New Zealand Rehabilitation Association, Inc.

In this editorial, Derick Wade presents another thought provoking opinion piece about rehabilitation theory and research.  Here he attempts to confront the difficulties that rehabilitation researchers and practitioners have describing what it is that they do.  In comparison to some medical interventions (such as drug treatments or surgery), rehabilitation is arguably far more complex to describe.  Wade suggests that in order to provide a full description of rehabilitation, an account is required of:

1. the organization of programmes,
2. the theoretical models underlying the programmes, and
3. the specific activities/interventions undertaken. 

Wade goes on to describe some theoretical models that could be useful for assisting with explanations of rehabilitation interventions.  These he relates to some already established concepts, such as the International Classification of Health, Disability and Function (ICF), as well as those related to the ‘process’, ‘structure’ and ‘outcomes’ of rehabilitation.  This work, however, is unlikely to pass without debate and there are several gaps in his framework to date.  For example, Wade’s opinion that ‘behaviour change… underpins most if not all rehabilitation treatments’ (p812) does not fit well with some professional approaches to rehabilitation.  Physiotherapy is arguably more about changing an individual’s functional capacity rather than their behaviour.  This said, debate of this nature is important for raising the discussion of rehabilitation above just that of individual treatment approaches.