Results: Six conceptual rehabilitation models were identified in the literature: the Biomedical Model, the Social Model, the Bio-Psycho-Social Model (BPS), the International Classification of Impairments, Disabilities, and Handicaps Model (ICIDH), the Community Based Rehabilitation Model (CBR), and the Health-Related ..

1. UNIT-VII
MODELS AND METHODS OF
REHABILITATION
DR.ANJALATCHI MUTHUKUMARAN
VICE PRINCIPAL
ERA COLLEGE OF NURSING

2. REHABILITATION
• Rehabilitation is the process of helping a person
to reach the fullest physical, psychological, social,
vocational, and educational potential consistent
with his or her physiologic or anatomical
impairment, environmental limitations, and
desires and life plans.
• According to WHO “ Rehabilitation is the
combined and coordinated use of the medical,
social, educational, and vocational measures for
training and re-training the individual to the
highest possible level of functional ability”.

3. REHABILITATION NURSING
• Important and essential part of comprehensive
nursing.
• Rehabilitation nursing ideally starts at the
moment a patient enter into the health care
system. However, rehabilitation program may
take place in the special units of hospital or
independent centre in the community.

4. OBJECTIVES OF REHABILITATION
NURSING
There are 4 broad objectives of rehabilitation
nursing:
• a. To restore affected abilities to the highest
possible level of function.
• b. To prevent further disability/ handicap.
• c. To protect the person abilities.
• d. To assist the person / patient to use his or
her abilities

5. PRINCIPLES OF REHABILITATION
• Rehabilitation should begin during the initial contact with the
patient.
• Restoring the patient to independent or to regain his pre-
illness/pre-disability level of function in as short a time as possible.
• Maximizing independence within the limits of the disability.
• He must be an active participant.
• The activities of daily living are facilitated.
• The individual with a disability is encouraged to wear his clothing
enhances self-esteem and dignity.
• Motivates the patient and helps him to attain social independence.
• Focus is on the needs of groups of people with specific condition
• Every patient has a right to the rehabilitation services.

6. METHODS OF REHABILITATION
NEUROLOGICAL REHABILITATION
• In this type of rehabilitation, patients suffering
from stroke, neuromuscular disease, certain
types of head trauma and spinal cord injury are
treated.
• It aims at making the patient self-dependent
• It helps create a positive thinking in patient
• The patient is treated so that he leads a improved
life physically, emotionally, and socially.

7. CARDIAC REHABILITATION
• Cardiac rehab program is designed to help those
people who have heart problem. Heart patients are
educated to live a healthy life and reduce stress for the
proper functioning of the heart.
• Educating people about the various risk factors that
contribute to developing a heart disease. These risk
factors include, high blood pressure, obesity, smoking,
drinking, drug abuse, lack of physical activity, etc.
• Recovery programs from heart disease/surgery.
• Educating people about improving their quality of life.

8. DRUG REHABILITATION
• Drug rehabilitation programs involve
programs that are designed to make an addict
free from the addiction of alcohol,prescription
drug and street drugs (cocaine, heroin etc)
•

9. ALCOHOL REHABILITATION
• Alcohol rehabilitation program is designed to
make an alcoholic free from the addiction. It
involves programs that will teach people the
various bad effects of consuming excess
alcohol
• Effective detox programs that will cleanse the
body from the various toxins of alcohol

10. PHYSICAL REHABILITATION
• Physical rehabilitation is for those people whose
lifestyle has changed after they have gone
through a serious illness, surgery, accident or
illness. Here the therapist introduces programs to
improve the mobility and functioning of the
injured body part of the patient.
• Proper exercising program is designed to
improve the functioning often physical body.
• Includes therapies that will help a patient re-
learn the basic physical and cognitive functioning.

11. VOCATIONAL REHABILITATION
• Programs focus on improving major and minor
skills that are in the basic life.
• Assessing patient in every step to improve the
activities of basic
• Vocational rehab program is designed to help
those people who find it difficult to employment
or retain it they have gone through certain
situation that caused mental or physical disability
in them.
• Providing physiological and medical assessment
Job placement, job training and on job training

12. MEDICAL REHABILITATION
• Medical rehabilitation includes treatment
programs that help a person perform better in
all his daily physical and mental activities.
• Medical rehabilitation is a follow up
treatment after any kind of treatment
program.

