Rehabilitation - Holistic Approach Oriented by Functionics (underlying concepts)

Rehabilitation - Holistic Approach Oriented by Functionics
-- Underlying Concepts --

Introduction

This site was created hastily for PT and OT students in 2004 when the author was teaching in a school of rehabilitation. So far it is English and Japanese link collection and bulletin boards. We have a lot of similar sites, so he needs originality, creativity, and background philosophy for the sake of students, too.
The idea of top page, a list of principles and purposes, are the result of many years of practice, and presentation of his belief in summary, so now the author has to explain them at least. English came first, and the Japanese equivalence is its translation.
We began clinical practice right after graduation in 1981, at a municipal mother-child training center for the handicapped in Kishiwada City, Osaka. Although small, it was a fulfilling environment for us freshmen. Of course we are proud of having worked from September 1981, before the Bobath Hospital was founded in 1982. We worked with Dr. Paul D. Andrew who wished to work both as a practitioner and researcher as well as Mr. Katsumasa Kii.
After coming back to Gifu, the author worked with senior citizens most of times. He experienced some geriatric health facilities and/or day care facilities under nursing care insurance. Wherever he worked, he was the first therapist.
These principles he writes here, are necessary expression for us clinicians though sound to be unusual. He studied the field of technique starting that of the Bobaths, then came to be impressed with flexible idea and humanism lying under its origin. After they passed away various instructors now developed it in many countries. The author here presents his understanding as follows:

Three Practical Principles

1. Therapists are true *Terrans (* people on the Earth in Latin)

Therapists easily stand on daily life. Before professional be a man, ordinary citizen, it is often said, but a citizen is not free from prejudices. We live amid cultural prejudices as well as having inferior complexity with Westerners, and superior complexity with the developing countries. Works with sympathy of disability, the disabled, or the weak persons make us free from biases. Dedicated days for the sake of others are enough to try our humanity and change our personality. Jump to the global citizenship is right before us.

2. From learning of disability into *Functionics

International Classification of Functioning, Disability, and Health (ICF) was published in 2001 after revising International Classification of Impairment, Disability, and Handicap published in 1980. The beta-1 draft (1997) and beta-2 were open on the Internet to download and the discussion among experts were very hot.
As the attached document IMPORTANT with beta-1 draft shows us, the main change is to focus on more positive aspects rather the 1980 Classification may have connoted negative meaning. For example, according to the Classification of Impairment, Disability, and Handicap, we assess negative factors resulting in more severe evaluation than reality. Classification of "Functioning," by the author's understanding, is what hard efforts including prognosis or capacity looking for brighter aspects in people who have to live with difficulties seem to have resulted in terminology change. It needs to create, not the learning of disability, but the learning of functioning as a prerequisite.
So he calls Functionics can't be born by a single person, nor can it by a therapist. However, being aware of the beg change of principles, we keep studying and make use of it for our clinical practice.

Reference：
１．Table 1. An overview of ICF, p. 11 International Classification of Functioning, Disability, and Health (ICF), World Health Organization 2001
２．"IMPORTANT," ICIDH-2 (International Classification of Impairments, Disabilities, and Handicap -2) Beta-1 Draft for Field Trials, WHO June 1997
３．International Classification of Functioning, Disability, and Health (ICF, WHO)

3. From dependence on others, through autonomy, to independence,
From the bottom of our heart, with compassionate love.
It's literal, not syllabic, translation from his Japanese poem below; the principle of development and education:
他律から自律をば経て独立へ
心からなる慈愛を込めて

Four Fundamental Purposes

1. Newly-Established (after wars) self-Re-education based inValuable Effectiveness (NERVE)

The acronym NERVE does not only seek for integrating various neuro-physiological approaches but notices the innovation and effectiveness of every approach. The idea came to the author in 1994 when he visited the second time to the U.S. alone for 5 weeks. In summary, aiming at an invaluable effectiveness is our daily practice, and we have to treat clients with respect and target for the best result if treatment time is limited or working under disadvantageous conditions. This expression shows the attitude of the author as a clinician, and of course the appreciation and respect for our forerunner therapists who developed the treatment rapidly especially after wars.

2. Personality Education based on sound individualism accompanying professional training

The issue of medicine and ethics is old and new. Hippocrates of Cos, who is also an origin of the work of therapists, is called the Father of Medicine, not only began the scientific medicine, but have done a lot. Hippocratic Oath, attributed to earlier than him, is one of the most famous document, by which many people urge that professionals should swear ethical conduct as well as physicians.
It is an essential principle to be a human before expert in modern days of cultural crises. The need of Humanitarian Education, Personality Education is to clarify what is not sufficient in terms of technique. It is never forced by others, but the autonomy and self-regulation as a human who protect the independence and dignity of weak and suffering people.

3. Dedicate us to what is the most important.

Therapists, especially the author who is a physical therapist, cares too much for physical functions. He intended to involve psychological factors or life in general from the beginning, but found only "intended to" afterwards. As we name rehabilitation or habilitation every effort to restore and keep the "dignity" of people with disabilities, we have to focus on dignified and diverse human themselves. The author reaffirms with caution.

4. Therapists for Eco-Health

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