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Introduction to Rehabilitation


Rehabilitation is a widely discussed concept across the globe. This is no accident, as more than 1 billion people live with some form of disability, accounting for more than 15% of the world’s population. Furthermore, according to a recent report, 2.41 billion people worldwide suffer from Ailments that affect their daily functioning and would benefit from rehabilitation services, which equates to one in three people requiring rehabilitation services throughout the course of their illness or injury. [1]

Over the next 30 years, the proportion of the world’s population aged over 60 will double, and most of them will suffer from chronic diseases, especially non-communicable diseases. These changing health and demographic trends have resulted in a rapidly increasing global population Experiencing a decline in function results in a huge unmet need for rehabilitation. Most of these unmet needs are concentrated among the poorest and most vulnerable populations in low- and middle-income countries and in conflict-affected settings, who are often less equipped to respond to these needs Demand for rehabilitation services is increasing. [2][3]

According to the World Health Organization (WHO), rehabilitation is one of the key components of universal health coverage (UHC), characterized by “good health prevention that promotes disease treatment and palliative care”. [2] Therefore, rehabilitation focuses on achieving Functional Independence in Activities of Daily Living (ADL) Participation in work, play, and education enables individuals to play meaningful roles in everyday life. [2] Clearly, rehabilitation is critical not only to the realization of individual health benefits but also to overall general health The goal of creating a healthy and functional global population.



Fundamentally, recovery is based on the idea that each individual has an inherent inclination and a right to be their own healthcare professional. [6] Thus, this marks the difference between first aid and rehabilitation, first aid is concerned with the health of the individual Survival during recovery is related to the education and training of individuals to enable them to carry out activities of daily living independently, thereby promoting self-care and functional independence. [7] Nonetheless, there is no universal definition or understanding of Rehabilitation, which is described in a variety of ways depending on the context, including developmental issues, disability issues, health issues, human rights issues, substance abuse issues, and safety issues, to name a few. Therefore, different people use broad definitions of rehabilitation authorities:

“Refers to services and programs designed to assist individuals who have experienced trauma or illness that has resulted in impairment resulting in loss of functioning (physical psychosocial or occupational).” [8]

“Aimed at restoring compensation to prevent or slow the deterioration of function (sensory physical intellectual psychocognitive or social) in order to help individuals perform at their optimum level.” [1]

“The process of restoring the mental and/or physical ability lost as a result of injury or illness to function in a normal or near-normal manner”[9]

Rehabilitation is one of WHO’s core health strategies, along with the promotion of preventive care and palliative care. WHO defines rehabilitation as

A set of measures that assist individuals who experience or are likely to experience a disability to achieve and maintain optimal function in their interactions with the environment. “[10]

Rehabilitation is a series of interventions designed to optimize the functioning of an individual with a health condition as he interacts with his environment. Health condition can refer to disease (acute or chronic) injury or trauma and may also include other conditions such as pregnancy aging Congenital abnormality or genetic predisposition to stress. Any health condition that suffers from some form of functional limitation, such as moving vision or cognition, may require rehabilitation. Since the best features of this rehabilitation are through the use of biopsychosocial models Use interventions that address the impairment’s activity limitations and participation limitations, taking into account individual and environmental contextual factors, including assistive technology that affects functioning.

Rehabilitation should be considered an essential service provided by the health care system at all levels. Many people without long-term injuries will require rehabilitation services at some point in their lives. Likewise, many people with long-term injuries do not always require rehabilitation Services such as spinal cord injury patients may require intensive rehabilitation for several months after the initial spinal cord injury, but once they have received adequate treatment to perform to their maximum capacity and are provided with assistive devices, they can enable them to continue to function well in their community and family environment, then they may not need to access more rehabilitation services. Some people with long-term impairments may also need intermittent rehabilitation services, such as those with depression or degenerative diseases.

Rehabilitation is a highly person-centered health strategy in which treatment caters to the underlying health condition as well as the user’s goals and preferences. Information on function is crucial for rehabilitation decision-making at all levels of the health system, as the goal is Rehabilitation is about optimizing function according to injury and acute or chronic illness:[11]

  • At the user level, information on functionality guides goal setting and outcome assessment throughout rehabilitation care (primary, secondary, and tertiary) and treatment phases (post-acute care and long-term care).
  • At an institution or program level, functional information from users can be aggregated to help monitor clinical outcomes and improve service planning and quality assurance.
  • At the policy level, integrated clinical information on functioning provides policymakers with a source of evidence for planning health and rehabilitation services and monitoring their impact.

