Physical Rehabilitation: A Historical Look

Medicine aims toward restoring, maintaining, and improving human health, and engineering aims toward restoring, maintaining and improving human wellness. Both disciplines apply knowledge from science and technology at large to accomplish such objectives. Bioengineering, also called biomedical engineering, is defined as the application of engineering principles and techniques to problems in medicine and biology (always with restoration, maintenance, and improvement in mind), which now also includes veterinary medicine, and the environment in general.

[The Danish history of rehabilitation - and what is the doctor's role in the future?]

Not least tuberculosis caused the growth of many spas. In Denmark, the Society for Physical Therapy and Dietetic was formed in 1902, and in 1921 it changed its name to the Danish Physiatrists Society, later the Danish Society for Physiatrists and Rehabilitation. In the early 1980's the National Board of Health decided, that all specialties should rehabilitate patients within their own area, and the specialty for rehabilitation was abolished. Therefore, all doctors need to have knowledge of the biopsychosocial model and the involvement of other professional groups and sectors.

Psychosocial Adaptation to Disability Within the Context of Positive Psychology: Philosophical Aspects and Historical Roots

PURPOSE

The purpose of this article is to review the conceptual and clinical similarities that exist between the principles of positive psychology and those underlying rehabilitation counseling and psychology, occupational rehabilitation, and those espoused by the field of psychosocial adaptation to chronic illness and disability (CID).

METHODS

Three themes were selected for review. These included the historical contributions of early scholars in the area of psychosocial adaptation to CID that later were indirectly infused into mainstream positive psychology; state and trait constructs that constitute much of the infrastructure of positive psychology and psychosocial adaptation to CID; and, finally, the philosophical congruencies between positive psychology and psychosocial adaptation to CID.

CONCLUSION

The existing literature indicates that there is a substantial philosophical and conceptual overlap between the fields of positive psychology and psychosocial adaptation to CID. Since theoreticians and researchers, from both fields, often use differing terminology and definitions to describe similar concepts, as well as seek similar research goals, it would behoove both fields to seek a closer partnership in order to establish a meaningful dialogue that focuses on human strengths and virtues in the lives of people with CID.

[The medical, social and institutional challenges resulting from poliomyelitis: comprehensive rehabilitation in Argentina in the mid-twentieth century]

Poliomyelitis on an epidemic scale gave rise to several challenges, one of which was the rehabilitation from the after-effects on many of the people who suffered from the disease. Paralysis and the ways it transformed the concept of physical rehabilitation (where the objective was only to restore the mobility of the affected muscles) and comprehensive rehabilitation that included social, educational and professional aspects in Argentina in the mid-twentieth century are the themes addressed in this article. It uses the methodology of institutional history that interacts in an ongoing manner with the history of health and disease.

[The Karachi health resort: synthesis of science and practice]

This article is devoted to the history of one of the oldest Siberian health resorts known as "The Karachi Lake". It describes the stages of its development, the scientific component of the system of spa-and-resort therapy and medico-social rehabilitation of the patients. The detailed analysis of the mechanisms underlying the beneficial action of the natural therapeutic factors, cooperation with the leading research institutions, and the formation of the modern scientific and technical basis have strengthened the position of the resort on the market of the medical, health-promoting, and recreational services due to the development of the new activities in this field.

Rehabilitation and restoration: orthopaedics and disabled soldiers in Germany and Britain in the First World War

This article offers a comparative analysis of the evolution of orthopaedics and rehabilitation within German and British military medicine during the Great War. In it, we reveal how the field of orthopaedics became integral to military medicine by tracing the evolution of the discipline and its practitioners in each nation during the war. In doing so, however, we document not only when and why both medical specialists and military officials realized that maintaining their respective national fighting forces depended upon the efficient rehabilitation of wounded soldiers, but also how these rehabilitative practices and goals reflected the particularities of the military context, civilian society and social structure of each nation. Thus, while our comparison reveals a number of similarities in the orthopaedic developments within each nation as a response to the Great War, we also reveal significant national differences in war-time medical goals, rehabilitation treatments and soldierly 'medical experiences'. Moreover, as we demonstrate, a social and cultural re-conceptualization of the disabled body accompanied the medical advancements developed for him; however, this re-conceptualization was not the same in each nation. Thus, what our article reveals is that although the guns of August fell silent in 1918, the war's medical experiences lingered long thereafter shaping the future of disability medicine in both nations.

