John Whyte, MD, PhD Archives of Physical Medicine and Rehabilitation

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Contributions of Treatment Theory and Enablement Theory to Rehabilitation Research and Practice John Whyte, MD, PhD Archives of Physical Medicine and Rehabilitation Volume 95, Issue 1, Pages S17-S23.e2 (January 2014) DOI: 10.1016/j.apmr.2013.02.029 Copyright © 2014 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 1 A hypothetical and simplified enablement model. The existence of clinical characteristics at all levels of the ICF is noted with arrows, indicating causal influences between them. Each clinical characteristic tends to be influenced to varying degrees by multiple different characteristics from the level below. Several hypothetical body structure characteristics are shown as relevant to determining a specific body function, passive elbow extension. The causal weight of each arrow is indicated with a hypothetical value ranging from 0 (no impact on the next characteristic) to 1 (exclusively determining the value of the next characteristic). Archives of Physical Medicine and Rehabilitation 2014 95, S17-S23.e2DOI: (10.1016/j.apmr.2013.02.029) Copyright © 2014 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 2 An illustration showing that both treatment and outcome measurement can take place at any ICF level. Treatment levels are indicated by rows and outcome levels by columns. When the outcome is measured at the same level as the intervention (light colored cells along the diagonal), there is little need to invoke enablement theory. For dark shaded cells above and below the diagonal, however, the treatment may or may not induce substantial change in distal clinical outcomes, as specified by the predictions of enablement theory. Archives of Physical Medicine and Rehabilitation 2014 95, S17-S23.e2DOI: (10.1016/j.apmr.2013.02.029) Copyright © 2014 American Congress of Rehabilitation Medicine Terms and Conditions