Chapter 4 Rehabilitation

Abstract

Rehabilitation has long lacked a unifying conceptual framework (1). Historically, the term has described a range of responses to disability, from interventions to improve body function to more comprehensive measures designed to promote inclusion (see Box 4.1). The International Classification of Functioning, Disability and Health (ICF) provides a framework that can be used for all aspects of rehabilitation (11-14). For some people with disabilities, rehabilitation is essential to being able to participate in education, the labour market, and civic life. Rehabilitation is always voluntary, and some individuals may require support with decision-making about rehabilitation choices. In all cases rehabilitation should help to empower a person with a disability and his or her family. Article 26, Habilitation and Rehabilitation, of the United Nations Convention on the Rights of Persons with Disabilities (CRPD) calls for: "… appropriate measures, including through peer support, to enable persons with disabilities to attain and maintain their maximum independence, full physical, mental, social and vocational ability, and full inclusion and participation in all aspects of life". The Article further calls on countries to organize, strengthen, and extend comprehensive rehabilitation services and programmes, which should begin as early as possible, based on multidisciplinary assessment of individual needs and strengths, and including the provision of assistive devices and technologies. This chapter examines some typical rehabilitation measures, the need and unmet need for rehabilitation, barriers to accessing rehabilitation, and ways in which these barriers can be addressed. Understanding rehabilitation Rehabilitation measures and outcomes Rehabilitation measures target body functions and structures, activities and participation, environmental factors, and personal factors. They contribute Rehabilitation involves identification of a person's problems and needs, relating the problems to relevant factors of the person and the environment, defining rehabilitation goals, planning and implementing the measures, and assessing the effects (see figure below). Educating people with disabilities is essential for developing knowledge and skills for self-help, care, management, and decision-making. People with disabilities and their families experience better health and functioning when they are partners in rehabilitation (3-9). The rehabilitation process Identify problems and needs Assess e ects Relate problems to modi able and limiting factors De ne target problems and target mediators, select appropriate measures Plan, implement, and coordinate interventions Source: A modified version of the Rehabilitation Cycle from (10). Rehabilitation-provided along a continuum of care ranging from hospital care to rehabilitation in the community (12)-can improve health outcomes, reduce costs by shortening hospital stays (15-17), reduce disability, and improve quality of life (18-21). Rehabilitation need not be expensive. Rehabilitation is cross-se...

Design, Development, and Testing of an Intelligent Wearable Robotic Exoskeleton Prototype for Upper Limb Rehabilitation

“…There are some drawbacks inherent in the traditional approach to rehabilitation, where the procedures often lack comprehensive coverage due to the partially subjective and limited experience of physicians [ 17 , 18 ], and the time lag between the injury event and the initiation of treatment [ 19 ]. In many cases, the injury is not addressed in terms of neuromotor functioning, limiting the patient’s progress [ 20 ].…”