[Medical rehabilitation in the Armed Forces: history, current state and prospects]

Authors analyzed history, current state and prospects of medical rehabilitation in the Armed Forces of the Russian Federation. Current system of medical rehabilitation in the Armed Forces provides all categories of military personnel and members of their families complete rehabilitative and remedial measures. An integration of rehabilitative experience of the medical service of the Armed Forces of the Russian Federation into the State system of medical rehabilitation, active participation of the medical service of the Armed Forces of the Russian Federation in activity of National association of specialists of medical rehabilitation and regenerative medicine will allow to increase the effectiveness of the rehabilitation system of the Armed Forces.

Western medical rehabilitation through time: a historical and epistemological review

Medical rehabilitation is the process targeted to promote and facilitate the recovery from physical damage, psychological and mental disorders, and clinical disease. The history of medical rehabilitation is closely linked to the history of disability. In the ancient western world disabled subjects were excluded from social life. In ancient Greece disability was surmounted only by means of its complete removal, and given that disease was considered a punishment attributed by divinities to human beings because of their faults and sins, only a full physical, mental, and moral recovery could reinsert disabled subjects back in the society of "normal" people. In the Renaissance period, instead, general ideas functional for the prevention of diseases and the maintaining of health became increasingly technical notions, specifically targeted to rehabilitate disabled individuals. The history of medical rehabilitation is a fascinating journey through time, providing insights into many different branches of medicine. When modern rehabilitation emerges, around the middle of the twentieth century, it derives from a combination of management approaches focusing on the orthopaedic and biomechanical understanding of patterns of movement, on the mastering of neuropsychological mechanisms, and on the awareness of the social-occupational dimension of everyday reality.

[Reflexotherapy in the context of rehabilitative medicine]

The main stages of the history of reflexotheray and its principal methodological aspects are reviewed in the context of the introduction of this approach into rehabilitative medicine. Productive results of such integration find the demonstrative reflection in the defense of 56 theses for the degree of candidate of science and 28 ones for the degree of doctor of science devoted to various aspects of reflexotherapy. The growing tendency toward the more extensive application of non-pharmacological approaches to complementary medicine opens up new prospects for the further development of reflexotherapy in the context of modern health care practices.

Outline of medical rehabilitation history in Poland and worldwide

The study is an outline of the historical development of rehabilitation as a new medical discipline in Poland and worldwide. Rehabilitation has developed dynamically in the interwar period. In the US, it was pioneered by Howard Rusk, while in Poland, rehabilitation was introduced by Wiktor Dega. Medical rehabilitation is an interdisciplinary approach and is an integral and irremovable element of treatment at all treatment stages. Of note is the contribution of Wiktor Dega, who has developed and presented the Polish concept of rehabilitation, considered by the World Health Organization (WHO) as worth of being followed. Wiktor Dega believed that rehabilitation should be started possibly early--as soon as in the active disease stage and should provide and maintain good functional results after surgical treatment. The article discusses the contribution of pioneer specialists in rehabilitation in two first rehabilitation centers in Poland, established after World War II in Poznań and Konstancin near Warsaw.

Twenty years of multidisciplinary research and practice: the Journal of Occupational Rehabilitation then and now

BACKGROUND

Early research of work disability in the 1980s showed a complexity of factors influencing pain and health-related functional limitation at work; hence, multidisciplinary perspectives were necessary to understand the complex interplay between biomechanical, organizational, social, and psychological factors impacting work disability. To address this need, the Journal of Occupational Rehabilitation was founded in 1991 with the goal of providing a scientific, yet practical forum for presenting multidisciplinary research and practice in work disability. Now, the 20-year collection of articles in the Journal reflects important trends and directions in the field of occupational rehabilitation.

METHODS

We conducted a retrospective summary of the past 20 years of the Journal of Occupational Rehabilitation, including its inaugural goals and intent, rates of submission and acceptance, trends in the types of articles published, study topics, global distribution of authors, and future directions.

RESULTS

The original goal of providing a multidisciplinary scientific and practical forum has been met, but current trends reflect a maturing scientific evidence base, with less representation of employer-based case studies and practical innovations. There has been a dramatic increase in the international representation of studies, authors, and peer reviewers outside of the US. Also, published studies now address work disability for a larger number of health concerns.

CONCLUSIONS

Contributions to the Journal continue to reflect a multidisciplinary perspective, but the Journal has seen significant changes with respect to international representation, the expanding study of non-musculoskeletal sources of work disability, and the maturing scientific evidence base in the field of occupational rehabilitation. Future volumes of the Journal will likely reflect continuing changes in the global economy, workforce fitness, and job demands.

