Rehabilitation Team Members

Original Editors - Naomi O'Reilly and ReLAB-HS

Top Contributors - Naomi O'Reilly, Oyemi Sillo, Chelsea Mclene, Kim Jackson, Lucinda hampton, Tarina van der Stockt, Vidya Acharya, Jess Bell and Aminat Abolade      

Introduction

Rehabilitation services are “interventions designed to optimise functioning and reduce disability in individuals with health conditions in interaction with their environment”. These services have the potential to improve an individual’s functioning and their ability to successfully and optimally interact with their environment (Vos et al., 2020). Seven core professions offer rehabilitation services: audiology, occupational therapy, physical and rehabilitation medicine, physiotherapy, prosthetics and orthotics, rehabilitation nursing and speech-language pathology. Each rehabilitation profession has developed its own international and/or national framework. These frameworks or guidelines communicate professional standards, support education, guide curriculum planning and development for entry-level healthcare professionals and help to establish individual and service-wide development priorities.

All rehabilitation professionals require profession-specific clinical knowledge to assess patients who need or would benefit from rehabilitation services and share the same requirement of having the knowledge, skills and ability to implement evidence-based intervention and management programs that are patient-centred while also monitoring, adapting, and redesigning intervention plans based on the patient’s needs and response to care. As such rehabilitation team members will play different roles within the rehabilitation based on the type of team structure they are working in, what phase of rehabilitation, the environment and specific resources available. Similarly the composition of the team will also vary, and exactly who is included in the team will adjust through each of the different phases of management, and is often dependent on the specific health system set up and resources available locally.

The clinical role of team members as health providers is hugely diverse given the different phases (primary, secondary and tertiary care) and range of healthcare subspecialties. For example, during the acute phase following a spinal cord injury the team members may include a spinal surgeon, a physiatrist and/or neurologist often a spinal cord injury specialist, an anaesthesiologist, intensive care nurses, specialist respiratory and acute neurology physiotherapists, occupational therapists, speech and language therapists, dieticians, social workers, and psychologists. While during the rehabilitation phase of treatment, the team members might include a physiatrist with a specialism in spinal cord injury, urologist with an interest in neurology, specialist spinal cord injury rehabilitation nurses, physiotherapists who have skills in motor learning, balance, strength, cardiovascular, gait and wheelchair mobility, recreational therapists who have an interest in disability sport and recreation programs, occupational therapists who have skills in facilitating independence in wheelchair prescription, self-care and adaptive aids, social workers who work with families as well as patients, dietitians, clinical psychologists and neuropsychologists, peer support workers, family members and care support workers and, most importantly, the individual.  In support of patient-centred care and patient safety, the patient and their carers are increasingly being considered as active members of the health-care team. As well as being important in terms of issues such as shared decision making and informed consent, engaging the patient as a team member can improve the safety and quality of their care as they are a valued information source being the only member of the team who is present at all times during their care.

Individual / Patient

The individual accessing rehabilitation services are and always should be a key member of the team throughout each phase of the rehabilitation process. They are key in the development of goals and should always have the opportunity to question the process and / or the goals, and direct their rehabilitation needs in order to optimise their function.

Perhaps the most important trait that separates an empowered patient from one who is not is the role of "active participant," as a fully participating partner on the healthcare team. Active participants are those patients who realize that when they begin to experience symptoms, or at the point where they recognize that something in their body isn't functioning correctly, it's time for them to actively seek answers and solutions in collaboration with other members of their healthcare team. In reality the patient is the most important team member, and it is their right to participate fully in decision-making regarding their care, and therefore part of your responsibility as a healthcare professional to involve them in their own care.

Family & Friends

Family members, friends and caregivers play an essential role and provide key emotional support to the individual and should be an important and integral part of any rehabilitation program.

Physiotherapist

Physiotherapy is treatment to restore, maintain, and make the most of a patient’s mobility, function, and well-being. Physiotherapists help people affected by injury, illness or disability through physical rehabilitation, injury prevention, and health and fitness. They help to encourage development and facilitate recovery, enabling people to stay in work while helping them remain independent for as long as possible.

Occupational Therapist

Occupational Therapy is a client-centred health profession concerned with promoting health and well being through occupation, which refers to the practical and purposeful activities that allow people to live independently and have a sense of identity. This could be essential day-to-day tasks such as self-care, work or leisure.

The primary goal of occupational therapy is to enable people to participate in the activities of everyday life. Occupational Therapists achieve this outcome by working with people and communities to enhance their ability to engage in the occupations they want to, need to, or are expected to do, or by modifying the occupation or the environment to better support their occupational engagement.

Speech and Language Therapist

Speech and Language Therapy enables people with communication disorders and swallowing disorders to achieve their maximum potential. They are involved in assessing their client's communication and swallowing difficulties and developing treatment programmes to meet their needs.

Prosthetists and Orthotists

Prosthetics and Orthotics is a dynamic and expanding allied health science profession. Technically, Prosthetics and Orthotics are separate disciplines, but their common goals in rehabilitation unite them into one cooperative entity. In some cases individuals may have dual training, while others have training only in prosthetics or orthotics.

A prosthetist is a healthcare professional who assesses and treats the physical and functional limitations of people resulting from illnesses and disabilities, including limb amputations, and are trained to prescribe, design, fit and monitor prosthesis, which is an artificial device attached or applied to the body to replace a missing part.

