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KCE reports 57 Musculoskeletal & Neurological Rehabilitation 11
1 CONCEPTUAL DEFINITION OF
MUSCULOSKELETAL AND NEUROLOGICAL
REHABILITATION
1.1 DEVELOPMENT OF A CONCEPTUAL DEFINITION OF
MUSCULOSKELETAL AND NEUROLOGICAL
REHABILITATION
1.1.1 Introduction
In this part of the report, the researcher describes the method to identify the domain of
rehabilitation and all of its related aspects, to avoid a too limited view on rehabilitation
while answering the questions formulated by the minister of health care. First, the
literature search for existing definitions of rehabilitation is described, followed by a
proposal for the development of a conceptual definition for musculoskeletal and
neurological rehabilitation based on existing literature.
In Belgium the term ‘locomotor’ is used instead of ‘musculoskeletal and neurological’. The
researchers will use the term “musculoskeletal and neurological rehabilitation”. Besides,
musculoskeletal rehabilitation can not be seen disconnected of neurological rehabilitation
because many patients have to contend with musculoskeletal and neurological problems at
the same time. Within this project musculoskeletal as well as neurological rehabilitation
will be discussed.
1.1.2 Critical view on the current published literature
Looking for a definition of rehabilitation in the literature, the researchers ascertained that
most of the existing definitions are developed around a specific pathology. No definitions
for musculoskeletal and neurological rehabilitation were found. Papers which contain a
description of a scientific approach in the development of a definition of rehabilitation are
scarce.
A lot of definitions refer to the International Classification of Functioning, Disease and
Health (ICF) or components of the ICF. However, ICF is still a theoretical framework. ICF
did not yet prove any additional value on relevant data collection about rehabilitation,
organisational design for rehabilitation or simulation of the financial impact of
rehabilitation.
“ICF is a multidimensional system across which the individual codings are not mutually
exclusive and can vary across raters so that “core sets” for different clinical conditions
must be agreed upon by users.” 1
1.1.3 Methodology
The objective of the search of the literature was to formulate a definition of
musculoskeletal and neurological rehabilitation.
The search of the literature for existing definitions of rehabilitation was preceded by
asking some questions. Does a definition for rehabilitation have to be built around a type
of patients (pathology, age,…), the different therapies, the concerned professional groups
or the goals to achieve? The researchers agreed on a patient centred approach. The
definition is built around the outcome and goals because different diagnostic conditions
may share the same type of rehabilitation needs. The appropriateness of a therapy is
function of the needs and related aims whereas the appropriateness of a specific
professional is function of the therapy.
As a result two main questions were formulated before the start of the search:
• How can goals be achieved?