What is Rehabilitation?

Amitesh Narayan MPT/ NDT (Ped)/ MISCP Associate Professor KMC Mangalore

Definition: Rehabilitation
Rehabilitation is a process that assist people with disabilities to develop or strengthen their physical, mental and social skills. Rehabilitation is an intervention aimed at restoring functional abilities (Physical, cognitive and emotional).

When to Initiate Rehabilitation..

As soon as DISABILITY becomes EVIDENT
E.g.
For a Child with Movement related disability:- Most crucial need is to provide training and equipment for mobility. For a child who is Deaf:- First priority will be training for communication.

When to Initiate Rehabilitation..

Keep in mind;

both children later will require education and skill training.

&

Both should be able to join in the activities of their families and communities.

When to Initiate Rehabilitation

To achieve this, rehabilitation process requires various services and community action.

Rehabilitation Services
2- Types:a. Traditional rehabilitation services E.g. In-/Out-patient clinics, special institutions, hospitals. b. Community Rehabilitation Services It enlarges the concept of rehabilitation to include all the services that assist disabled people to develop their abilities.

Rehabilitation Services
2 types:a. Multi-disciplinary:- Health professionals from different disciplines involved in the same task and working alongside each other, but functioning independently. b. Inter-disciplinary:- Health professionals from different disciplines working independently in an integrated manner on the same task.

Major strategies for Rehabilitation

1. Institution based Rehabilitation Services 2. Out-reach Rehabilitation Services 3. Community Based Rehabilitation

1. Institution based Rehabilitation Services

Provided in residential settings/ hospital institution for special treatment or intensive therapy. Focus is on persons disability and gives little or no attention to persons families or community or any other relevant social factors.

Have provision for special assessment, surgical interventions, qualified professionals, special equipments and skilled interventions.
Located in urban centers and financially expensive. Inaccessible to those living away from urban location.

2. Out-reach Rehabilitation Services

Provided by health care professionals based at institutions. Provided through visits by health care professionals to the homes of disabled people. Focus is on disabled person and their families. Important part of referral system for delivery of services to remote areas. Community involvement- very limited; so evokes little social changes. Education and vocational training not included. Cost- Per person treatment :- Very high.

3. Community Based Rehabilitation

Characterized by active role of disabled person, their families and community in the rehabilitation process. Knowledge and skills of basic treatment of disabled people are transferred to disabled adult themselves, families and to community members. Community committee- facilitates removal of physical and attitudinal barriers and ensure opportunities of disabled people to participate in school, work, leisure, social and political activities within the community.

3. Community Based Rehabilitation

A person is available to work with disabled people and their families in rehabilitation activities. Community members attempt to find jobs locally for disabled people. Community resources and supported by referral services. Community workers training provided for effective application of rehabilitation measures.

Reference
1. Community based Rehabilitation and the Health care referral services: a guide for programme managers. Rehabilitation, WHO, 1994. 2. ILO, UNESCO, WHO (1994). The Joint Position PaperCommunity-Based Rehabilitation, CBR for and with People with Disabilities.

3. Jonsson, Ture (1994). OMAR in Rehabilitation, A Guide on Operations Monitoring and Analysis of Results.
4. Korpela, R. et al. (1993). "Rehabilitation Service Evaluation: a Follow-up of the Extent of Use of Technical Aids for Disabled Children". Disability and Rehabilitation, Vol 15, No. 3; 143- 150.