REHABILITATION

FUNCTIONAL REHABILITATION OF THE LOWER LIMB

CONCEPTS

AND CLINICAL APPLICATION

By Nicholas Clark, MSc, MCSP

INTRODUCTION The term ‘functional rehabilitation’ is frequently used in contem- porary clinical dialogue, and is applied in the literature to describe ‘comprehensive’ lower limb rehabilitation programmes (1,2). However, some scientists and clinicians criticize the use of such a term, suggesting that it is poorly defined and questioning how functional rehabilitation differs from ‘traditional rehabilita- tion’ (3,4). This article seeks to define the term ‘functional reha- bilitation’ and offers an overview of the basic concepts of the term, progressing to the clinical application.

To understand the concept of ‘functional rehabilitation’ it is use- ful to first separately define the terms ‘functional’ and ‘rehabilita- tion’. According to the Oxford Dictionary (5) ‘functional’ is defined as “of a function” where ‘function’ is defined as “the special activ- ity or purpose”. According to Kent (6) ‘rehabilitation’ is defined as

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“the restoration of an injured person to the level of physical fit- ness he or she had before the injury”. Therefore, in view of these separate definitions, a definition of ‘functional rehabilitation’ is the restoration of an injured person to the level of physical fitness specific to the person’s activity or purpose. This is clearly a very general definition of functional rehabilitation. However, such a general definition illustrates that each person’s activity or pur- pose is potentially unique when compared to another person - functional rehabilitation for one person may not be functional rehabilitation for another person. This means the clinician must understand the physical demands unique to an individual person’s activity or purpose if a truly ‘functional’ rehabilitation programme is to be administered.

ACTIVITY-SPECIFIC NEEDS ANALYSIS In order to fully understand the physical demands unique to an individual person’s activity or purpose, the clinician may perform an ‘activity-specific needs analysis’ (Table 1) as outlined by Fleck

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