13. VESTIBULAR REHABILITATION
• It helps in improving the ear deficit by working the
central nervous system. Also deals in improving eye
and head coordination
STROKE REHABILITATION
• This treatment type helps to restore damage that is
caused after a stroke, which is the 3 rd leading cause
for death worldwide
• Stroke rehabilitation aims at helping people gain
normal functioning after the occurrence of a stroke.
• Help the person to get back to normal lifestyle and be
independent in daily activities.
•

14. COMMUNITY BASED REHABILITATION

15. Evaluation for community based
rehabilitation

16. MODELS OF REHABILITATION
NAGI MODEL
• The Disablement Model is one of the many
models developed over the years initially
developed by sociologist Saad Nagi in the
1960,several revisions of Nagi’s model was done
in the mid 1990
• Nagi described four basic phenomena that he
considered fundamental to rehabilitation as
follows.
• active pathology
• impairment
• functional limitations disability

17. Continued
• Active pathology is an interruption in normal body
processes that leads to a deviation from the normal
state such as infection, trauma, disease processes or
other degenerative conditions.
• Impairment is a loss or abnormality at the tissue,
organ, and body system level.
• Functional limitations relate to the individual's
inability to perform the tasks.
• Disability defined as a physical and/or mental
limitation in performing socially defined roles and tasks
expected of an individual.
• For instance, a 12-year old girl with mental retardation
does not attend school, she stays home with her
parents helping with household chores

18. INSTITUTE OF MEDICINE (IOM)
• MODEL IOM used the original Nagi model but
incorporated two important concepts in known
as secondary conditions or risk factors and quality
of life
• Risk factors included biological, environmental
which include both social and physical, and
lifestyle or behaviour factors capable of
interacting with the disabling process
• quality-of-life or the general wellbeing of the
individual was seen to both affect and be affected
by each stage of the process.

19. Stroke rehabilitation

20. • In 1997 IOM revised its own model as follows:
• disability was removed from the model, and was
instead viewed as an outcome of the individual
interacting within the environment.
• disability was defined through an "enablement-
disablement process," which is important
because it identifies disability is as changeable
and reversible the risk factors were renamed to
transitional factors, as they were responsible for
the transitions between the categories of the
enabling-disabling process.

22. NATIONAL CENTER FOR MEDICAL
REHABILITATION (NCMRR)
• NCMR Rincorporated the basic NCMRR incorporated the basic phenomena
described in the Nagi model but also included a specific component but
also included a specific component related to societal influences or
limitations related as contributors to disability.
• NCMRR defines societal limitations as the restrictions resulting from social
or barriers, which limit fulfilment of roles or deny access to services and
opportunities associated with full participation in society.
• The model defined disability as limitations in performing tasks, activities,
and roles to levels expected in personal and social contexts where focus
was placed on how a person with a disability adapts to functional
limitations in the family, work, local community.
• In 2006 the NCMRR started working on a new version in which
rehabilitation is seen as an active process, requiring the active
participation of the patient, with the ultimate goal of improving the
patient's quality of life.

23. A NEW MODEL FOR THE ENABLING-
DISABLING PROCESS
• A common understanding of such terms as injury, impairment,
handicap, functional limitation, disabling conditions, and disability
is essential to building effective, coherent programs in rehabilitation
science and As described above, several frameworks have been to
describe disability-related concepts, but none of these been
universally adopted.
• The lack of a uniformly accepted conceptual foundation is an
obstacle to research and to other elements critical to rehabilitation
science and engineering. this committee presents a new set of
models, based primarily on the previous IOM model (1991), to
enhance the robustness of the previous models with respect to
reversing the disabling process, i.e., This section presents an
overview of "the enabling-disabling process," explains its stages,
and describes the nature of disability

24. NEW IOM MODEL
• Some modifications are designed to both improve the model and
to adapt it more towards rehabilitation. The 1991 IOM model (IOM,
1991) established a new conceptual foundation the field of
disability in that it analyzed and described the components of the
disabling process in such a way as to for the identification of
potential points for preventive intervention.
• Identifying and describing the importance of the different types of
risk factors that affect the disabling process as well as the
interaction and integral nature of quality of life were fundamental
contributions to the emerging field of disability prevention. Over
time, however, some shortcomings in the 1991 IOM model have
emerged, including the implication that the disabling process is
unidirectional, progressing inexorably toward disability without the
possibility of reversal.

