Introduction and progress of Rehabilitation

Department of rehabilitation medicine of the 6th hospital affiliated jiaotong university,shanghai

Basic Concepts Of Rehabilitation

Physiatrics Historical overview

Purposes Of Rehabilitation

Rehabilitation and medicine related

Classification of disability

Basic concepts of rehabilitation

Z The Source Of “Rehabilitation”

Z To Include In Rehabilitation

Z Definitions Of Rehabilitation

Z Rehabilitation PrinciplesRehabilitation Principles

Z Rehabilitation service modalityRehabilitation service modality

？？

The Source Of “Rehabilitation”

康复医学的英文表达以物理为词根 Physiatrics ,PhPhysiatrics ,Ph

ysiatry( Americanysiatry( American ，， Canada)Canada)

Physical Medicine ( BrithishPhysical Medicine ( Brithish ，， South And NortSouth And Nort

h America )h America )

Physical medicine and rehabilitation (AmericaPhysical medicine and rehabilitation (America

n n ，， Australian etc)Australian etc)

rehabilitationrehabilitation （（ JapaneseJapanese ））

To Include In RehabilitationTo Include In Rehabilitation

RehabilitationRehabilitation

Engineer Engineer

Comprehensive Rehabilitation

Social Social

RehabilitationRehabilitation

Medical Medical

RehabilitationRehabilitation

VocationalVocational

RehabilitationRehabilitation

Educational Educational

RehabilitationRehabilitation

Rehabilitation is dedicated to Rehabilitation is dedicated to optimizing patients functioning optimizing patients functioning and health and to prevent or and health and to prevent or minimize disabilityminimize disability

Definitions Of Definitions Of RehabilitationRehabilitation

Rehabilitation GoalRehabilitation Goal

Rehabilitation goals include :

reestablishing emotional well-being,

preserving residual function ,preventing

disabling complications ,and developing

compensatory functional capacities

needed for carrying out daily activities.

Rehabilitation service Rehabilitation service modalitymodality IBR (Institution-based rehabilitation)

康复机构康复 ORS (Out-reaching rehabilitation

service) 上门康复服务 CBR (community-based rehabilitation)

社区康复

Rehabilitation service Rehabilitation service modalitymodality

IBRIBR

ORSORS

CBRCBR

Physiatrics Historical Physiatrics Historical OverviewOverview

L Prehistoric Period （ before 1910s ）

L Form Period （ 1910 － 1946s ）

L Definition Period （ 1947 － 1970s ）

L Development Period （ after 1970s ）

Prehistoric Prehistoric PeriodPeriod （（ before1910sbefore1910s ）） This period to utilized physical therapy ,per This period to utilized physical therapy ,per exemplum massageexemplum massage 、 、 athletic trainersathletic trainers 、、 light light therapytherapy 、、 infrared therapyinfrared therapy 、、 ultraviolet therapy ultraviolet therapy etc.etc.

infrared therapyinfrared therapyinfrared therapyinfrared therapy

Form PeriodForm Period （（ 19101910 －－ 1946s1946s ） ） This period was after World This period was after World ⅠⅠ.during this period .during this period ，，

wounded and infantile paralysis fashion modalitwounded and infantile paralysis fashion modality could be increase disability. y could be increase disability.

Definition PeriodDefinition Period （（ 19471947 －－ 19701970ss ）） This period was from World to early 1970s.duriⅡThis period was from World to early 1970s.duriⅡng this period ng this period ，， rehabiliatation pioneer Howard Rurehabiliatation pioneer Howard Rusk(1901-1989) was one of the first to recognize the sk(1901-1989) was one of the first to recognize the contribution of the team approach for individuals wcontribution of the team approach for individuals who were disabled and needed to access multidisciplho were disabled and needed to access multidisciplinary expertise to meet their medical and rehabilitatinary expertise to meet their medical and rehabilitation needs. For example, physical therapyion needs. For example, physical therapy 、、 psychopsychological therapylogical therapy 、、 occupational therapyoccupational therapy 、 、 speech tspeech therapyherapy 、、 prosthet and orthoses.prosthet and orthoses.

