Understanding Rehabilitation as a Health Strategy | End of Week 1 of MOOC Reflection

It has been an exciting first week for the annual Physiopedia MOOC, which this year has been developed as part of the ReLAB programme on Understanding Rehabilitation as a Health Strategy.

The first course of the MOOC this week focused on providing a broad overview of rehabilitation. We were very lucky to have Professor Derek Wade, Consultant in Neurological Rehabilitation, visiting Professor at Oxford Brookes University and Editor of Clinical Rehabilitation Journal provide us with his views and thoughts on what rehabilitation is and the key role it plays in allowing an individual to optimise their function and participation.

It was really interesting to look back over the history of rehabilitation and to reflect on the early development of rehabilitation predominantly in response to the impact of war, with an emphasis on physical rehabilitation. I personally found this a timely reminder of the life changing role that rehabilitation has played since its early development, which I was reminded of as I watched the 2020 Paralympic Games in Tokyo a few weeks ago, given the development of the Paralympic Games by Sir Ludwig Guttman.

Guttman was a strong believer in ‘purposeful, dynamic physical management’ and the role that sport could play in the physical and mental rehabilitation of people with a spinal cord injury. So sport was introduced as a key component to the program at Stoke Mandeville Hospital and became a vital element in the treatment of all individuals. If we consider how Guttman’s inclusion of physical rehabilitation has totally changed spinal cord injury rehabilitation services, particularly on the outcome and long term prognosis for individuals after a spinal cord injury the changes have been astronomical. The following video gives just a glimpse of the impact Sir Ludwig Gutmann has had.

What has not changed unfortunately is the impact of global conflict on the rehabilitation needs but as Associate Professor Sumit Kane highlights it is a rapidly ageing population accompanied with a rise in chronic conditions, improved trauma/injury survival and non-communicable diseases that are really leading to a rapid shift in health care needs and with it an increasing global need for rehabilitation services, which are currently not being adequate met. Sumit highlights the urgent need to scale up rehabilitation, particularly at primary health care level, to ensure services reach those who need them most in all contexts around the globe.

Reflections of COVID-19 Impact on Rehabilitation

And finally I am reminded of the huge impact of COVID-19 rehabilitation services. Firstly we have those who have been affected directly by COVID-19, both in terms of those who required critical care within the hospital environment and are now on the road to recovery but also those who did not need hospital based care initially but are faced with the impact of long-Covid that for many has led to a dramatic reduction in both function and participation.

But we must not consider only those who have had COVID-19 but also those who were forced into long periods of isolation and restriction in their daily activities, that likewise have had a huge impact on their function and participation. So many have had reduced or in some cases no access to rehabilitation services over these last 18 months, which has further increased the burden on rehabilitation services globally.

Certainly this first course in the MOOC has given me a lot of food for thought, and reminded me of some of the challenges that we are currently facing in provision of adequate rehabilitation services to meet the growing demand for our services. I just look at my own service, and the increase in waiting lists and reduced capacity as a result of service restrictions during COVID-19 and critically reflect on what I can do to address teh increased need, with currently no extra resources to cater for them.

On that note I am hoping that Course 2 of the MOOC on Rehabilitation in Health Systems will help guide me as I look at my own service, and consider access to rehabilitation services. I hope it has presented you with some opportunities to reflect on your own work context and where rehabilitation services currently sit.

This post was written by Naomi O’Reilly the MOOC manager at Phyisopedia.

ReLAB-HS is made possible by the generous support of the American people through the United States Agency for International Development (USAID) and is implemented under cooperative agreement number 7200AA20CA00033. The consortium is managed by prime recipient, Johns Hopkins Bloomberg School of Public Health.