Rehabilitation occurs across the life course from newborn to end of life and can occur before a health condition in acute care (prophylactic “pre-rehabilitation” facilitation) and post-acute to long-term care, and many provide rehabilitation interventions for health and Non-health professionals as well as individuals, their families and carers. By restoring to prevent or slow the deterioration of function (sensory, physical, intellectual, psychological, cognitive or social), rehabilitation puts the person at the center of the process and helps people reach their goals Realize your full potential and encourage participation in society. Therefore, its impact is not only on individuals, but also on their families, communities and economies.

Rehabilitation Elements

Dietz [12] described four elements of rehabilitation in relation to cancer patients that are now used in rehabilitation for a wide range of conditions: preventive restorative supportive palliative care:

Preventative Rehabilitation

Occurs shortly after a new diagnosis or new injury. The aim is to provide educational advice and interventions to prevent or slow the onset of further injury and maintain a person’s level of ability. This is a common form of rehabilitation in long-term illnesses such as cancer Chronic Obstructive Pulmonary Disease (COPD) Diabetes and many neurological disorders. It also supports supported self-management and can include interventions aimed at maintaining function for as long as possible.

Restorative Rehabilitation

Restorative rehabilitation focuses on interventions that improve muscle strength or impairments such as respiratory function and cognitive impairment to maximize return of function. This is a common form of recovery after being ill after surgery or after an acute event such as a severe trauma or stroke for maximum functionality.

Supportive Rehabilitation

Supportive rehabilitation uses methods such as providing self-help equipment and teaching people compensation strategies or alternative ways of doing things to improve a person’s self-care and mobility. This may include the provision of auxiliary equipment or environmental modifications. This is sometimes called adaptive rehabilitation. [13]

Palliative Rehabilitation

Palliative rehabilitation enables people with life constraints to live a high quality of life physically, mentally and socially, while respecting their wishes. It usually focuses on relieving symptoms such as pain, dyspnea, and edema, preventing contractures and assisting breathing Mental Health Relaxation or use of assistive devices to maximize functional independence and support comfort dignity and quality of life. [14]

Rehabilitation Objectives

Rehabilitation objectives include:

  • Prevention of the loss of function
  • Slowing the rate of loss of function
  • Improvement or restoration of function
  • Loss of Function Compensation (Compensation Strategies)
  • Maintenance of current function

Rehabilitation Outcomes

Rehabilitation outcomes are the benefits and changes in individual functioning over time that are attributable to a single measure or set of measures. There is also compelling evidence that rehabilitation services can also lead to long-term cost reductions and increased value and equity Health and care system. They may include:

  • Prevention and reduction of demand for health services
    • Integrate out-of-hospital care to reduce length of stay and unplanned admissions
    • fewer hospitalizations or readmissions
    • Decreased Length of Stay
  • Increased independence
  • Increased self-management of condition
  • Decreased burden of care
  • Return to roles/occupations related to age, gender and background (eg home nursing school work)
  • Improved quality of life

Good recovery focuses on good outcomes set by the people we treat and is driven by their goals Centering people’s needs rather than their diagnoses Aiming high, including career outcomes is an active and beneficial process – not reactive of care relies on interdisciplinary teams Work Responds to Changes in People’s Needs Integrating Specialist and Generalist Services Requires Leadership for Transformational Change Brings Hope

Range and Scope of Rehabilitation

Rehabilitation covers a wide range of areas in our patient pathway. It includes support for learning basic communication skills; exercise classes to improve or maintain optimal health and career; and complex neurorehabilitation after major trauma or stroke. Rehabilitation may work at any age because a person’s needs change throughout their life. For example, they may need support to:

