Rehabilitation – approaches, consideration and avoidance

Managing Director, Heather Batey discusses rehabilitation approaches, areas to consider and gaps to avoid.

Traditional vs Functional Rehabilitation

What is rehabilitation?

Different parties have differing “concepts” of rehab and how this process works. The central focus has to be the Injured Party (IP) and how to enable them to maximise their rehabilitation performance.
Achieving this results in a better quality of life for the IP, maximizing independence, and reducing long-term care needs.

This is a win/win for all involved.

However, the methodology involved should vary from IP to IP and from clinical to injury-specific needs.
Traditionally, many question the full MDT approach’s outcomes, while favoring a more functional approach with time-limited rehabilitation and SMART goals.  

Let me explain:       

As a neuro clinician, I explore the best possible ways to maximise IP outcomes and am often approached to As a neuro clinician, I explore the best possible ways to maximise IP outcomes and am often approached to review/audit rehab programmes, most of which follow a traditional MDT approach which is longer term, Case Management lead, sessional clinicians and robust support programmes…where outcomes can be compromised by early support.

Options are necessary

Research of the available literature outlines the issues surrounding a traditional full Multi-Disciplinary Team approach Vs the Functional approach to rehabilitation. Exploring the benefits of “real life rehab in real-life settings”.

 Issues relating to traditional MDT approaches can include:  

• Conflict between professionals
• Consistency of service and care
• Communication barriers from lack of specific shared goals.
• Lack of targeted intervention between disciplines
• Limited resources and time
• Lack of awareness, appreciation and overlapping of roles and responsibilities  

Conclusion: In some client areas, including neuro, the traditional full MDT approach can compromise effective multidisciplinary working, therefore affecting the client’s rehabilitation outcomes.  

We have a choice

The alternative is a very functional approach which gives the IP goal consistency within their home environment and offers them the invaluable guidance and structure required to successfully achieve their rehabilitation goals, through a “rehab first and support second” approach.

This is evidenced as a very effective route to rehab. Rehabilitation strategies are reinforced daily which reduces the margin of mistakes and increases efficiency, providing an overall more effective outcome over a shorter timescale. We have learned to our detriment, through protracted, multi-professional rehabilitation programmes the flaws of some MDT’s where, at times, the client and the goals become lost. This just highlights the key importance of great Case Management for these IP’s

Conclusion

In conclusion, interested parties need to be aware of available options to facilitate gaining the best outcome for an IP. Ultimately, rehabilitation is about optimising performance through functional restoration, and this allows a client to get their life back as much as possible.

Full literature review paper and References available on request.