Organizing human functioning and rehabilitation research into distinct scientific fields. Part I: Developing a comprehensive structure from the cell to society.

There is a need to organize rehabilitation and related research into distinct scientific fields in order to overcome the current limitations of rehabilitation research. Based on the general distinction in basic, applied and professional sciences applicable to research in general, and the rehabilitation relevant distinction between the comprehensive perspective based on WHO's integrative model of human functioning (ICF) and the partial perspective focusing on the biomedical aspects of functioning, it is possible to identify 5 distinct scientific fields of human functioning and rehabilitation research. These are the emerging human functioning sciences and integrative rehabilitation sciences from the comprehensive perspective, the established biosciences and biomedical rehabilitation sciences and engineering from the partial perspective, and the professional rehabilitation sciences at the cutting edge of research and practice. The human functioning sciences aim to understand human functioning and to identify targets for comprehensive interventions, with the goal of contributing to the minimization of the experience of disability in the population. The biosciences in rehabilitation aim to explain body injury and repair and to identify targets for biomedical interventions. The integrative rehabilitation sciences design and study comprehensive assessments and interventions that integrate biomedical, personal factor and environmental approaches suited to optimize people's performance. The biomedical rehabilitation sciences and engineering study diagnostic measures and interventions suitable to minimize impairment, including symptom control, and to optimize people's capacity. The professional rehabilitation sciences study how to provide best care with the goal of enabling people with health conditions experiencing or likely to experience disability to achieve and maintain optimal functioning in interaction with the environment. The organization of human functioning and rehabilitation research into the 5 distinct scientific fields facilitates the development of academic training programs and career building as well as the development of research structures dedicated to human functioning and rehabilitation research.     

Developing human functioning and rehabilitation research. Part I: Academic training programs.

Key to building research capacity is the development of a qualified workforce. This requires the establishment of academic training programs and the creation of attractive research career opportunities. The adoption of the International Classification of Functioning, Disability and Health as unifying conceptual model for rehabilitation, the emergence of distinct scientific fields of human functioning and rehabilitation research, and the change to Bachelor and Master degrees in Europe provide opportunities to initiate academic training programs in human functioning and rehabilitation research. Applied training includes certificate programs in rehabilitation effectiveness and Masters and Doctoral programs in rehabilitation with specializations, e.g. in rehabilitation studies, management, education and rehabilitation counseling. Scientifically-oriented training includes Masters of Science and PhD programs in human functioning sciences and integrative rehabilitation sciences. There is also potential for collaborative Masters and Doctoral programs with the rehabilitation professions, movement sciences, psychology and the behavioral and social sciences. When initiating the process to develop these programs, one may learn from and co-operate with established programs in public health.     

Developing human functioning and rehabilitation research. Part II: Interdisciplinary university centers and national and regional collaboration networks.

There is a strong movement towards interdisciplinary research around common and scientifically competitive themes, both at universities and at the national and regional level. Human functioning and rehabilitation is a new, highly innovative and relevant theme. It has the potential to attract researchers from a wide range of disciplines, institutions and organizations. It is thus of interest for universities seeking to embark upon a new and unique research area. Similarly, it is a promising theme for individual researchers, institutions and organizations aiming to develop a national or regional collaboration network for interdisciplinary research. Human functioning and rehabilitation complements established themes from the biomedical perspective. In the context of the life sciences, it can be seen as an extension of the biosciences towards a comprehensive understanding of human life, including human interaction and communication, against the background of the natural and social environment. Based on a better understanding of human functioning and disability, there is a wide range of largely unexplored possibilities to optimize populations' functioning and minimize persons' experience of disability in the presence of a health condition. Rehabilitation research is uniquely positioned to integrate and translate scientific advances into benefits for people and the society. Rehabilitation research from the comprehensive perspective can thus become a catalyst of interdisciplinary research that crosses the boundaries of the natural sciences and engineering research, the human and behavioral sciences, the social sciences and a wide range of related scientific areas. Rehabilitation research is also uniquely positioned to cross the boundaries of medicine and the health sector at large, and to translate knowledge across sectors including education, labor and social affairs.     

