Rehabilitation By : Dr.Hassan Hussien El- sharkawy

Objectives To know the following: - Definition of rehabilitation - Differentiation between impairment, disability and handicap. - Aim of rehabilitation. - Rehabilitation team and its role. - Musculoskeletal assessment and common disorders. - Rehabilitation methods. - Transfer methods & ADL. - Wheel chair activities.

Definition re·ha·bil·i·tate re·ha·bil·i·tat·ed, re·ha·bil·i·tat·ing, re·ha·bil·i·tates 1. To restore to good health or useful life, as through therapy and education. 2. To restore to good condition, operation, or capacity. 3. To reinstate the good name of. 4. To restore the former rank, privileges, or rights of.

Rehabilitation: The process of helping a person who has suffered an illness or injury restore lost skills and so regain maximum self-sufficiency. -For example, rehabilitation work after a stroke may help the patient walk and speak clearly again.stroke

But we must differentiate between Impairment - is a change in normal structure or function resulting from a disease, disorder or injury. -It encompasses any loss or abnormality of a psychological, physiological or anatomical structure or function. -The disturbance is at the level of the 'organ', e.g. loss of a limb, hearing or sight. The result is a structural disablement.

Disability - is any restriction or lack (resulting from an impairment) of the ability to perform an activity, e.g. climbing stairs, operating machinery, in the manner or within the range considered normal for a human being. -It reflects disturbance at 'person' level, e.g. behaviour, performance, mobility, communication, memory.

Handicap is a disadvantage for a given individual resulting from an impairment or disability that limits or prevents the fulfillment of a normal role for that individual.

Types of Disabilities Types of disabilities include various physical and mental impairments that can reduce a person's ability to carry out his day to day activities. which include the following a) Mobility and Physical Impairments b) Spinal Cord Disability c) Head Injuries - Brain Disability d) Vision Disability e) Hearing Di sability f) Cognitive or Learning Disabilities j) Psychological Disorders h) Invisible Disabilities

a)Mobility and Physical Impairments This category of disability includes people with varying types of physical disabilities including: Upper limb(s) disability. Lower limb(s) disability Manual dexterity. Disability in co-ordination with different organs of the body. Disability in mobility can be either an in-born or acquired with age problem. It could also be the effect of a disease. People who have a broken bone also fall into this category of disability.

b) Spinal Cord Disability: Spinal cord injurySpinal cord injury (SCI) can sometimes lead to lifelong disabilities. This kind of injury mostly occurs due to severe accidents. The injury can be either complete or incomplete. In an incomplete injury, the messages conveyed by the spinal cord is not completely lost. Whereas a complete injury results in a total dies-functioning of the sensory organs. In some cases spinal cord disability can be a birth defect.

c) Head Injuries - Brain Disability A disability in the brain occurs due to a brain injury. The magnitude of the brain injury can range from mild, moderate and severe. There are two types of brain injuries: Acquired Brain Injury (ABI) Traumatic Brain Injury (TBI) ABI is not a hereditary type defect but is the degeneration that occurs after birth. The causes of such cases of injury are many and are mainly because of external forces applied to the body parts. TBI results in emotional dysfunctioning and behavioral disturbance.

d) Vision Disability There are hundreds of thousands of people that suffer from minor to various serious vision disability or impairments.vision disability These injuries can also result into some serious problems or diseases like blindness and ocular trauma, to name a few. Some of the common vision impairment includes scratched cornea, scratches on the sclera, diabetes related eye conditions, dry eyes and corneal graft.

e) Hearing Disability Hearing disabilitiesHearing disabilities includes people that are completely or partially deaf, (Deaf is the politically correct term for a person with hearing impairment). People who are partially deaf can often use hearing aids to assist their hearing.hearing aids Deaf people use sign language as a means of communication.

f) Cognitive or Learning Disabilities Cognitive DisabilitiesCognitive Disabilities are kind of impairment present in people who are suffering from dyslexia and various other learning difficulties and includes speech disorders.

f) Psychological Disorders Affective Disorders: Disorders of mood or feeling states either short or long term. Mental Health Impairment is the term used to describe people who have experienced psychiatric problems or illness such as: Personality Disorders - Defined as deeply inadequate patterns of behavior and thought of sufficient severity to cause significant impairment to day-to-day activities.

h) Invisible Disabilities Invisible DisabilitiesInvisible Disabilities are disabilities that are not immediately apparent to others. It is estimated that 10% of people in the U.S. have a medical condition considered a type of invisible disability.

Aim of rehabilitation The aim is to maximize recovery and help the patient return to maximum independence -The aim of rehabilitation is to restore some or all of the patient's physical, sensory, and mental capabilities that were lost due to injury, illness, or disease. -Rehabilitation includes assisting the patient to compensate for deficits that cannot be reversed medically. -It is prescribed after many types of injury, illness, or disease, including amputations, arthritis, cancer, cardiac disease, neurological problems, orthopedic injuries, spinal cord injuries, stroke, and traumatic brain injuriescancerstroke

Prevention and treatment of physical impairments can be divided into main concept areas: 3.1 Prevention of primary physical impairment 3.2 Prevention of secondary physical impairment 3.3 Treatment of physical impairment

3.1 Prevention of primary physical impairment To prevent physical impairments arising from avoidable diseases, e.g. by health education, nutrition and immunization. To prevent physical disabilities resulting from trauma, e.g. by seeking ways to prevent accidents.

3.2 Prevention of secondary physical impairment To prevent or at least limit the development of physical impairment by early referral and by prompt appropriate treatment, e.g. by family, physical therapist, orthopedic technician or surgeon. Curable impairments, such as clubfoot and cleft lip take priority.

3.3 Treatment of physical impairment To treat established physical impairment by physical therapy, appliances and surgery in order to minimize its impact.