Benefits of Rehabilitation
Original Editors - Neha Duhan, Naomi O'Reilly and and ReLAB-HS
Top Contributors - Naomi O'Reilly, Neha Duhan, Kim Jackson, Shaimaa Eldib, Oyemi Sillo, Olajumoke Ogunleye, Aminat Abolade, Merinda Rodseth, Admin, Lucinda hampton and Ashmita Patrao
Introduction[edit | edit source]
Rehabilitation is defined as ‘a set of interventions designed to optimize 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 daily life activities and allows them to participate in work, recreation and life roles. It enables them to do so by addressing underlying conditions and improving their way of performing everyday activities, supporting them to overcome difficulties with thinking, communicating or walking around. Any person may need rehabilitation at some point in their lives such as due to injury, surgery, any disease or decrease in mobility due to age factor.
The rehabilitation process involves six major areas of focus:
- Preventing, recognizing, and managing comorbid illness and medical complication.
- Training for maximum independence.
- Facilitating maximum psychosocial coping and adaptation by patient and family.
- Preventing secondary disability by promoting community reintegration, including resumption of home, family, recreational, and vocational activities.
- Enhancing quality of life in view of residual disability.
- Preventing recurrent conditions.
Physical Benefits[edit | edit source]
- Increase Physical Capacity 
- Reduces Pain
- Strengthens muscles
- Improves balance
- Reduces risk of falls
- Improves coordination
- Improves flexibility and joint mobility
- Reduces swelling in the affected joints and muscles
- Prevents deformities and limb problems 
- Improves gait 
- Improves posture 
- Reduction of unnecessary complications 
Psychological Benefits[edit | edit source]
- Enhances your self-confidence and your ability to deal psychologically with your illness or injury.
- Provides you with greater independence – returns you to your pre-injury state of mental wellbeing.
Lifestyle Benefits[edit | edit source]
- Improved Participation 
- Decreased dependence 
- Improved quality of life 
- Quicker return to work which can reduce financial concerns and increase social participation
- Supports return to sport or exercise so your health and your sense of wellbeing can benefit – you also improve your general health when you can exercise or play sport to your original capacities
Economic Benefits[edit | edit source]
There are several ways that rehabilitation intervention can deliver savings within the context of health and social care. For example, it can:
- enable a person to return to work, get into work or stay in work reduce the cost of nursing, residential and social care
- reduce the risk of falls
- reduce the associated costs of mental health illness
- reduce the costs associated with diabetic care
- reduce length-of-stay costs
- realise the potential of children and young people
A recent report indicates that from every dollar invested in assistive technology, the return on investment is 9 dollars. Podiatry and Orthotic services have been shown to have many economic benefits including reduction in number of appointments and various cost savings. Savings of £400m were seen, with £4 saved for every £1 spent on orthotic services for individuals with cancer.  Multidisciplinary foot care team intervention produces a 70% reduction in amputation rate in individuals with diabetes, which leads to a reduction in length of stay and annual savings of £0.5m to offset £120,000 annual costs. Similar economic benefits have been seen in more complex patients with a reduced need for continuing care, and reduced dependence with an average saving in weekly cost of care in the NHS of £243 as a result.  Huge economic benefits have also been shown in many respiratory and lung conditions. Preoperative pulmonary rehabilitation for lung cancer patients reduced their complication rate from 16% to 9%, and reduced their readmissions from 14% to 5% with a cost saving of £244 per patient. While an integrated multidisciplinary 7-day joint emergency teams service, which resulted in reduced hours of work for the Community COPD service, resulting in £900,000 savings for the domiciliary care budget and reduced hospital admissions.
Types[edit | edit source]
Orthopaedic and Musculoskeletal Rehabilitation[edit | edit source]
It is a therapeutic approach to recovery, the purpose of which is to correct musculoskeletal limitations and alleviate pain from trauma, illness, or surgery. The Musculoskeletal system includes muscles, bones, joints, ligaments, tendons, cartilage so that orthopaedic rehab can address any of those structures.
Physiotherapist creates a personalized treatment program according to condition, goals and abilities of patient. Physical therapists uses a variety of techniques to help muscles and joints work to improving, maintaining or restoring physical strength, cognition and mobility with maximized results. Many of the reviews concluded that both aerobic and strengthening exercise, as well as individual and group exercise, are effective in patients with knee osteoarthritis.
