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References

Alonso, C. et al. 2008. Scoliosis of the spine: History [Online]. Available at: http://biomed.brown.edu/Courses/BI108/BI108_2008_Groups/group14/pages/history.html [Accessed: 05 February 2015].

Early, M. B. 2006. Occupational therapy and physical disabilities: Scope, theory, and approaches to practice. In: Early, M. B. Physical dysfunction practice skills for the occupational therapy assistant. 2nd ed. Missouri: Mosby Elsevier, pp. 13-27.

Eldar, R. and Jelić, M. 2003. The association of rehabilitation and war. Disability And Rehabilitation 25(18), pp.1019-1023.

Fisher, A. G. 1998. Uniting practice and theory in an occupational framework: Eleanor Clarke Slagle lecture. The American Journal of Occupational Therapy 52(7), pp. 509-521.

Foster. M. 2002. Theoretical frameworks. In: Turner, A., Foster, M. and Johnson, S. E. eds. Occupational Therapy and physical dysfunction: principles, skills and practice. 5th ed. London: Churchill Livingstone.

GreshamCollege. 2014. The Work of the Defence Medical Rehabilitation Centre, Headley Court - Colonel John Etherington [Online]. Available at: [Accessed: 05 February 2015].

Moore, O. 2015. Wheelpower: National spinal injuries centre celebrates 70th birthday [Online]. Available at: http://www.wheelpower.org.uk/WPower/index.cfm/news/national-spinal-injuries-centre-celebrates-70th-birthday/ [Accessed: 05 February 2015].

National Health Services. 2014. Recovering after an amputation [Online]. Available at: http://www.nhs.uk/Conditions/Amputation/Pages/Recovery.aspx [Accessed 03 February 2015].

Olseen, D. 2006. Treatment of disturbances in perception and cognition. In: Early, M. B. Physical dysfunction practice skills for the occupational therapy assistant. 2nd ed. Missouri: Mosby Elsevier, pp. 453-462.

Peterson, L. 2015. 360 Orthotics and Prosthetics: Transradial days [Online]. Available at: http://www.360oandp.com/LizzPetersonsBlog-1958-transradial-days.aspx [Accessed: 05 February 2015].

Royal Pavilion, Museums and Libraries. 2014. Dr Brighton's war: Hospitals and healing in Brighton during WW1 [Online]. Available at: http://www.brighton-hove-rpml.org.uk/WhatsOn/Pages/DrBrightonsWar9julto31aug2014.aspx [Accessed: 05 February 2015].

Trombly, C. A. 1995. Occupational therapy for physical dysfunction. 4th ed. Baltimore: Williams & Wilkins.

Types of clients the approach may be used with

. Perceptual dysfunction as a result of brain injury (Neistadt, 1990)

. Stroke- compensation as a result of hemiplegia (Krug & Mc Cormack, 2004)

. Arthritis (Walker and Helewan, 2004)

. Palliative care (Barwid et al. 2015)

. Neurological disorders (Foley, 2008)

Conclusion

Influenced by world war and advances in medical procedures.

Aims to increase function of the individual.

Encourages independence.

Does not focus on recovery but on adaption or compensatory interventions to facilitate occupational performance.

There are a variety of interventions that can be utilized within this approach.

Other professionals do use the approach.

It can be used alone or with other approaches.

What approach/approaches the therapist uses will be influenced by the clients dysfunction, aims and goals.

History of the Functional Rehabilitation Approach

The Functional Rehabilitation Approach (FRA)

Early records of rehabilitation in Europe in the 18th century included balneotherapy and orthopaedics

  • Also referred to as the 'compensatory' or 'rehabilitative' approach
  • one of the oldest frames of reference for rehabilitation, associated with the medical model (Foster, 2002).

World War One (WWI) (1914 - 1918)

(Alonso et al. 2008)

In Great Britain severe fractures were treated within military hospitals

  • ‘humans are functional animals, and their ability to function – by whatever means – is essential to wellbeing’ (Foster 2002, p. 76).

(Royal Pavilion, Museums and Libraries 2014)

1919, US nurses were trained as “reconstruction aides” providing physical rehabilitation services in several army hospitals

Artificial limb centres and head injury rehabilitation centres were established

In Switzerland 1780 the first orthopaedic institute was formed caring and educating disabled children

World War Two (WWII) (1939 - 1945)

In 1944 the Stoke Mandeville spinal injury centre opened

(Moore 2015)

In the UK, US and the Soviet Union, brain injury specialist services were set up to provide rehabilitation

Korean War and the war in Croatia lead to greater need upon rehabilitation services, resulting in community based services.

Amputation and Prostheses

Early European prosthetic fittings lead to improved outcomes in terms of patient mobility, self-care and avoidance of “stump oedema”

Survival rates improved with the development in medical practices and also through more complex rehabilitation processes, concepts such as “cineplasty”

(Peterson 2015)

The Functional Rehabilitation Approach

Current Application of the Approach

The latest occupational therapy interventions, following amputation, involve encouragement of patient mobility, transfers and exercises (National Health Services 2014)

Advanced progress and application of the approach can be seen at the military rehabilitation centre, Headley Court

Current Application of the Approach

(GreshamCollege 2014)

  • enabling the individual to live as independently as possible through compensatory measures despite their residual disability (Early, 2006)
  • ‘uses intact skills to compensate for deficits’. Olseen (2006 p.458)

  • the FRA does not focus upon improving a person’s dysfunction, therefore it is applied to those with permanent loss in function (Foster, 2002).
  • Early (2006, p.22), ‘rehabilitation is concerned with the intrinsic worth and dignity of the individual and with the restoration of a satisfying and purposeful life’.
  • focus for treatment rests upon a person’s abilities rather than their disabilities (Early 2006, p. 22).
  • OT must identify the individual’s strengths and use these to work around physical limitations.
  • However: "the patient’s values, interests, and sense of personal causation are not directly addressed" Early (2008, p.23).
  • Early argues that the FRA must be used along with other approaches if the complete person is to be taken into account.
  • the FRA consists mainly of environmental adaptation and compensatory strategies (Trombly 1995, p. 13).

The Functional Rehabilitation Approach

The functional rehabilitation approach is widely used with people with neurological dysfunction...

Helping another person to complete an occupation is part of the functional rehabilitation approach...

The functional rehabilitation approach should only be used in isolation....

The functional rehabilitation approach is used with people who are likely to get better...

Out of the following disorders; social phobias. stroke and depression, which one would the FRA most likely be chosen for..?

The beginnings of the functional rehabilitation approach are rooted at the end of WWII...

The functional rehabilitation approach is used by physiotherapists....

True or False Statements

Ella Tyler, Sophie Smallwood, Catherine Davies, Rhian Harman, Sarah Pugh, Anna Bullimore

The functional rehabilitation approach is also called the 'compensatory' approach...

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