[The 'Krüppelfürsorge' during the Weimar Republic. Oscillating between an own position and the adoption of eugenic arguments]

This article examines the discourse about physical disability led by the German 'Krüppelfürsorge'. It deals with the exhibition GeSoLei (Gesundheitspflege, soziale Fürsorge and Leibesübungen), which took place in Düsseldorf in 1926. The GeSoLei was one of the most popular platforms of the healthy and aesthetic body in the 1920s. It stood in the context of the German 'national recovery' after World War I and collected all types of medical, social and athletic professionals to expose their work to a broader audience. Also representatives of the so called 'Krüppelfürsorge' presented themselves and at the same time their perspective on people with physical disabilities on this exhibition. The article points out the ambivalent character of their perspective and shows the mixture of including and excluding people with physical disabilities, which was typical for the view of the 'Krüppelfürsorge'. It demonstrates that the 'Krüppelfürsorger' on the one hand were quite progressive towards people with disabilities, but on the other hand showed a striking openness towards eugenic values.

The development of cardiac rehabilitation: a historical critical approach

Cardiac rehabilitation is an interdisciplinary and multidimensional process aimed at preventing and containing cardiovascular mortality, morbidity and disability, and promoting health in subjects with cardiocirculatory pathologies. A body of scientific evidence is today available with regard to the benefits of cardiac rehabilitation in terms of the containment of the progression of atherosclerosis, the increase in physical work ability, the reduction in symptomatology, the improvement in psychological well being and social re-adaptation, and the lowering in hospitalization rates and in recurrent clinical cardiac events. Cardiac rehabilitation derives its origin from the application of physical activity to the therapy of ischemic heart disease, and in this paper the historical evolution of the concept of angina pectoris and myocardial infarction as also the major progress in therapeutic exercise are discussed. Cardiac rehabilitation has become through time a multi-faceted process implemented in hospitals, in outpatient clinics and at home in a variety of models. However, recent data indicate that, in the USA, no more than 20% of eligible patients per year enter cardiac rehabilitation programs, and in Europe no more than 30% participate in them. The historical perception of cardiac rehabilitation provides knowledge of the fact that, through a long and articulated process, this health intervention has achieved relevant medical and social results and it also generates the awareness of the further advantages to be obtained in future cardiovascular patients.

Sculpting soldiers and Reclaiming the Maimed: R. Tait McKenzie's work in the First World War period

This article examines the work of Canadian physician and physical educator Dr. Robert Tait McKenzie. It argues that during and after World War I, McKenzie made a unique contribution in military and medical history, spanning physical training, rehabilitation and commemoration via sculpture. McKenzie returned veterans to better physical function either directly by his hand, through devices and techniques of rehabilitation developed by him, or through advice given in his publications. In doing so, McKenzie helped lay a sound basis for modern physical therapy. In addition McKenzie's sculpture offered healing and consolation in its time.

[Tourville, a center of rehabilitation during the 1914-1918 war]

After WWI, an important centre of rehabilitation was created for the severely disabled in Tourvielle. It created the opportunity to invent and manufacture many prostheses to compensate the war amputations. In particular, the artificial arm/hand prosthesis enabled amputees to live more productive lives. Raphael Freida, who was an exceptional artist, illustrated the centre of rehabilitation when it was inaugurated by the town of Lyons.

[System of rehabilitation in the Armed Forces: history, current situation, and perspectives of development]

There are two main directions of development of medical rehabilitation in the Armed Forces of RF for now-days: medical-psychological rehabilitation of military service men among special contingents, realizing special military duty (air- and NAVY-staff, staff duty shift of Missile Force of Special Purpose) and medical rehabilitation of military service men, participants of battle action in accordance with sub-program "Social support and rehabilitation of invalids in consequence of battle action or battle trauma" of Federal Purpose Program in the sphere of social support of invalids. The authors mark necessity of reorientation of medical strategy from evaluation of determination of symptoms of already existent disease to evaluation of determination of adaptation reserves of organism of military service men, determination of changes in organism on the stage of pre-disease.

Rehabilitation medicine in countries of Central/Eastern Europe

PURPOSE

To describe attributes of rehabilitation medicine common to the five countries of Central Eastern Europe (CEE) and their implications for future challenges.

