Rehabilitation Medicine 1




      Dr. G.M.Rommers

Department of Rehabilitation Medicine
Rehabilitation Medicine

• Rehabilitation Medicine is a branch of medicine which aims
  to enhance and restore functional ...
What is fun in rehabilitation medicine?
What is fun in rehabilitation medicine?
What is fun in rehabilitation medicine?



• Different

• Total person concept

• Functioning
What is fun in rehabilitation medicine?

• Long ongoing contact

• Young and (very) old

• Technical solutions
Brinkhuis
What is fun in rehabilitation medicine?

• Real care

• After hospital a lot of work to
   be done!

• Cure is not always ...
Participation or Handicap?

                neutral language
               • “politically correct”
               • corre...
Leprocy   Stroke   Spinal cord




                    10
Universal Model vs. Minority Model




Everyone may have disability Certain impairment groups
Continuum                   ...
ICF Components


 Body Functions      Activities     Environmental
       &                  &            Factors
   Struc...
ICF
 Health Condition
(disorder/disease)
ICF
                      Health Condition
                     (disorder/disease)


       Body               Activities ...
ICF
                      Health Condition
                     (disorder/disease)


       Body               Activities ...
ICF
                      Health Condition
                     (disorder/disease)


       Body               Activities ...
Vascular pathology / Diabetes Mellitus




                               500.000 people
                             with...
Entrance into the Healthcare system
General Practitioner
           • GP visits in basic insurance

           • Referral to paramedic and
              podia...
Hospital (Footcare)


        • Team approach towards
          diabetic foot

        • Frequent control of patient

    ...
Hospital (Amputation)

       • Preoperative screening by Spec PRM

       • Functional approach

       • Dialogue with S...
Rehabilitation Center
           • 8000 admissions annually

           • 42000 outpatients annually

           • 15% of ...
Community

     • Local council for primary care

     • Funding by local government

     • Not the same in every local
 ...
Walking aids




                                                Picure: ANP

• Presentation of a special beach rollator. ...
Take home message

• What is rehabilitation medicine?

• What makes rehabilitation medicine different

• Participation or ...
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Rehabilitation Med 1

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  • ICF does not only describe negative health experiences, but neutral health domains in which the state can be described as both positive and negative. For example: read slide

  • [Keywords] concept###[Narration] ICIDH applies to 100 %
    disablement applies to nearly all###
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    Der ICIDH-2 unterscheidet zwischen drei Dimensionen…












  • Rehabilitation Med 1

    1. 1. Rehabilitation Medicine 1 Dr. G.M.Rommers Department of Rehabilitation Medicine
    2. 2. Rehabilitation Medicine • Rehabilitation Medicine is a branch of medicine which aims to enhance and restore functional ability and quality of life to those with physical impairments or disabilities.
    3. 3. What is fun in rehabilitation medicine?
    4. 4. What is fun in rehabilitation medicine?
    5. 5. What is fun in rehabilitation medicine? • Different • Total person concept • Functioning
    6. 6. What is fun in rehabilitation medicine? • Long ongoing contact • Young and (very) old • Technical solutions
    7. 7. Brinkhuis
    8. 8. What is fun in rehabilitation medicine? • Real care • After hospital a lot of work to be done! • Cure is not always possible
    9. 9. Participation or Handicap? neutral language • “politically correct” • correct use – intervention – opportunity –positive aspects
    10. 10. Leprocy Stroke Spinal cord 10
    11. 11. Universal Model vs. Minority Model Everyone may have disability Certain impairment groups Continuum Categorical Multi-dimensional Uni-dimensional
    12. 12. ICF Components Body Functions Activities Environmental & & Factors Structures Participation Functions Capacity Barriers Structures Performance Facilitators
    13. 13. ICF Health Condition (disorder/disease)
    14. 14. ICF Health Condition (disorder/disease) Body Activities Participation function&structure (Limitation) (Restriction) (Impairment)
    15. 15. ICF Health Condition (disorder/disease) Body Activities Participation function&structure (Limitation) (Restriction) (Impairment) Environmental Personal Factors Factors
    16. 16. ICF Health Condition (disorder/disease) Body Activities Participation function&structure (Limitation) (Restriction) (Impairment) Environmental Personal Factors Factors
    17. 17. Vascular pathology / Diabetes Mellitus 500.000 people with Diabetes in the Netherlands In 2020: 800.000
    18. 18. Entrance into the Healthcare system
    19. 19. General Practitioner • GP visits in basic insurance • Referral to paramedic and podiatry treatment in local area • Referral to A&E Hospital and Referral to Nursing Home • Community care • Local Council facilities • National Alarm 1-1-2
    20. 20. Hospital (Footcare) • Team approach towards diabetic foot • Frequent control of patient • Case management • Shoe prescription • Funding by insurance company
    21. 21. Hospital (Amputation) • Preoperative screening by Spec PRM • Functional approach • Dialogue with Surgeon about operation and preferred level of amputation • Post operative stump formation • Post operative paramedic treatment • Referral for Post Hospital treatment • Hospital period approx. 10 - 14 days
    22. 22. Rehabilitation Center • 8000 admissions annually • 42000 outpatients annually • 15% of all amputees are admitted to the Rehab Center
    23. 23. Community • Local council for primary care • Funding by local government • Not the same in every local council across the country • Help; mobility items and home adaptations • New adaptations • Domotica
    24. 24. Walking aids Picure: ANP • Presentation of a special beach rollator. Testers were elderly people from the special care home : Sint Jacob in de Hout from Overveen. There was a special beach race against people with an ordinary rollator. MC 2007
    25. 25. Take home message • What is rehabilitation medicine? • What makes rehabilitation medicine different • Participation or handicap • ICF components • How to deal with a diabetic foot • Community care

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