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Introduction and progress of Rehabilitation. Department of rehabilitation medicine of the 6 th hospital affiliated jiaotong university,shanghai. Basic Concepts Of Rehabilitation Physiatrics Historical overview Purposes Of Rehabilitation
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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 • The Source Of “Rehabilitation” • To Include In Rehabilitation • Definitions Of Rehabilitation • Rehabilitation Principles • Rehabilitation service modality
? Rehbailitation
The Source Of “Rehabilitation” 康复医学的英文表达以物理为词根Physiatrics ,Physiatry( American,Canada) Physical Medicine ( Brithish,South And North America ) Physical medicine and rehabilitation (American ,Australian etc) rehabilitation(Japanese)
To Include In Rehabilitation Medical Rehabilitation Comprehensive Rehabilitation Vocational Rehabilitation Rehabilitation Engineer Social Rehabilitation Educational Rehabilitation
Definitions Of Rehabilitation Rehabilitation is dedicated to optimizing patients functioning and health and to prevent or minimize disability
Rehabilitation 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 modality • 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 modality IBR ORS CBR
Physiatrics Historical Overview • Prehistoric Period( before 1910s) • Form Period(1910-1946s) • Definition Period(1947-1970s) • Development Period (after 1970s)
Prehistoric Period(before1910s)This period to utilized physical therapy ,per exemplum massage、 athletic trainers、light therapy、infrared therapy、ultraviolet therapy etc. infrared therapy infrared therapy
Form Period(1910-1946s) This period was after World Ⅰ.during this period , wounded and infantile paralysis fashion modality could be increase disability.
Definition Period(1947-1970s) This period was from World Ⅱto early 1970s.during this period ,rehabiliatation pioneer Howard Rusk(1901-1989) was one of the first to recognize the contribution of the team approach for individuals who were disabled and needed to access multidisciplinary expertise to meet their medical and rehabilitation needs. For example, physical therapy、psychological therapy、occupational therapy、 speech therapy、prosthet and orthoses.
Physiatrics Historical Overview Published
Purposes Of Rehabilitation • Rehabilitation basis of principles • Rehabilitation evaluation and assessment • purposes of rehabilitation • Rehabilitation Therapeutic • Clinical rehabilitation
Rehabilitation basis of Principles • Functional training • Total rehabilitation • Integration with society • Increase quality of life
Rehabilitation evaluation and assessment Functional assessment is a method for describing a person’s abilities and limitations ,in order to measure performance of activities necessary for daily living .its include : Motion function evaluation Electromyography and nerve conduction studies Cardiorespiratory function and physical examination Speech communication evaluation vocational assessment evaluation Social evaluation
Team approach( multipurpose team approach ) 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 RN 0T Psy CTMT ST RD-DP RE (P&0) PT RT SW VC
Rehabilitation Therapeutic Rehabilitation Nursing (RN) Physical Therapy (PT) Rehabiliatation counseling Psychotherapy Others Occupational Therapy (OT) Sanatory rehabilitation Rehabilitation Engineering Recreational therapy Speech Therapy (ST) Vocational Counseling Prostheis And orthosis (Pr&o)
Rehabilitation and medicial related actualization Esteem Love/Belonging safety Physiological
Rehabilitation and medicine related 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 disability • WHO 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 disability • 1. Impairments at the organ level • 2. Disabilities at the person level • 3. handicaps at societal level
Transactional factors Biology Lifestyle & behavior Environ-ment Events e.g., falls, infections QoL Enabling-process Disabling-process No disabling Condition Pathology (e.g. Arthritis) Impairment (limited ROM in joint) Functional Limitation (inability to type)
The biopsychosocial model of functioning and disability of the World Health Organization Health condition(disease, trauma) Functioning Environmental factors Personal factors Contextual factors
Body functions & structures Activity & Participation
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.
Impaired body functions & structures Limitation in activity Restriction in participation
The biopsychosocial model of functioning and disability Health condition(disease, trauma) Body functionand body structure Activity Participation Environmental factors Personal factors Contextual factors
Health condition(disease, trauma) Impairment of body function & structure Limitation in activities Restrictionin participation Environmental factors Personal factors Contextual factors Disability
相 关 网 站 www.isprm.org 国际物理医学与康复医学学会(ISPRM) http://www.phisiatry.org 美国康复医师学会 http://www.archives-pmr.org 美国PMR文献 http://www.apta.org 美国物理治疗学会 http://www.aapmr.org 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 http://www.crrc.com.cn 中国康复研究中心