METHODS

Critical collection and study of pertinent data on evolvement and present state of rehabilitation medicine in CEE countries by a coordinated team of rehabilitation experts from each of the relevant countries.

RESULTS

CEE countries are similar in their need for rehabilitation medicine, its evolvement, present state and current practice. Settings largely emerged without strategic planning on the national level and lagged behind those in Central and Western Europe both in time and content.

CONCLUSION

The framework that evolved in all except Slovenia is not appropriate to needs. In order to meet future challenges all five CEE countries need the incorporation of inpatient, outpatient and community-based rehabilitation into one system.

And they shall walk: ideal versus reality in polio rehabilitation in the United States

This essay explores the significance that rehabilitation physicians and polio patients in the United States put on recovering the ability to walk. Polio often paralyzed or severely weakened the legs of those who contracted the disease. Regaining the ability to walk was thus a significant measure of recovery from the disease. However, walking meant more than the physical act itself. Regaining the ability to walk meant, in a symbolic sense, that one was no longer disabled, that one had again become normal. This attitude was shared by rehabilitation specialists and patients alike. This essay examines this attitude and the cultural values it embodied through a study of the efforts of selected polio survivors to learn to walk again and of the rehabilitation literature that held walking as an ideal. It also explores what happened when polio patients were unable to walk again because of the severity of their paralysis.

Polio chronicles: warm springs and disability politics in the 1930s

During the 1920s and 1930s, disabled polio survivors initiated a campaign which made them active, dissenting subjects in public discourse about disease and disability. Its source was a core of Warm Springs patients who wanted more than a healing refuge. They were well aware of the need to construct a new image of the disabled, and saw the resort's high public profile as a potent weapon in a cultural war to remake popular images of the disabled, whether as pathetic charitable objects or as horrific movie villains. Drawing on their own, disheartening experiences, this group of activists boldly critiqued the medical care offered most disabled patients as well as the training and attitudes of doctors, nurses and physical therapists. Protesting the narrow, medicalized definition of rehabilitation, they provocatively posed the need to "rehabilitate" prejudiced, able-bodied employers and health professionals. And most of all, they consciously designed the polio center at Warm Springs to function not as an inward-looking refuge but as an exemplar of the way polio survivors and other disabled people should be allowed to live, work and love. This story begins and ends in the 1930s. It traces a rise and fall: the rise of an activist community at the rehabilitative center at Warm Springs; and its decline with the creation of the National Foundation for Infantile Paralysis (known popularly as the March of Dimes) in 1937.

[The 60th anniversary of the Croatian Balneological and Climatological Institute]

Sixty years ago, more precisely on 28 August 1949, Croatian Ministry of Health founded the Balneological and Climatological Institute as a result of a long-term endeavor and attempts to provide Croatia with an institution of this type, already existing in many European countries. In 1953, the Institute came under the management of the Yugoslav Academy of Arts and Sciences/YAAS [today Croatian Academy of Sciences and Arts and became the Department of Balneoclimatology of the Medical Research Institute of YAAS. In 1958, it was transferred to the Medical School of the University of Zagreb, continuing to function first as the Institute of Balneoclimatology and Physical Therapy and, since 1963, as the Institute of Physical Medicine and Rehabilitation. In spite of financial difficulties and occasional lack of understanding from the officials in this field, significant contributions have been made to balneology during this time, justifying the need for such an institution. On 15 April 2008, the Institute of Physical Medicine and Rehabilitation became Department for Balneoclimatology, under the Department of Environmental and Occupational Health of Andrija Stampar School of Public Health, Rockfellerova 4, Zagreb.

Stanisław Kuczborski (1912-2004): pulmonologist and phtysiatrist

Stanisław Kuczborski was born in Lódź on January 31, 1912. In 1937, he got his medical degree at the Medical Department of the Warsaw University. Afterwards, he was employed in a sanitarium in Otwock near Warsaw. As a physician, he was a pulmonary and phtysiatric consultant. After Second World War, Kuczborski performed many managerial duties in Lódź. In the 1950s, he was Deputy Director of the Tuberculosis Institute in Warsaw. He held foreign (Denmark, France) scientific internships and was a member of the International Union against Tuberculosis and Lung Disease in Paris. In Poland, he received an honorary membership of the Polish Phtysiatry and Pneumonology Association. Kuczborski published 70 works. He died in Lódź on August 23, 2004.