Neurological Rehabilitation[edit | edit source]
Some of the common conditions like Spinal Cord Injury, Stroke, Multiple Sclerosis, Parkinsons may present with varying degrees of e.g. spasticity, muscle weakness, impaired coordination and balance, difficult in speech and swallowing. Individuals with a neurological condition can show great potential for recovery in both the early and late stages of rehabilitation following injury. Enhancement of the recovery process could be achieved with new rehabilitation approaches alone or in combination with pharmacological intervention. For example rehabilitation of movement after stroke requires repeated practice and involves learning and brain changes. Brain stimulation plays a crucial role in treating stroke patients.
If an individual is having difficulties with activities of daily living, rehabilitation can support them in developing strategies to accomplish the same tasks in different way or through the use of assistive technology. Physiotherapy and occupational therapy can help patients improve their activities of daily living as well as their mobility.
Practical techniques and assistive devices may ease the burden of dressing, bathing, eating, household chores, and daily care. Vestibular rehabilitation attempts to help patients adapt to balance problems. Some equipment has been designed to improve stability. Assistive devices, hand rails, and safety training can reduce the risk of falling. Overall, exercise can improve fitness and function and maintain function for those with moderate to severe impairment.
Cardiac Rehabilitation[edit | edit source]
Cardiac rehabilitation is a complex intervention offered to individuals with cardiovascular disease or following a myocardial infarction, which includes components of health education, advice on risk reduction, physical activity and stress management. These programs are designed to limit the physiological and psychological effects of cardiac illness, reduce the risk for sudden death or re-infarction, control cardiac symptoms, stabilize or reverse the atherosclerotic process, and enhance the psychosocial and vocational status of patients. Cardiac rehabilitation reduces mortality, morbidity, unplanned hospital admissions in addition to improvements in exercise capacity, quality of life and psychological well-being is increasing. In addition to these benefits, upper extremity exercises and instruction on breathing technique are included in most rehabilitation programs and reduce dyspnoea.
Pulmonary Rehabilitation[edit | edit source]
Pulmonary rehabilitation is a “comprehensive intervention based on a thorough patient assessment followed by patient-tailored therapies that include, but are not limited to, exercise training, education, and behaviour change, designed to improve the physical and psychological condition of people with chronic respiratory disease and to promote the long-term adherence to health-enhancing behaviours”
Pulmonary rehabilitation is tailored to the individual who has recently had an exacerbation, with the aim of optimizing their respiratory function and therefore their quality of life (QOL) and participation in their everyday lives. It has been proven to significantly improve health related quality of life (HR-QOL) and exercise capacity in individuals with Chronic Respiratory Pulmonary Disorder (COPD) compared to usual care. Studies suggest it is useful in patients with moderate to severe COPD. Increased functional exercise capacity, and enhanced quality of life of patients with chronic obstructive pulmonary disease (COPD) are established benefits of pulmonary rehabilitation.
Geriatric Rehabilitation[edit | edit source]
Ageing is characterized by decline in general physiologic function and this make chronic condition and multi-morbidity prevalent among older adults. This characteristics among others make recovery a challenging one among older adults, therefore, understanding principles of rehabilitation will facilitates delivery of effective therapeutic outcome to older adults.
Although no amount of physical activity can stop the biological ageing process, there is evidence that regular exercise can minimize the physiological effects of an otherwise sedentary lifestyle and increase active life expectancy by limiting the development and progression of chronic disease and disabling conditions. There is also emerging evidence for significant psychological and cognitive benefits accruing from regular exercise participation by older adults. Regular physical exercise can reduce the risk of chronic disease and increase life expectancy as well as productivity improvements in muscle function (strength and power). Multi-modal exercise has a reported beneficial effect on falls rates. A randomized control trial suggests home-based exercise and nutrition strategies have a positive outcome on the frailty score and physical performance in the pre-frail or frail older adults.
Renal Rehabilitation[edit | edit source]
Renal rehabilitation in both pre-dialysis and dialysis patients with chronic kidney disease has been shown to maintain and in many cases improve exercise tolerance and importantly improves QOL related to physical functions, although there is no evidence currently that exercise therapy improves the vital prognosis or renal outcome. Intradialytic exercise protocols had positive outcomes in chronic kidney disease patients with poor cardiopulmonary function and reduced exercise tolerance and ventilatory efficiency.For individuals with chronic kidney disease Stages 3 and 4 a 12-week/24-session renal rehabilitation exercise program has been shown to improve physical capacity and quality of life, although longer follow-up is needed to determine if these findings will translate into decreased mortality rates."
Secondary sarcopenia due to chronic kidney disease is associated with malnutrition, osteoporosis, mobility limitations, and elevated falls risk. Supervised physiotherapy for the management of secondary sarcopenia in individuals with chronic kidney disease has been shown to improve QOL through enhanced cardiovascular fitness and bone strength via strength training.