  • Developing new skills—Children may need help developing skills (adaptive training) to overcome developmental difficulties and barriers from medical conditions to maximize their health and independence. [15][16][17][18]
  • Maintaining skills and independence – For progressive diseases such as dementia motor neurone disease and advanced cancer, early diagnostic evaluation and rehabilitation interventions can help people maintain skills and independence for as long as possible. [19][20][21]
  • Improving Performance – Rehabilitation will provide opportunities for athletes and individuals to improve performance following injury or withdrawal from sports.
  • Recovery from unexpected illness – such as depression anxiety acute hospital admission after stroke surgery, falls chest infection and cardiac events. [19][22][23][24]
  • Recovering from Major Trauma – Rehabilitation and rehabilitation helps people recover and maximize their skills and independence, including returning to work.
  • Managing Long-Term Conditions – When people with chronic or long-term conditions become unexpectedly ill or their condition worsens, they benefit from rehabilitation interventions to help them regain or maximize their independence. [19][22]
  • Self-management conditions – people with chronic or long-term medical conditions are able to manage their own health and reduce the risk of developing secondary complications that affect their physical and mental health, such as decreased physical strength and cardiovascular health contractures pressure ulcers Pain Anxiety and Depression. [19][25][26]
  • Access Advocacy – Provides advocacy to vulnerable groups and those in need of support, such as those with cognitive disabilities or communication difficulties, as part of their rehabilitation interventions.

Misconceptions about Rehabilitation


Rehabilitation is undoubtedly an important aspect of health, aimed at enhancing function and independence. As a field of health, it has gone through different stages before arriving at the current model, which incorporates different components of biosocial and contextual factors, Has implications for the health and function of individuals experiencing a variety of health challenges. Optimizing function is the ultimate goal of rehabilitation and contributes to the recovery of the patient, regardless of the beneficiary or the environment in which rehabilitation is provided Happiness has nothing to do with underlying health conditions. [27] By restoring to prevent or slow the deterioration of function (sensory, physical, intellectual, psychological, cognitive or social), rehabilitation places the person at the center and helps people to reach their full potential and Get involved in society. [10] Therefore, its impact is not only on individuals, but also on their families, communities and economies. [28]


