optimise functioning in individuals with health conditions in interaction with their environment. Health conditions can refer to disease (acute or chronic), injury or trauma, which may also include other circumstances such as pregnancy, ageing, stress, congenital anomaly, or genetic predisposition. Anyone with a health condition who experiences some form of limitation in functioning, such as mobility, vision, or cognition, may need rehabilitation. As such rehabilitation should is best characterised using the biopsychosocial model through the use of interventions that address impairments, activity limitations and participation restrictions, considering contextual factors both personal and environmental, including assistive technology that impact functioning.
Rehabilitation should be seen as an essential service offered across all levels of the health care system. Many people without long-term impairments will need rehabilitation services at some point in their lives. Similarly, many people with long-term impairments do not constantly need rehabilitation services e.g., a person with a spinal cord injury may need intensive rehabilitation in the months following their initial spinal cord injury, but once they have received enough therapy to function to their maximum capabilities and have been provided with the assistive devices, they need to enable them to continue to function well in their community and home environment, then they may not need to access more rehabilitation services. Some people with long-term impairments may also need episodic rehabilitation services, such as persons with depression or degenerative conditions.
Rehabilitation is a highly person-centered health strategy where treatment caters to the underlying health conditions as well as the goals and preferences of the user. Information on functioning is essential to decision-making in rehabilitation at all levels of the health system since the goal of rehabilitation is to optimize functioning in light of impairments, injuries, & acute or chronic diseases:[11]
- At the user level, information on functioning guides goal setting and outcome evaluation across the continuum of rehabilitation care (primary, secondary and tertiary), and in the treatment phases (acute care, post-acute care and long-term care).
- At the facility or programme level, information on functioning from users can be aggregated to help monitor clinical outcomes and improve service planning and quality assurance.
- At the policy level, aggregated clinical information on functioning gives policy-makers a source of evidence for planning health and rehabilitation services and monitoring their impact.
By restoring, preventing, or slowing deterioration in functioning (sensorial, physical, intellectual, mental, cognitive, or social), rehabilitation places the person at the center of the process and it helps people in reaching their full potential and encourages participation in society. Its impact is therefore, not only on the individuals, but also on their families, communities, and economies.
Rehabilitation Objectives[edit | edit source]
Rehabilitation objectives include:
- Prevention of the loss of function
- Slowing the rate of loss of function
- Improvement or restoration of function
- Compensation for loss of function
- Maintenance of current function
Rehabilitation Outcomes[edit | edit source]
Rehabilitation outcomes are the benefits and changes in the functioning of an individual over time that are attributable to a single measure or set of measures. They may include:
- Fewer hospital admissions
- Increased independence
- Decreased burden of care
- Return to role/occupation that is age, gender, and context-relevant (e.g. home care, school, work)
- Improved quality of life
Misconceptions about Rehabilitation[edit | edit source]
Summary[edit | edit source]
Rehabilitation is, without doubt, a crucial aspect of health that is aimed at enhancing function and independence. As a field of health, it has evolved through different stages before arriving at its present model that incorporates different components of biological, societal and contextual factors that have effects on the health and function of individuals experiencing various health challenges. Regardless of who the beneficiary is, who delivers it, or the context in which rehabilitation is delivered, optimising function is the ultimate goal of rehabilitation and is instrumental to a patient's wellbeing, regardless of the underlying health condition. [12]
Resources[edit | edit source]
References [edit | edit source]
- ↑ 1.0 1.1 Duttine A, Battello J, Beaujolais A, Hailemariam M, Mac-Seing M, Mukangwije P, et al. Introduction to Rehabilitation Factsheet. Handicap International. 2016. Available from: https://humanity-inclusion.org.uk/sn_uploads/document/2017-02-factsheet-rehabilitation-introduction-web_1.pdf [Accessed on 8 January, 2020].
- ↑ 2.0 2.1 2.2 Shimizu Y. Rehabilitation. World Health Organization. 2020. Available from: https://www.who.int/news-room/fact-sheets/detail/rehabilitation. [Accessed on 8 January, 2020].
- ↑ Cieza, Alarcos. "Rehabilitation the health strategy of the 21st century, really?." Archives of physical medicine and rehabilitation 100.11 (2019): 2212-2214.
- ↑ World Health Organisation (WHO). Rehabilitation is about health and functioning in everyday life. Available from: https://youtu.be/uG_VdZe9VNU[last accessed 26/06/2021]
- ↑ World Health Organisation. WHO: Rehabilitation: Key for Health in the 21st Century. Available from: https://youtu.be/a8uaRziXruc[last accessed 30/06/21]
- ↑ Gender AR. Scope of rehabilitation and rehabilitation nursing. Chin P, Finocchiaro D. Rosebrough, A. Rehabilitation nursing practice. New york: McGraw-Hill,.1996.
- ↑ Mauk KL. Overview of rehabilitation. Rehabilitation Nursing: A Contemporary Approach to Practice. 2011.
- ↑ Lubkin IM, Larsen PD, editors. Chronic illness: Impact and interventions. Jones & Bartlett Learning; 2006.
- ↑ National Cancer Institute. Rehabilitation. 2007. Available at: https://www.cancer.gov/search/results?swKeyword=rehabilitation. [Accessed on 8 January, 2020].
- ↑ World Health Organization. World Report on Disability 2011. Geneva: World Health Organization, 2011. Rehabilitation.
- ↑ World Health Organization. Health information systems and rehabilitation. Rehabilitation. 2017;2030.
- ↑ 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. 2020 Dec 19;396(10267):2006-17.