Definition PeriodDefinition Period （（ 19471947 －－1970s1970s ））

Published

Physiatrics Historical Physiatrics Historical OverviewOverview

Physiatrics Historical Physiatrics Historical OverviewOverview

Purposes Of RehabilitationPurposes Of Rehabilitation

Rehabilitation basis of principlesRehabilitation basis of principles

Rehabilitation evaluation and assessmentRehabilitation evaluation and assessment

purposes of rehabilitation purposes of rehabilitation

Rehabilitation Therapeutic Rehabilitation Therapeutic

Clinical rehabilitation Clinical rehabilitation

Rehabilitation basis of Rehabilitation basis of PrinciplesPrinciples

Functional training Total rehabilitation Integration with society Increase quality of life

Rehabilitation evaluation and Rehabilitation evaluation and assessmentassessment

Functional assessment is a method for describing a person’s abilities and limitations ,in order to measure performance of activities necessary fordaily living .its include :

Motion function evaluation Electromyography and nerve conduction studies Cardiorespiratory function and physical examinati

on Speech communication evaluationvocational assessment evaluation Social evaluation

purposes of rehabilitationpurposes of rehabilitation

Team approachTeam approach( multipurpose team ( multipurpose team

approach )approach )

RD-DPST

PT

0T RN

Psy

SW

RT

RE(P ＆ 0)

CTMT

VC

RD ：康复医师DP ：残疾人PT ：物理治疗师OT: 作业治疗师ST: 言语治疗师RE: 康复工程Psy : 心理学家RN: 康复护士RT: 文娱治疗师CTMT: 中医康复技师VC: 职业顾问SW: 临床社会工作者

Rehabilitation Rehabilitation TherapeuticTherapeutic

Speech Therapy

(ST)

PhysicalTherapy (PT)

RehabiliatationRehabiliatationcounselingcounseling

RecreationalRecreationaltherapytherapy

Sanatory rehabilitation

PsychotherapyPsychotherapy

RehabilitationRehabilitationEngineeringEngineering

Vocational Counseling

ProstheisProstheisAnd orthosisAnd orthosis

(Pr&o(Pr&o))

Others

RehabilitationNursing(RN）

Occupational Occupational TherapyTherapy

(OT)(OT)

Rehabilitation and medicial relatRehabilitation and medicial relateded

safety

Love/Belonging

Physiological

Esteem

actualization

Rehabilitation and medicine Rehabilitation and medicine relatedrelated

临床医学模型 康复医学模型

解决问题 疾 病 残疾、疾病

医生的作用 行动者、知情者 教师、促进者

病人的作用 被动者 主动者

治疗定向 个别进行、未形成组 协作组工作方法

治疗手段 治疗疾病及人 治疗残疾及人

Classification of disabilityClassification of disabilityWHO international classification of

impairments, Disabilities , and Handicaps (ICIDH) is widely accepted and provides a theoretical foundation for discussing rehabilitation outcome. The WHO model distinguishes and clarifies the three levels of disablement outcomes as follows:

Classification of disabilityClassification of disability

1. Impairments at the organ level

2. Disabilities at the person level

3. handicaps at societal level

Functional Limitation

(inability to type)

Pathology(e.g. Arthritis)

Impairment

(limited ROM in joint)

Transactional factors

QoL

Biology

Environ-ment

Lifestyle &

behavior

Events e.g., falls, infections

No disabling Condition

Disabling-process

Enabling-process

Health condition(disease, trauma)

Environmental factors

Personal factors

Contextual factors

Functioning

The biopsychosocial model of functioning and disability of the World Health Organization

& ParticipationActivityBody functions& structures

Activity is the execution of a task or action by an individual. It represents the individual perspective of functioning.

Activity is the execution of a task or action by an individual. It represents the individual perspective of functioning.

Participation is involvement in a life situation. It represents the societal perspective of functioning.

Impairedbody functions& structures

Limitation in activityRestriction in participation

Health condition(disease, trauma)

Environmental factors

Personal factors

Contextual factors

The biopsychosocial model of functioning and disability

ActivityBody functionand body structure

ParticipationParticipation

Impairment Impairment of of body function body function & structure& structure

LimitationLimitationin activitiesin activities

RestrictionRestriction in in participationparticipation

Environmental factors

Personal factors

Health condition(disease, trauma)

Contextual factors

DisabilityDisability

www.isprm.org 国际物理医学与康复医学学会国际物理医学与康复医学学会 (ISPRM) (ISPRM) http://www.phisiatry.org 美国康复医师学会美国康复医师学会http://www.archives-pmr.org http://www.archives-pmr.org 美国美国 PMRPMR 文献 文献 http://www.apta.org http://www.apta.org 美国物理治疗学会美国物理治疗学会http://www.aapmr.org美国物理医学与康复学会美国物理医学与康复学会http://www.capmr.org中华医学会物理医学与康复学分会中华医学会物理医学与康复学分会http://www.crrc.com.cn中国康复研究中心中国康复研究中心

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