An orthotist is a healthcare professional who assesses and treats the physical and functional limitations of people resulting from illnesses and disabilities, and are trained to prescribe, design, fit and monitor orthoses, which are externally applied devices that are designed and fitted to the body to control biomechanical alignment, correct or accommodate deformity, protect and support an injury to increase mobility and decrease pain.

A prosthetic and orthotic technician is a non-clinical service providers, who work under the supervision of the orthotist or prosthetist to support the technical design of prosthetic and orthotic devices and are competent in prosthetic and orthotic device fabrication.

Podiatrist

Podiatrists specialise in the diagnosis and treatment of lower limb conditions, common foot ailments and chronic medical conditions that affect the feet and lower limbs.

Dietician

Dieticians translate the science of nutrition into everyday information about food and advise people on their food and nutrition choices. They assess, diagnose and treat dietary and nutritional problems with their overall aim to promote good health and prevent disease in individuals and communities.

Psychologist

Clinical psychology aims to reduce distress and to enhance and promote psychological well-being, minimise exclusion and inequalities and enable individuals to engage in meaningful relationships and valued work and leisure activities. They work with individuals, families and groups of different ages experiencing psychological distress or behavioural problems which disrupt their everyday functioning and wellbeing.

Social Worker

Social workers work in partnership with individuals, families and groups experiencing marginalisation, disadvantage, social, and/or emotional difficulties. The aim of social work is to facilitate and enable individuals to identify options and make decisions for themselves so that they may develop strategies to solve problems and to effect improvement in the quality of their own lives.

Rehabilitation Nurse

Nurses have a broad role covering a range of rehabilitation issues including personal care, activities of daily living, short and long term health, social, independence issues and emotional support. They also facilitate other discipline rehabilitation activities outside therapy time as they are present “24-7,” thus allowing and even encouraging the patient to practice what they have been learning in their therapy sessions.

Rehabilitation Physician / Physiatrist

The physician role and type of physicians involved will vary hugely depending on the type of illness or injury and phase of management i.e. acute, rehabilitation or post discharge. Types of physicians involved include can include specialists in Physical and Rehabilitation Medicine, often referred to as Physiatrist, Neurologist, Respiratory, Orthopaedist, Urologist. Diagnosis and management of underlying pathology and impairments through medical assessment, treatment whether conservative or surgical, including prescribing pharmacological and non-pharmacological, and rehabilitation planning are key roles of the physician. They have an important role in ensuring that the individual is well enough to participate in rehabilitation. 

Audiologist

Audiologists are experts in the prevention, identification, assessment, treatment and rehabilitation of auditory and vestibular difficulties across the lifespan in order to improve an individuals quality of life and maximize their participation in society. Audiological (re)habilitation is the process of providing training and treatment to improve hearing for those who are hearing impaired. These services focus on supporting an individual to adjust to hearing loss and make the best use of audiological assistive devices to better manage conversations, and take charge of their own communication. Hearing, balance, and other related disorders are complex, with medical, psychological, physical, social, educational, and employment implications. Treatment services require audiologists to know existing and emerging technologies, intervention strategies, and interpersonal skills to counsel and guide individuals and their family members through the rehabilitative process.

Optician, Optometry and Ophthalmology

Opticians are technicians trained to design, verify and fit eyeglass lenses and frames, contact lenses, and other devices to correct eyesight. They use prescriptions supplied by ophthalmologists or optometrists, but do not test vision or write prescriptions for visual correction.

Optometrists are healthcare professionals who provide primary vision care ranging from sight testing and correction to the diagnosis, treatment, and management of vision changes, which primarily involves performing eye exams and vision tests, prescribing and dispensing corrective lenses, detecting certain eye abnormalities, and prescribing medications for certain eye diseases.

An ophthalmologist is a medical doctor who specializes in eye and vision care. Ophthalmologists differ from optometrists and opticians in their levels of training and in what they can diagnose and treat. An ophthalmologist diagnoses and treats all eye diseases, performs eye surgery and prescribes and fits eyeglasses and contact lenses to correct vision problems.

Assistive Technologist

Assistive technology and adaptive devices, both low tech and high tech, are key for many people to assist with independence in daily living activities i.e. pressure relief mattresses, moving beds, switches and controllers, computers and power wheelchairs. Assistive technologists often play a key role in rehabilitation at all phases. These individuals tend to have a background in either rehabilitation engineering and/or occupational therapy. The solutions provided are usually designed to enhance communication, mobility and access to computers, educational materials and environmental control, thus promoting greater independence by enabling the person to perform tasks that they were previously unable to accomplish or had great difficulty accomplishing. 

Community Health Worker

Community health workers are frontline public health workers who have a close understanding of the community they serve. This trusting relationship enables them to serve as a liaison/link/intermediary between health services and the community to facilitate access to services and improve the quality and cultural competence of service delivery.

Community health workers also build individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counselling, social support and advocacy.

Peer Support Worker

Peer support workers are individuals who have lived experience of the specific illness or injury and use their own experiences and empathy to support other people and their families receiving rehabilitation services. Peer support workers join other members of someone’s care team to help support their wellbeing and provide inspiration for their recovery.