25. • The person: Arrows pointing left were added to represent the
potential effects of rehabilitation and the "enabling process" (risk
factors and enabling factors are now combined into "transitional
factors"). In addition, the new model includes the designation "no
disabling conditions" to indicate that there is a beginning and an
end to the disabling process when a pathology, impairment,
functional limitation, disability does not exist.
• The environment: The shaded gray area from the 1991 model
becomes "the environment," including the physical, social, and
psychological components of the environment, and is represented
as a three- dimensional mat that supports and interacts with the
person and the disabling process, serving to highlight the
importance of the person- environment interaction.
• Disability: The box that was labeled "disability" in the 1991 model
has been moved from being a part of the disabling process to being
a product of the interaction of the person with the environment.
The Person In the new model a new designation was added to
indicate people with no disabling conditions. This feature of the
model will allow for ''complete" rehabilitation

26. Transitional Factors
• Transitional Factors in the new model, the committee defines the
converse of risk factor as "enabling factor.“
• Risk factors are phenomena that are associated with an increase in
the likelihood that an individual will move from left to right in the
new model, that is, from no disabling condition toward functional
limitation.
• In contrast, enabling factors are phenomena that are associated
with an increase in the likelihood that an individual will move from
right to left in the new model, that is, toward less limitation. He
general types of enabling factors are the same as the general types
of risk factors, that is, environmental (social, psychological, and
physical) along with lifestyle and behavioral.
• Thus, since both disabling and enabling factors affect transitions
between the stages of the model, the committee groups them
together as "transitional factors."

27. The Environment
• The environment is represented as a flexible three-
dimensional mat in the new model. The strength and
resilience of this mat are proportional to the quantity and
quality of accessible support systems and the existence of
various Stronger mats equate with more supportive
environments, for example, access to appropriate health
care, the availability of assistive technology social support
networks, and receptive cultures. Weaker mats equate with
non-supportive environments. For example, physical
barriers, discrimination, lack of accessible and affordable
assistive technology, and lack of appropriate health care
result in greater displacement of the mat and, therefore,
cause greater disability.

29. Continued
• The environment is represented as having two general
categories: the social-psychological and the physical.
• Psychological and Social Environments
• Discrimination, Access to health and medical care,
Appropriate care, Access to technology
• Culture, Employment, Family, Economy, Community
organizations, Access to social services, Traits and
personality factors, Attitudes and emotional states, Access
to fitness and health-promoting activities, Education,
Spirituality, Independence
• Physical Environments
• Architecture, Transportation, Climate, Appropriate
technology, Geography, Time

30. Enabling disability process

31. MODEL OF REHABILITATION

32. BIOMEDICAL REHABILITATION MODEL

33. CONTINUED

34. EDUCATIONAL REHABILITATION MODEL

35. SOCIAL REHABILITATION MODEL

36. ECONOMIC REHABILITATION MODEL

37. COMMUNITY BASED REHABILITATION MODEL

38. Community based rehabilitation (CBR)
Introduction

39. DEFINITION CBR

40. COMPREHENSIVE REHABILITATION MODEL

41. TYPES OF REHABILITATION

42. PHYSICAL REHABILITATION

43. Occupational rehabilitation

44. Speech /swallow rehabilitation therapy

45. Cognitive rehabilitation therapy

46. Vocational rehabilitation therapy

47. Summary
• Today we have discussed about model and
methods of rehabilitation like introduction,
definition, rehabilitation nursing, objectives,
models, methods and application of
community .

48. conclusions
• I hope you all understand about the models
and methods of rehabilitation . If got chance
to apply this model and methods in
community area will you able to apply though
this knowledge confidently.

49. References
• Clark M, J. ‗Nursing in the Community‘, Appleton and Lange,
Connecticut, Latest Edn
• Clemen – Stone S, Eigsti D, G. McGuire S, L. Comprehensive Family
and Community Health Nursing, Mosby, Latest Edn.
• Cookfair J, M. Nursing Process and Practice in the Community,
Mosby, Latest Edn.
• Dharr G, M.Robbani I, Foundations of Community Medicine
Elsevier, Latest Edn.
• Gulani K, K. Community Health Nursing:Principles and practices.
Latest Edn.
• Kerr J, Community Health Promotion Tindall, Latest Edn.
• Loudan, N. Glasier A, Gebbie A Hand book of Family Planning
Reproductive Health Care, Churchill Livingstone. Latest Edn.