中国运动康复专业人才培养体系的构建

目的 分析运动康复人才培养政策背景,探讨我国运动康复专业培养目标、学科知识以及课程原则,构建中国运动康复专业人才培养体系。 方法 依据«世界残疾报告»行动建议,参照世界卫生组织康复指南«健康服务体系中的康复»的相关要求,以«国际功能、残疾和健康分类»(ICF)的理论体系为指导,分析康复发展政策背景,探讨我国运动康复专业的理论架构与方法体系。 结果 康复是国家健康服务体系的重要组成部分,是实现联合国2030可持续发展目标三“健康全覆盖”的重要手段之一,而运动康复人才的培养是建立和完善康复服务体系的重要保障。运动康复专业的培养目标是构建针对全人群和全生命周期的健康知识体系,运动康复人才学习“体医融合”知识与技能,并在健康服务体系中从事“体医融合”的相关工作。基于ICF理论架构,运动康复专业是综合性交叉学科,包括体育、生物、心理、社会和环境等多学科因素;学科可以分为与基础学科相对应的通识教育和学科基础知识,与应用学科相对应的专业基础知识,与康复专门学科相对应的康复知识和技能。基于ICF构建现代运动康复科学课程体系原则,开发与国际接轨的健康相关通识教育课程,根据康复科学和体育科学的规律强化运动康复学科基础课程,从健康科学和康复科学视角发展专业基础课程,以康复服务业的从业要求为导向发展职业相关的技能。 结论 运用ICF理论,依据«健康服务体系中的康复»的要求和«世界残疾报告»的行动建议,提出了我国运动康复专业人才培养的目标、理论框架、方法体系、学科知识以及课程体系,为进一步推动我国运动康复的专业发展,提高运动康复人才培养体系的科学化和规范化水平,提供理论基础和科学依据。     

Chronic obstructive pulmonary disease self-management activation research trial (COPD-SMART): Design and methods

BackgroundTreatment of COPD requires multiple pharmacological and non-pharmacological intervention strategies. One target is physical inactivity because it leads to disability and contributes to poor physical and mental health. Unfortunately, less than 1% of eligible patients have access to gold-standard pulmonary rehabilitation.MethodsA single-site parallel group randomized trial was designed to determine if a self-management lifestyle physical activity intervention would improve physical functioning and dyspnea. During the first six weeks after enrollment patients receive COPD self-management education delivered by a health coach using a workbook and weekly telephone calls. Patients are then randomized to usual care or the physical activity intervention. The 20 week physical activity intervention is delivered by the health coach using a workbook supported by alternating one-on-one telephone counseling and computer assisted telephone calls. Theoretical foundations include social cognitive theory and the transtheoretical model.ResultsPrimary outcomes include change in Chronic Respiratory Questionnaire (CRQ) dyspnea domain and 6-minute walk distance measured at 6-, 12-, and 18-months after randomization. Secondary outcomes include other CRQ domains (fatigue, emotion, and mastery), SF-12, and health care utilization. Other measures include process outcomes and clinical characteristics.ConclusionsThis theory driven self-management lifestyle physical activity intervention is designed to reach patients unable to complete center-based pulmonary rehabilitation. Results will advance knowledge and methods for dissemination of a potentially cost-effective program for patients with COPD.     

基于ICF模式的康复心理学:学科范式与内容北大核心CSCD

目的应用ICF的生物-心理-社会的功能与残疾模式,探讨基于ICF的康复心理学的研究内容与范式。方法采用ICF的功能与残疾理论,从康复科学和心理科学的学科架构出发,应现代康复科学发展的要求,在ICF功能架构下构建现代康复心理学的研究内容与范式。结果ICF构建了一个涉及到身心和环境的整体康复模式。基于ICF的功能模式,现代康复心理学研究的主要内容不仅涉及身体层面的功能和结构,更要研究活动和参与,强调个体与环境的交互作用。现代康复心理学涉及的领域不仅包括身体功能障碍的心理康复,还包括活动干预和环境干预。基于ICF的架构可以采用共同的术语和编码方法,使康复心理学工作者能够与相关学科专业人员进行多学科和跨学科交流。结论基于ICF构建现代康复心理学的研究理论架构与研究范式,可以形成融入心理科学和康复科学的康复心理学体系。