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Rehabilitation stakeholders need to unite behind the common concept of functioning https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32340-0/fulltext
2) Optimising functioning is the ultimate objective of rehabilitation, regardless of who the beneficiary is, who delivers it, or the context in which rehabilitation is delivered.
@JanHartvigsen
Optimising functioning is the ultimate objective of rehabilitation, regardless of who the beneficiary is, who delivers it, or the context in which rehabilitation is delivered. @JanHartvigsen
3) Optimising functioning is instrumental to a patient's wellbeing, regardless of the underlying health condition. @_Tyson_Beach @MyCuppaJo @LivingWellPain @adelaide_psn
Optimising functioning is instrumental to a patient's wellbeing, regardless of the underlying health condition. @_Tyson_Beach @MyCuppaJo @LivingWellPain @adelaide_psn
4) Functioning is WHO's third health indicator, alongside mortality and morbidity. @fiona_bull @M_Stamatakis
Functioning is WHO's third health indicator, alongside mortality and morbidity. @fiona_bull @M_Stamatakis
5) In an ageing world where more and more people live longer due to advances in preventive strategies & medical interventions, but often w/ more disability, functioning needs urgent attention from political leaders and presents a unique opportunity for advocacy. @OsteloR
In an ageing world where more and more people live longer due to advances in preventive strategies & medical interventions, but often w/ more disability, functioning needs urgent attention from political leaders and presents a unique opportunity for advocacy. @OsteloR
6) Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019
Cieza, Alarcos et al. The Lancet: December 01, 2020
Cieza, Alarcos et al. The Lancet: December 01, 2020
7) #everymovecounts @who @lasportsandspine #backtoactivity #beactive @DianParry @jeubanksMD @MaryOKeeffe007 @jpcaneiro @CGMMaher
8) The @WHO guidelines give suggestions for 
functional capacity by suggesting metrics for MVPA & strength training & 
demand by giving metrics for sedentary time. Dr Lewit highlights the benefits of the person-centered functional approach.
functional capacity by suggesting metrics for MVPA & strength training & demand by giving metrics for sedentary time. Dr Lewit highlights the benefits of the person-centered functional approach.
9)”Traditional models of treatment prioritize remediation of deficits in structures & functions of the body, such as m strength & ROM. On the other hand, patients wish to improve their performance in activities they consider essential 4 their physical, psych & social well-being.
10) ... Correction of deficits may benecessary to therapy, but it cannot be its ultimate goal,because it is not sufficient for the promotion of patients’interests.”
https://www.revistas.usp.br/rto/article/download/120800/129291
https://www.revistas.usp.br/rto/article/download/120800/129291
11) “patients generally have great judgment about their functional difficulties” https://www.revistas.usp.br/rto/article/download/120800/129291
12) “main aim is to improve engagement in functional tasks, & such aim cannot be achieved by con- sidering the individual or the organism in isolation from its context.
13) .. growing body of evidence indicates that traditional treatment approaches grounded in neurophysiologic (individual/organism-limited) theories are not effective in improving function and urge clinicians to move towards activity-based therapy.” https://www.sciencedirect.com/science/article/abs/pii/S0167945717300581
14) “The medical model emphasizes the disease and pathological processes and their impact on body parts and corresponding functions as the fundamental unit of analysis (Engel, 1977)....
15) .. Such focus does not ensure the restoration of function in daily life, as it does not address the task and context-specific constraints on the activities performed by an individual.”
16) “Put simply, arresting a disease process or reducing its symptoms may improve functioning—for example, due to reduction of pain—but this goal, though laudable, may leave function unchanged.
17) .. Intervention at the level of the disease or its symptoms does not impart skills to a patient w/in a task-specific context.”
18) “The necessary tuning of clinical practice to the understanding of functioning and disability conceived by ICF, therefore, cannot be supported by organism-limited theories of perception and action and motor control.”
19) “An account of functional behavior (& any intervention aimed at improving functional behavior) must be sought at the interface between an individual’s set of capabilities..& the opportunities offered by the environment for realization of his or her goals—affordances,..
20) ... in ecological theory. Uncovering the underpinnings of successful functional performance, therefore, requires uncovering the processes that facilitate a given affordance-effectivity fit”
21) “Physical rehabilitation clinicians have (implicitly or explicitly) drawn much of their practice from theories of motor control... The central assumption of these theories is that functional movement can be reduced to the operation of special elements of the movement system,
22) .. taken to be context-independent units—specific to anatomical structures—that are properly arranged to form complex movement patterns...
Bernstein cogently argued that movement always takes place against a background (or context) of ongoing non-muscular forces..
Bernstein cogently argued that movement always takes place against a background (or context) of ongoing non-muscular forces..
23) that will necessarily influence the end result of any pattern of muscle inhibition & excitation initiated by either a motor command or a reflex...
24) .. The implication is that motor commands, reflexes & inhibition do not result in predictable movement outcomes independently of the context, that is, environmental constraints.” https://www.researchgate.net/publication/313470762_Towards_an_ecologically_grounded_functional_practice_in_rehabilitation
25) “To have a functional capacity made the lived world bigger and was related to self-confidence in a broad meaning as well as to trust in oneself but also to have empathy for others.” https://doi.org/10.3109/09593985.2012.692582
26) ““movement is related to the quality of life, functional capacity, and health, including relations between movement and physical, psychological, social, and environmental factors.”
27)“W/ increasing concerns around low prevalence of PA & rising levels of sedentary behaviour among many populations worldwide,important public health gains could be made by limiting excessive sedentary behaviour & replacing it w/ more PA of light,moderate or vigorous intensity.”
28) “moderate certainty evidence that higher amounts of sedentary behaviour increase the risk for all-cause, cardiovascular disease (CVD) and cancer mortality, as well as incidence of CVD, cancer, and type 2 diabetes.” https://ijbnpa.biomedcentral.com/articles/10.1186/s12966-020-01044-0
29) “Society in developed countries suffers not only from insufficient movement, but also from lack of variety of movement.”
Vladimir Janda MD
1977 Korr IM (Ed) The Neurobiologic Mechanisms in Manipulative Therapy https://www.amazon.ca/dp/1468489046/ref=cm_sw_r_cp_api_fabc_.dSZFb0HHC74S
Vladimir Janda MD
1977 Korr IM (Ed) The Neurobiologic Mechanisms in Manipulative Therapy https://www.amazon.ca/dp/1468489046/ref=cm_sw_r_cp_api_fabc_.dSZFb0HHC74S