Burns Rehabilitation[edit | edit source]
Burns rehabilitation has been shown to have many positive effects. Virtual reality through the use of a 3D interface video game, Xbox Kinect improved exercise time and patient satisfaction in patients who sustained minor upper limb burns. Robotics in the form of robot-assisted gait training in patients who have sustained burn injuries has been shown to improve their gait functions.
Music therapy has been shown to significantly decrease pain, anxiety and muscle tension associated with interventions of burn care, while cognitive behavioural therapy and hypnosis have also been demonstrated to lower pain and anxiety levels in patients who have sustained burn injuries
Resources[edit | edit source]
World Health Organisation work on Rehabilitation
References [edit | edit source]
- ↑ https://www.who.int/news-room/fact-sheets/detail/rehabilitation
- ↑ Smith TP, Kennedy SL, Smith M, Orent S, Fleshner M. Physiological improvements and health benefits during an exercise-based comprehensive rehabilitation program in medically complex patients. Exerc Immunol Rev. 2006 Jan 1;12:86-96.
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 Burks JS, Bigley GK, Hill HH. Rehabilitation challenges in multiple sclerosis. Annals of Indian Academy of Neurology. 2009 Oct;12(4):296.
- ↑ 4.0 4.1 4.2 4.3 Ghasemi N, Razavi S, Nikzad E. Multiple sclerosis: pathogenesis, symptoms, diagnoses and cell-based therapy. Cell Journal (Yakhteh). 2017 Apr;19(1):1.
- ↑ 5.0 5.1 5.2 5.3 Manoj Sivan, Margaret Phillips, Ian Baguley, Melissa Nott. Chapter.1 Concepts of Rehabilitation. In Oxford Handbook of Rehabilitation Medicine.
- ↑ Popadiuk, S and Rajbhandari, S (2010). Benefits of non-medical prescribing within an NHS podiatry service. Journal of Foot and Ankle Research, 3(Suppl 1) O20
- ↑ NHS London (1) (no date). Cancer care toolkit: How AHPs improve patient care and save the NHS money. Developed on behalf of the Strategic AHP Leads Group (SAHPLE). Retrieved from: https://www.networks.nhs.uk/nhs-networks/ahp-networks/ahp-qipp-toolkits/AHP_Cancer_Pathway_final%20-3.pdf
- ↑ National Institute for Health and Care Excellence (2014). Multiple sclerosis in adults: Management. CG186. Retrieved from: h[./Ttps://www.nice.org.uk/guidance/cg186 ttps://www.nice.org.uk/guidance/cg186]
- ↑ Wood, RL; McCrea, JD; Wood, LM and Merriman, RN (1999). Clinical and cost effectiveness of post-acute neurobehavioural rehabilitation. Brain Injury 13(2) 69-88
- ↑ Aronow, H (1987). Rehabilitation effectiveness with severe brain injury: Translating research into policy. Journal of Head Trauma Rehabilitation, 2(3) 24-36
- ↑ Turner-Stokes, L; Paul, S and Williams, H (2006). Efficiency of specialist rehabilitation in reducing dependency and costs of continuing care for adults with complex acquired brain injuries. Journal of Neurology, Neurosurgery and Psychiatry, 77(5) 634–39
- ↑ 12.0 12.1 Bradley, A; Marshal, A; Stonehewer, L; Reaper, L; Parker, K; Bevan-Smith, E; Jordan, C; Gillies, J; Agostini, P; Bishay, E; Kalkat, M; Steyn, R; Rajesh, P; Dunn, J and Naidu, B (2013). Pulmonary rehabilitation programme for patients undergoing curative lung cancer surgery. European Journal of Cardio-Thoracic Surgery, 44 (4)e 266-71
- ↑ Jamtvedt G, Dahm KT, Christie A, Moe RH, Haavardsholm E, Holm I, Hagen KB. Physical therapy interventions for patients with osteoarthritis of the knee: an overview of systematic reviews. Physical therapy. 2008 Jan 1;88(1):123-36.
- ↑ Barbeau H, Fung J. The role of rehabilitation in the recovery of walking in the neurological population. Current opinion in neurology. 2001 Dec 1;14(6):735-40.
- ↑ Allman C, Amadi U, Winkler AM, Wilkins L, Filippini N, Kischka U, Stagg CJ, Johansen-Berg H. Ipsilesional anodal tDCS enhances the functional benefits of rehabilitation in patients after stroke. Science translational medicine. 2016 Mar 16;8(330):330re1-.
