Overview of Physical Deficiencies and Rehabilitation.
Introduction to Orthotists, Physical Therapists, Physicians and Clients
Rehabilitation is defined as:
restoration to a former capacity; restoration to a state of efficiency;
restoration to a state of good health or useful and constructive
activity. In order to achieve these goals in the presence of physical
deficiencies, we need to understand the underlying causes and how best
to treat them. It is a team effort to recognize and develop real
solutions to real problems. Specialization has brought about
advancements in specific areas. Specialization must stay focused on the overall goals of the client. It is imperative
for the team to blend their specialties for a common goal. Outcomes
will depend on everyone working on the individual solution. Each member
has an important role in reinforcing the common goals and plugging in
their skills into the rehabilitation equation for the betterment of
people in need.
In order to provide workable solutions to the problems at hand, we must all become clinicians
or rehabilitation specialists. We must have the same
goals and combine our specialties to obtain them.
We must work together as
clinicians rather than separate specialists. The client must play an
important role. It is the responsibility of the team members to educate the client regarding their deficiency
and how to continue to improve. Rehabilitation should not end when the
treatment is over. Clients must learn how to improve on their own! EDUCATION is the most important tool that clinicians can give to clients. The
client in turn must become in some degree of clinician of their
physical limitations.
Specialties must overlap for the team approach to
be successful. Unity of purpose should be the primary motivation.
Orthotic services cannot be separated from Physical Therapy services.
Each clinician must reinforce the same treatment plan in order to
achieve a common goal. Every member of the team is responsible to the
goals of rehabilitation. The client is ultimately
responsible for the outcome with the help of the team clinicians.
Physical
Deficiencies vs. Functional Deficiencies
Physical deficiencies have a mechanical basis. Muscle weakness and muscle imbalance adversely affect the normal
mechanics of the body. The structure and integrity of joints change
which ultimately leads to deformity. In time, these changes affect
function. The problems begin before they become evident. Functional
deficiencies are the ultimate result. The rehabilitation process can be
greatly reduced by recognizing the difference.
Any physical deficiency also has a psychological counterpoint. The mind
and body cannot be separated. Physical deficiencies
can be tolerated until function is affected. The ability to ambulate is
taken for granted until it becomes a conscious effort or a task. The perception of the problems and how they are dealt with are very personal issues.
Clinicians working with clients are merely people working with other
people. Rehabilitation is about people.
The physical deficiencies and the corresponding mechanical problems
create balance problems. Balance
problems in turn cause compensations as the body tries to cope with security issues. The compensations begin
as conscious responses to insure safety. Eventually these compensations
are assimilated into normal behavior and become habit.
This cycle of events is progressive and
self-defeating.
Only through education and understanding,
can this cycle be broken. Information can also be misleading. Personal
opinions, misunderstanding, wrong information and unproven or
unsuccessful approaches must be replaced with science, technology and
outcomes based upon workable solutions.
The re-education process needs
to be a conscious mental activity before it can affect the physical and
functional deficiencies.
Formula
for Success
Education and understanding are fundamental to the
success of any endeavor. In rehabilitation, understanding of the
scientific and technical information related to a treatment approach
must lead to acceptance of the plan by every member of the team. Any
doubts that arise will undermine the success of the treatment. A great
deal of effort is required on
the part of all team members. Everyone must believe
in the approach and adhere to the protocols of
treatment. Commitment to the
approach and the goals of treatment are necessary to insure success. A
half-hearted effort on the part of any member of the team will result
in less than optimal results. Success can also be defined as perseverance.
The client must recognize the need to improve and want to improve
in order to put forth the effort. The enthusiasm of the team will bring
about positive changes and improvement that will ultimately lead to
success.
Conclusion
Rehabilitation is about change;
however, even positive change does not come easy for most human beings.
In the case of physical deficiencies that affect function, the
compensations and habits that develop become part of the individual's
lifestyle. Changes that disrupt the "normal" lifestyle are often
resisted. The old ways seem "easier to deal with". In order to benefit
from a program of rehabilitation, one must plan for
change. Talking about change does not make it
happen! Clients and clinicians alike must look forward to change as we
explore new strategies that offer hope. Rehabilitation is hope in action! Education, desire, effort and dedication to the goals of rehabilitation
on the part of passionate team members can turn hope into reality.