Rehabilitation Team Members
Introduction[edit | edit source]
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. Seven core professions offer rehabilitation services: audiology, occupational therapy, physical and rehabilitation medicine, physiotherapy, prosthetics and orthotics, rehabilitation nursing and speech and language therapy and are supported by many other rehabilitation professionals depending on the specific needs of the individual. 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 process based on the type of team structure they are working in, what phase of rehabilitation they are involved in, the environment or context 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, the resources available locally and the specific needs of the individuals.
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 physiatrist and/or neurologist often a spinal cord injury specialist, a spinal surgeon, an anesthesiologist, intensive care nurses, specialist respiratory and neurology physiotherapists, occupational therapists, speech and language therapists, dieticians, social workers, psychologists and peer support workers. While during the post-acute phase of treatment, the team members might include a physiatrist with a specialism in spinal cord injury, urologist, specialist spinal cord injury rehabilitation nurses, physiotherapists with a specialism in neurology who have skills in motor learning, balance, strength, cardiovascular, gait and wheelchair mobility, 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, recreational therapists who have an interest in disability sport and recreation programs, peer support workers, family members and care support workers and, most importantly, the individual.  In support of person-centred care and safety, the individual and their family / carers are increasingly being considered as active members of the health-care team .
The Rehabilitation Team Members[edit | edit source]
Individual / Patient[edit | edit source]
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 rehabilitation goals and should always have the opportunity to question the process and direct their rehabilitation needs in order to optimise their function.
Perhaps the most important trait that separates an empowered individual from one who is not is that of the role of "active participant," the person as a fully participating partner on the healthcare team. Active participants are those individuals who realize that when they begin to experience symptoms, or at the point where they recognise that something in their body is not functioning as it should be, it's time for them to actively seek answers and solutions in collaboration with other members of their healthcare team. In reality, the individual accessing rehabilitation is the most important team member, and it is their right to participate fully in decision-making regarding their care. As such it is a key responsibility as a healthcare professional to involve them in their own care.
As well as being important in terms of issues such as shared decision making and informed consent, engaging the individual 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. 
Family & Friends[edit | edit source]
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[edit | edit source]
Physiotherapists are experts in human movement and have a key role in prevention, identification, assessment, treatment and (re)habilitation of individuals when movement and function are threatened or affected by ageing, injury, diseases, conditions or environmental factors. Physiotherapists support people at all stages of life to recover from injury, reduce pain and stiffness, increase mobility and movement and maximise function and quality of life, incorporating physical, psychological, emotional and social wellbeing. 
Physiotherapy provides rehabilitation interventions to restore, maintain, and make the most of a patient’s mobility, function, and well-being. They help to encourage development and facilitate recovery, enabling people to stay at work while helping them remain independent for as long as possible.
Occupational Therapist[edit | edit source]
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. These 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[edit | edit source]
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[edit | edit source]
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 the deformity, protect and support an injury to increase mobility and decrease pain. 
A prosthetic and orthotic technician is a non-clinical service provider, 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[edit | edit source]
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[edit | edit source]
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[edit | edit source]
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[edit | edit source]
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[edit | edit source]
Rehabilitation 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.
Physical Medicine and Rehabilitation Physician (Physiatrist)[edit | edit source]
The physician role and type of physicians involved in the rehabilitation team will vary hugely depending on the type of condition or injury and the phase of management i.e. acute, rehabilitation or post-discharge. Types of physicians involved can include but is not limited to specialists in Physical and Rehabilitation Medicine (often primary physician), Neurology, Rheumatology, Respiratory, Gerontology and Paediatrics. Diagnosis and management of underlying pathology and impairments through the medical assessment, treatment whether conservative or surgical, including prescribing pharmacological and non-pharmacological interventions, and rehabilitation planning are key roles of the physician. They also have an important role in ensuring that the individual is well enough to participate in rehabilitation. 
Physical Medicine and Rehabilitation is a medical speciality that specifically deals with the evaluation and treatment of patients whose functional abilities have been impaired. Physical Medicine and Rehabilitation physicians, also known as physiatrists, are medical doctors who have completed training in the speciality of Physical Medicine and Rehabilitation, often with a subspecialty in areas such as Brain Injury Medicine, Neuromuscular Medicine, Pain Medicine, Pediatric Rehabilitation Medicine, Spinal Cord Injury Medicine, Sports Medicine and/or Hospice and Palliative Medicine. Specifically Physical Medicine and Rehabilitation physicians;
- Treat patients of all ages
- Focus treatment on function
- Have broad medical expertise that allows them to treat conditions throughout a person’s lifetime
- Diagnose and treat pain as a result of an injury, illness, or impairment.
- Work within a team of medical professionals, which may include physiotherapists, occupational therapists, and other rehabilitation team members to optimise care and ensure rehabilitation needs are met.
- Treat the whole person, not just the problem area
Audiologist[edit | edit source]
Audiologists are experts in the prevention, identification, assessment, treatment and rehabilitation of auditory and vestibular difficulties across the lifespan in order to improve an individual's 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[edit | edit source]
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[edit | edit source]
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[edit | edit source]
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[edit | edit source]
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.
References [edit | edit source]
- World Health Organization. Rehabilitation. Geneva, Switzerland; 2020b. [Cited 2021 July 1].
- Vos T, Lim SS, Abbafati C, Abbas KM, Abbasi M, Abbasifard M, Abbasi-Kangevari M, Abbastabar H, Abd-Allah F, Abdelalim A, Abdollahi M. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet. 2020 Oct 17;396(10258):1204-22.
- Mills JA, Cieza A, Short SD, Middleton JW. Development and Validation of the WHO Rehabilitation Competency Framework: A Mixed Methods Study. Archives of Physical Medicine and Rehabilitation. 2021 Jun 1;102(6):1113-23.
- Marshall, R and Hasnan, N. Chapter.27 Team Based Care. In: Chhabra HS, ISCoS Textbook on Comprehensive Management of Spinal Cord Injuries. International Spinal Cord Society. 2015
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- World Health Organisation. WHO Patient Safety Curriculum Guide for Medical Schools - Topic 4: Being an Effective Team Player. 2009
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- The Australian Orthotic Prosthetic Association. About Orthoses and Prostheses. Available from: https://www.aopa.org.au/careers/what-are-orthoses-and-prostheses. [Accessed 30/06/2021]
- International Society for Prosthetics and Orthotics. ISPO Education Standards for Prosthetic and Orthotic Occupations. 2018
- Physiopedia. Pat Quigley - What is Rehabilitation Nursing ? Available from: https://vimeo.com/575151857/783d2aa0f1[last accessed 30/07/21]
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- American Association for Pediatric Ophthalmology & Strabismus. Difference between an Ophthalmologist, Optometrist and Optician.(accessed 26 June 2021).