- ↑ Brown TR, Kraft GH. Exercise and rehabilitation for individuals with multiple sclerosis. Physical medicine and rehabilitation clinics of North America. 2005 May 1;16(2):513-55.
- ↑ World Health Organisation (WHO). Rehabilitation changes lives – Sana’s story from Pakistan. Available from: https://youtu.be/cy3xqEApmPI[last accessed 20/06/2021]
- ↑ Dalal HM, Doherty P, Taylor RS. Cardiac rehabilitation. Bmj. 2015 Sep 29;351.
- ↑ Spruit MA, Singh SJ, Garvey C, ZuWallack R, Nici L, Rochester C, Hill K, Holland AE, Lareau SC, Man WD, et al.; ATS/ERS Task Force on Pulmonary Rehabilitation. An official American Thoracic Society/ European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med 2013;188:e13–e64.
- ↑ 20.0 20.1 McCarthy B, Casey D, Devane D, Murphy K, Murphy E, Lacasse Y. Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane database of systematic reviews. 2015(2).
- ↑ Lee AL, Butler SJ, Varadi RG, Goldstein RS, Brooks D. The Impact of Pulmonary Rehabilitation on Chronic Pain in People with COPD. COPD: Journal of Chronic Obstructive Pulmonary Disease. 2020 Mar 3;17(2):165-74.
- ↑ Mark Van Driel - NEXUS. What are the benefits of pulmonary rehabilitation?. Available from: https://youtu.be/kCzxwQhYcvk[last accessed 30/08/21]
- ↑ Baker MK, Atlantis A, Fiatarone Singh MA. Multi-modal exercise programs for older adults. Age Ageing. 2007. Volume 36 (4): 375–381. Available at: https://academic.oup.com/ageing/article/36/4/375/40634. Accessed 26 June 2018.
- ↑ Hsieh TJ, Su SC, Chen CW, Kang YW, Hu MH, Hsu LL, Wu SY, Chen L, Chang HY, Chuang SY, Pan WH. Individualized home-based exercise and nutrition interventions improve frailty in older adults: a randomized controlled trial. International Journal of Behavioral Nutrition and Physical Activity. 2019 Dec 1;16(1):119.
- ↑ Andrade FP, Rezende PS, Ferreira TS, Borba GC, Müller AM, Rovedder PME. Effects of intradialytic exercise on cardiopulmonary capacity in chronic kidney disease: systematic review and meta-analysis of randomized clinical trials. Scientific Reports. 2019 Dec 5;9(1):18470.
- ↑ Rossi AP, Burris DD, Lucas FL, Crocker GA, Wasserman JC. Effects of a renal rehabilitation exercise program in patients with CKD: a randomized, controlled trial. Clinical journal of the American Society of Nephrology. 2014 Dec 5;9(12):2052-8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4255415/ (last accessed 22.6.2019)
- ↑ Hernandez H, Obamwonyi G, Harris-Love M. Physical therapy considerations for chronic kidney disease and secondary sarcopenia. Journal of functional morphology and kinesiology. 2018 Mar;3(1):5. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5784851/ (last accessed 22.6.2019)
- ↑ Voon K, Silberstein I, Eranki A, Philips M, Wood FM, Edgar DW. Xbox Kinect based rehabilitation as a feasible adjunct for minor upper limb burns rehabilitation: A pilot RCT. Burns 2016; 42(8): 1797-1804.
- ↑ Joo SY, Lee SY, Cho YS, Lee KJ, Kim SH, Seo CH. Effectiveness of robot-assisted gait training on patients with burns: a preliminary study. Computer Methods in Biomechanics and Biomedical Engineering 2020; 23(12): 888-893.
- ↑ Li J, Zhou L, Wang Y. The effects of music intervention on burn patients during treatment procedures: a systematic review and meta-analysis of randomized controlled trials. BMC Complementary and Alternative Medicine. 2017; 17: 158
- ↑ Tan X, Yowler CJ, Super DM, Fratianne RB. The Efficacy of Music Therapy Protocolsfor Drecreasing Pain, Anxiety, and Muscle Tension Levels During Burn Dressing Changes: A Prospective Randomized Crossover Trial. Journal of Burn Care & Research. 2010; 31(4): 590-597.
- ↑ King L. "Is music therapy intervention effective in decreasing pain after standard wound care in hospitalized burn patients?" PCOM Physician Assistant Studies Student Scholarship. 2019; 444
- ↑ Provençal SC, Bond S, Rizkallah E, El-Baalbaki G. Hypnosis for burn wound care pain and anxiety: A systematic review and meta-analysis. Burns. 2018; 44(8): 1870-1881.