  1. ↑ Jump up to:1.0 1.1 Duttine A, Battello J, Beaujolais A, Hailemariam M, Mac-Seing M, Mukangwije P, et al. Introduction to Rehabilitation Factsheet. Handicap International. 2016. Available from: https://humanity-inclusion.org.uk/sn_uploads/document/2017-02-factsheet-rehabilitation-introduction-web_1.pdf [Accessed on 8 January, 2020].
  2. ↑ Jump up to:2.0 2.1 2.2 Shimizu Y. Rehabilitation. World Health Organization. 2020. Available from: https://www.who.int/news-room/fact-sheets/detail/rehabilitation. [Accessed on 8 January, 2020].
  3.  Cieza, Alarcos. “Rehabilitation the health strategy of the 21st century, really?.” Archives of physical medicine and rehabilitation 100.11 (2019): 2212-2214.
  4.  World Health Organisation (WHO). Rehabilitation is about health and functioning in everyday life. Available from: https://youtu.be/uG_VdZe9VNU[last accessed 26/06/2021]
  5.  World Health Organisation. WHO: Rehabilitation: Key for Health in the 21st Century. Available from: https://youtu.be/a8uaRziXruc[last accessed 30/06/21]
  6.  Gender AR. Scope of rehabilitation and rehabilitation nursing. Rehabilitation nursing practice. New york: McGraw-Hill,.1996.
  7.  Mauk KL. Overview of rehabilitation. Rehabilitation Nursing: A Contemporary Approach to Practice. 2011.
  8.  Lubkin IM, Larsen PD, editors. Chronic illness: Impact and interventions. Jones & Bartlett Learning; 2006.
  9.  National Cancer Institute. Rehabilitation. 2007. Available at: https://www.cancer.gov/search/results?swKeyword=rehabilitation. [Accessed on 8 January, 2020].
  10. ↑ Jump up to:10.0 10.1 World Health Organization. World Report on Disability 2011. Geneva: World Health Organization, 2011. Rehabilitation.
  11.  World Health Organization. Health information systems and rehabilitation. Rehabilitation. 2017;2030.
  12.  Dietz Jr JH. Rehabilitation of the cancer patient. Medical Clinics of North America. 1969 May 1;53(3):607-24.
  13.  Dietz Jr JH. Adaptive rehabilitation in cancer: a program to improve quality of survival. Postgraduate medicine. 1980 Jul 1;68(1):145-53.
  14.  Parola V, Coelho A, Neves H, Cardoso D, Almeida M, Cruz A, Apóstolo J. Palliative rehabilitation interventions in palliative care: a scoping review protocol. JBI Evidence Synthesis. 2020 Nov 1;18(11):2349-56.
  15.  Department for Education and Skills (2007). Aiming high for disabled children. Retrieved from: http://webarchive.nationalarchives.gov.uk/20100420125503/http://www.dcsf.gov.uk/everychildmatters/_download/?id=659 (accessed 20/06/2021)
  16.  Field, F (2010). The foundation year: Preventing poor children becoming poor adults. Cabinet Office. London. Retrieved from: http://www.google.co.uk/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0ahUKEwjr7q7n8Y_+KAhVFuw4KHQMkAW0QFggfMAA&url=http%3A%2F%2Fwebarchive.nationalarchives.gov.uk%2F20110120090128%2Fhttp%3A%2Fpovertyreview.+independent.gov.uk%2Fmedia%2F20254%2Fpoverty-report.pdf&usg=AFQjCNE21aUqQ064mA6pgcJb2Q5I4VYMoQ
  17.  Allen, G (2011). Early intervention: The next steps. Cabinet Office. London. Retrieved from: https://www.gov.uk/government/uploads/system/uploads/+attachment_data/file/284086/early-intervention-next-steps2.pdf
  18.  Department for Education and Department of Health (2015). Special educational needs and disability code of practice 0-25 years. Retrieved from: https://www.+gov.uk/government/uploads/system/uploads/attachment_data/file/398815/SEND_Code_of_Practice_January_2015.pdf
  19. ↑ Jump up to:19.0 19.1 19.2 19.3 Department of Health (2005). National service framework for long term conditions. Retrieved from: https://www.gov.uk/government/uploads/system/uploads/+attachment_data/file/198114/National_Service_Framework_for_Long_Term_Conditions.pdf
  20.  Department of Health (2015). Prime minister’s challenge on dementia 2020. Retrieved from: https://www.gov.uk/government/publications/prime-ministers-+challenge-on-dementia-2020
  21.  National Action Team (2013). Cancer rehabilitation: Making excellent cancer care possible. Retrieved from: http://webarchive.nationalarchives.gov.+uk/20130513211237/http:/www.ncat.nhs.uk/sites/default/files/work-docs/Cancer_rehab-making_excellent_cancer_care_possible.2013.pdf
  22. ↑ Jump up to:22.0 22.1 Department of Health (2001). National service framework for older people. Retrieved from: https://www.gov.uk/government/publications/quality-standards-+for-care-services-for-older-people
  23.  Department of Health (2000). National service framework for coronary heart disease. Retrieved from: http://webarchive.nationalarchives.gov.uk/+/www.+dh.gov.uk/en/Healthcare/Longtermconditions/Vascular/Coronaryheartdisease/Nationalserviceframework/index.htm
  24.  National Institute for Health and Care Excellence (2011). Service user experience in adult mental health: Improving the experience of care for people using adult NHS mental health services. CG136. Retrieved from: https://www.nice.org.uk/guidance/cg136
  25.  NHS London (3) (no date) Allied Health Professions: Diabetes toolkit. Developed on behalf of the Strategic AHP Leeds Group. Retrieved from https://www.networks.nhs.uk/nhs-networks/ahp-networks/ahp-qipp-toolkits/AHP_Diabetes_Pathway_final%20-2.pdf
  26.  NHS London (2) (no date). MSK toolkit: How AHPs improve patient care and save the NHS money. Developed on behalf of the Strategic AHP Leads Group. Retrieved from: http://www.nras.org.uk/data/files/For%20professionals/MSK%20toolkit.pdf
  27.  Cieza A, Causey K, Kamenov K, Hanson SW, Chatterji S, Vos T. 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. The Lancet. 2020 Dec 19;396(10267):2006-17.
  28.  Humanity and Inclusion and Global Rehabilitation Alliance. Rehabilitation for the realisation of human rights and inclusive development. 2019

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