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Posts Tagged ‘rehabilitation’

In a previous post, “Tele-rehabilitation to the rescue!”, I stressed the point that rehabilitation should be put at the front of the healthcare process. Rehabilitation is also an aspect that can be easily “translated” into ICT applications. Taking advantage of this aspect should be a prime consideration for managers in the healthcare sector.

Facilitating the access of rehabilitation apps to patients will reduce the burden on rehabilitation professionals and, equally important, will also reduce the expense in medication. Both items, health professionals and medication, are at the top of the healthcare budget. The point is that rehabilitation apps should be incorporated into the prescription alternatives open to the rehabilitation professional, and its cost should be assumed by the healthcare provider, just as medicines are.

In PhysUp, a company I founded a couple of years ago, we believe in rehabilitation. We design our products to fit the customer, centring on making them simple and user friendly. The aim is to integrate into the digital domain those people who, whether due to  age or  other factors, are not yet an integral part of the active digital population.

As an example of what we have done, I am presenting an app for stroke rehabilitation. We have developed it in English, “Gaming for stroke rehabilitation”, and in Spanish, “Rehabilitación para ictus ACV”. Both can be downloaded from Google Play.

I hope you find them useful as a tool for those patients recovering from a stroke, and that this will aid them in regaining their psychomotor abilities.https://play.google.com/store/apps/details?id=com.physup.stroke

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Rehabilitation is mostly understood as a side order of a full-blown treatment of an illness. Should it be so? The first casualty of that point of view is rehabilitation itself. Rehabilitation is “a set of interventions needed when a person is experiencing limitations in everyday physical, mental, and social functioning due to ageing or a health condition, including chronic diseases or disorders, injuries, or trauma”[i] The definition does not imply that rehabilitation should be linked to the treatment of an illness. My point is that rehabilitation should be linked to maintaining one’s physical or mental health: a prevention tool more than a cure.

If we take that approach, rehabilitation would become part of primary care as against being a by-product of specialist care. Primary care is the point to which a person will turn when feeling something is wrong with his/her health. That does not mean necessarily that the person is ill; that the person is a “patient”. I resent very much that word. The label “patient” is diminishing any way you look at it. Does it mean you must be tolerant with the health professional who is treating you? Or is it that you must endure your suffering? The use of the word “patient” limits also the scope that rehabilitation should have since it links rehabilitation to illness.

Rehabilitation should take a bigger role in humans’ wellbeing. A recent paper[ii] points out that almost one in three people on the planet needs some kind of rehabilitation. If we narrow the focus, 1.71 billion people have musculoskeletal conditions that could benefit from rehabilitation. Narrowing even more, around 30% of the population in the European Region has musculoskeletal problems.

With an ageing society, that percentage is only going to increase and the health system, or primary care for that matter, is not and will not be able to cope with the problem. A different approach must be taken to devise a system that relies more on prevention and less on after- the fact- cure. The situation represents a unique opportunity for developing easy to use ICT tools that help primary care professionals address the growing demand for preventive and curative rehabilitation therapies.


[i] Cieza A. Rehabilitation the health strategy of the 21st century, really? Arch Phys Med Rehabil 2019; 100: 2212–14. Cited by Cieza A. et al Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019. thelancet.com on December 4, 2020

[ii] Cieza A. et al Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019. thelancet.com on December 4, 2020. https://www.thelancet.com/action/showPdf?pii=S0140-6736%2820%2932340-0 Accessed 08.12.20

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I was invited by The Economist to attend their conference on Ageing Societies, held in London (UK) during the 29th and 30th of November. I will not pretend to summarize one and a half days in this short post. I will try, nevertheless, to bring out those three interventions and a message that, to me, were more relevant.

Let´s start with the message. I have been involved with ageing for a long time. My first public intervention was at the London School of Economics in March 2011 although, previously, I attended the AAL Forum at Odense in 2010. Since then I have focused the problem on “older people”. No wonder, since I have worked with several hospitals dedicated to the rehabilitation of older people since 2006. Ten years make a mark on a person. So, the first realization was that at the conference we were not talking about “older people”; we were talking about “Ageing Societies”, which is completely different. The world population is ageing; from Asia to Europe and America and even in Africa. Societies are ageing. The socio-economic infrastructure was designed to care for a nice population pyramid, not for a population cylinder or, even worst, an inverted pyramid. Accordingly, we have to redesign the socio-economic infrastructure in general and the care infrastructure in particular so as to be able to handle an Ageing Society.

John Beard´s presentation (from the WHO) was a masterpiece introducing the importance of health care for the future of our societies. His presentation, based on the “Report on Ageing and Health”, highlighted two important aspects that we tend to forget. One is that older people are diverse. Probably because we are used to giving certain benefits linked to age, for example free entrance to museums or cheaper public transportation for over 65s, we put everybody over 65 into the same category. Of course this is not real and older people have very different functional capabilities. This was the second aspect. The category used to guide our efforts in dealing with an ageing society should be functional capability. The above mentioned report states that “burdens of disability and death arise from age related losses in hearing, seeing and moving, and non-communicable diseases”. So, it is my interpretation that we should move from focusing on age to focusing on those disabilities that hinder our functional capabilities. And it should be noticed that those kinds of disabilities do not come only with old age. They pop up at any time; how many young people need glasses?

It was mentioned by someone during the Focus on Asia interview that “the problem in an ageing society lies with the young people in their 30s”. Natalia Kanem (from the UN Population Fund) expanded on the same idea, and more. She introduced us, through the “The State of World Population 2016”, to the fact that “investing in 10-year-old girls could yield huge demographic dividends”. It all boils down to the same idea: prevention is the key to a successful design of our ageing societies. It is my belief that, unless we invest in our youth now, our societies are not going to be able to cope with the on-going demographic change.

And finally, the last intervention that I would like to bring to you was about breaking silos. When talking about ageing and its related problems, there is a part of society which focusses almost exclusively on social and health factors. There are also other professionals that focus exclusively on economic and financial factors. To my knowledge, very little has been done to bring those two worlds together. And a token sample of that lack is the composition of the speakers in the panel: both of them were from the financial sector with no representative of the other silo: the care sector. Nevertheless, the point was made: silos have to come down and the financial aspects of an ageing society have to be intertwined with the care aspects. So far their courses have run parallel. Now they should start running together.

I could summarize that tackling the problems of our ageing societies needs an intervention in our youth of today, fostering the development of their own functional capabilities in a holistic way, combining the socio-health-financial aspects of every human being.

And this is my summary of one and half days of a very intensive and interesting event.

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