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 a 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 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.