Tele-rehabilitation: present and future

During the last decade we assisted to relevant progress in rehabilitation studies and in technological development. From the combination of these issues rises the tele-rehabilitation--a subfield of telemedicine consisting of a system to control rehabilitation "at distance"--as an actual possibility of application and a promising development in the future. The present paper offers a short review of the state of the art in the field of tele-rehabilitation, with a special focus on upper limb tele-rehabilitation. The experience is also briefly reported of the preliminary application of the H-CAD (home care activity desk) system and the HELLODOC (Healthcare service linking tele-rehabilitation to disabled people and clinicians) tele-rehabilitation service, conducted by the authors within two European projects in the period 2003-2005 and 2005-2007 respectively.

[A historical review of the development of physical medicine and rehabilitation service in Vojvodina]

At the end of 1959, the Department of Physical Medicine and Rehabilitation was founded as a part of the Main Provincial Hospital in Novi Sad and it was located in the building built for that purpose in 1958. This institution specialized for rehabilitation was the first of its kind in the region of Vojvodina. Drilling of the first well in the area of today's Futoski park began in 1897. Chemical analysis showed the presence of iodine in the mineral water. Construction of the iodine spa started at the beginning of the 20th century, and it has been changing ever since. The Department of Child Rehabilitation, the first and only in Vojvodina, was established at the end of 1968, at the Institute of Mother and Child Health Care, and it has been treating children with cerebral palsy from the territory of Novi Sad. Although their names have been changed through the time, all three physically separated objects for medical rehabilitation have the same purpose: to promote and improve the quality of healthcare for children and adults with various disabilities, by using modern principles of physical therapy and medical rehabilitation. All three institutions, the present Medical Rehabilitation Clinic, Special Hospital for Rheumatic Diseases and the Child Rehabilitation Clinic, are teaching hospitals of the Faculty of Medicine and of the Secondary Medical School Physical Medicine and Rehabilitation is also an undergraduate and graduate course for medical students of the Faculty of Medicine in Novi Sad.

Vladimir Janda, MD, DSc: tribute to a master of rehabilitation

The purpose of this presentation is to pay tribute to the life's work of Professor Vladimir Janda, a key figure in the 20th Century rehabilitation movement. An accomplished neurologist, he founded the rehabilitation department at Charles University Hospital in Prague, Czechoslovakia. He was one of the seminal members of the Prague school of manual medicine and rehabilitation that expanded its influence throughout Central and Eastern Europe. His observations regarding muscle imbalances, faulty posture and gait, and their association with chronic pain syndromes, etiologically, diagnostically, and therapeutically, influenced the rehabilitation world. The authors comprise a multinational, multiprofessional group representative of rehabilitation specialists around the world who would like to pay tribute and give a final word of thanks to this innovative educator, clinician, and author.

TIES that BIND: an introduction to domain mapping as a visualization tool for virtual rehabilitation

The application of virtual reality (VR) to rehabilitation is a young, interdisciplinary field where clinical implementation very rapidly follows scientific discovery and technological advancement. Implementation is often so rapid that demonstration of intervention efficacy by investigators, and establishment of research and development priorities by funding bodies tend to be more reactive than proactive. An examination of the dynamic unfolding of the history of our young discipline may help us recognize the facilitators of current practice and identify the barriers that limit greater progress. This paper presents a first step towards the examination of the past and future growth of VR-based rehabilitation by presenting the use of concept maps to explore the publication history of application of VR to rehabilitation.

[The origins of rehabilitation: the first neuro and psychomotor rehabilitator's narratives]

The article is based on narratives gathered through anthropological methodology. The author recollects testimonies of the first women working in Italy as Rehabilitators of children affected by Neuro and Psicomotricity disorders.

[Contributions to the history of foundation and development of physical medicine and rehabilitation services in Serbia]

It is widely accepted that rehabilitation, as a new scientific discipline, was initiated by the foundation of the National Institute for Rehabilitation in Sokobanjska St. 13. However, the available data do not support this assumption. According to the article 23 of the Law on the Sanitary Code and Public Health, brought by the Serbian Principality in March of 1881, institutions for treating the sick and care for the incurable and disabled were to be provided. Numerous activities foreseen by laws of that time can be defined today as occupational and functional work therapy, as well as professional rehabilitation. Thus, there was a positive and truly humane attitude towards the disabled, resulting in better treatment outcome, less adverse events, with the aim of better professional education and training for occupational opportunities. Health-care centers of Serbia used to apply physical methods: electrotherapy, massage and physical training, documented in Serbian archives from 1888. The above mentioned data show that we have every right to be proud of the history of our profession.