Masters of physiotherapy 

Batch 2020-2022
Obs & Gynae 
Enrolment No.- 110320003

CONCEPTUAL FRAMEWORK
OF REHABILITATION
SUBMITTED TO:-                                                                                                  SUBMITTED BY:-
DR. JYOTI BALYAN                                                                                               SHIKHA SAGAR
 REHABILITATION

• REHABILITATION IS A GOAL-ORIENTED AND OFTEN TIME-LIMITED PROCESS,

WHICH ENABLES INDIVIDUALS WITH IMPAIRMENTS, ACTIVITY LIMITATIONS AND
PARTICIPATION RESTRICTIONS TO IDENTIFY AND REACH THEIR OPTIMAL
PHYSICAL, MENTAL AND SOCIAL FUNCTIONAL LEVEL THROUGH A CLIENT-
FOCUSED PARTNERSHIP WITH FAMILY, PROVIDERS AND THE COMMUNITY.
REHABILITATION FOCUSES ON ABILITIES AND AIMS TO FACILITATE
INDEPENDENCE AND SOCIAL INTEGRATION, AND INCLUDES PREVENTION OF
INJURY/ILLNESS RECURRENCE AND/OR SECONDARY CONDITIONS
 INTRODUCTION TO THE FRAMEWORK

• THE FRAMEWORK IS A GUIDANCE DOCUMENT DEVELOPED TO ASSIST CLINICIANS, MANAGERS AND PLANNERS IMPROVE ACCESS TO
QUALITY, SUSTAINABLE REHABILITATION SERVICES. THE FRAMEWORK OUTLINES THE KEY ELEMENTS CONSIDERS FOUNDATIONAL TO ITS
REHABILITATION SERVICES OR PROGRAMS AND TO ANY SERVICES PROVIDES BY THE CORE DISCIPLINES. IT:  
• PROMOTES A SHARED UNDERSTANDING BETWEEN AHS STAFF, PHYSICIANS, AND EXTERNAL PARTNERS IN UNDERSTANDING THE NATURE
OF REHABILITATION SERVICES AND THE RATIONALE FOR THE SERVICES THAT FACILITATES WORKING TOGETHER; 
• COMMUNICATES REHABILITATION’S UNIQUE CONTRIBUTION TO THOSE WHO USE, WORK IN OR COLLABORATE WITH THE HEALTH SYSTEM;  
• PROVIDES COMMON LANGUAGE AND DEFINITIONS THAT ARE RELEVANT TO REHABILITATION SERVICES FOR USE WITHIN AHS;  
• OUTLINES THE GUIDING PRINCIPLES THAT SHOULD UNDERPIN ALL REHABILITATION SERVICES; 
• IDENTIFIES KEY COMPONENTS THAT ENABLE MORE CONSISTENT WORK PRACTICES AND DECREASE FRAGMENTATION OF CARE;  
• PROMOTES OPTIMIZED SERVICE OUTCOMES AND EFFICIENCIES; AND 
• IS ALSO A PLANNING TOOL MEANT TO GUIDE IMPROVEMENTS, SERVICE PLANNING AND SERVICE IMPLEMENTATION RELATED TO
REHABILITATION, AT BOTH THE PROVINCIAL SYSTEM LEVEL AND LOCAL OPERATIONAL LEVELS IN THE ORGANIZATION.
 THE FRAMEWORK ARCHITECTURE

• 1. UNIQUE CONTRIBUTION OF REHABILITATION THE UNIQUE CONTRIBUTION OF

REHABILITATION WITHIN THE HEALTH SYSTEM IS: ENHANCING FUNCTION FOR
MEANINGFUL LIVING. (ALBERTA HEALTH SERVICES, REHABILITATION MODEL
SYNTHESIS WORKING GROUP, 2009). ASSISTING PEOPLE TO BE FUNCTIONAL IN
WAYS MEANINGFUL TO THEM IS HOW REHABILITATION PROVIDERS EXPERTLY
CONTRIBUTE TO A PERSON’S WELL-BEING AND IS WHAT REHABILITATION
SERVICES ARE DESIGNED FOR
 2. GOALS OF REHABILITATION SERVICES

• PRIMARY AND SECONDARY PREVENTION;  

• INFLUENCING PUBLIC AWARENESS, ACCEPTANCE AND EXPECTATIONS ABOUT HEALTH AND DISABILITY; 
• INFLUENCING SOCIETAL NORMS AND POLICIES THAT FOSTER THE ABILITY TO FUNCTION IN DAILY LIFE AND PARTICIPATE
IN SOCIETAL ROLES; 
• ENHANCING CAPACITY OF COMMUNITIES, INDIVIDUALS, FAMILIES AND SYSTEMS TO FACILITATE HEALTH IN ITS NARROW
AND BROAD SENSES; 
• INFLUENCING SOCIAL AND PHYSICAL ENVIRONMENTS THAT FOSTER THE ABILITY TO FUNCTION IN DAILY LIFE AND
PARTICIPATE IN SOCIETAL ROLES;  
• MINIMIZING IMPAIRMENT EXPERIENCED BY INDIVIDUALS; 
• MAXIMIZING AN INDIVIDUAL’S ACTIVITY IN DAILY LIFE; AND 
• MAXIMIZING AN INDIVIDUAL’S PARTICIPATION IN SOCIETAL ROLES.
 3. GUIDING PRINCIPLES

• ACCEPTABILITY - SERVICES ARE RESPECTFUL AND RESPONSIVE TO USER NEEDS, PREFERENCES AND
EXPECTATIONS.
• ACCESSIBILITY - SERVICES ARE OBTAINED IN THE MOST SUITABLE SETTING IN A REASONABLE TIME AND
DISTANCE. 
• APPROPRIATENESS - SERVICES ARE RELEVANT TO USER NEEDS AND ARE BASED ON ACCEPTED OR
EVIDENCE-BASED PRACTICE.  
• EFFECTIVENESS - SERVICES ARE PROVIDED BASED ON SCIENTIFIC KNOWLEDGE TO ACHIEVE DESIRED
OUTCOMES.  
• EFFICIENCY - RESOURCES ARE OPTIMALLY USED IN ACHIEVING DESIRED OUTCOMES. 
• SAFETY - RISKS ARE MITIGATED TO AVOID UNINTENDED OR HARMFUL RESULTS.
 4. DEFINITIONS

• DEFINING CONCEPTS THAT ARE COMMON IN REHABILITATION SERVICES LEADS

TO CLARITY IN COMMUNICATION, CONSISTENCY IN REPORTING AND ANALYSIS,
AND IMPROVED UNDERSTANDING BETWEEN PROVIDERS AND BETWEEN
VARIOUS PARTS OF THE ORGANIZATION. THE AHS ACCEPTED DEFINITIONS
RELEVANT TO REHABILITATION, WHICH ARE FOUND IN THE APPENDIX, ARE
THEREFORE FOUNDATIONAL IN THE FRAMEWORK. 
 5. REHABILITATION SECTORS

REHABILITATION SECTORS DESCRIBE HOW PUBLICLY FUNDED REHABILITATION SERVICES ARE

CATEGORIZED BASED ON: 
• LEGISLATIVE PARAMETERS; 
• CHARACTERISTICS OF THE RECIPIENT; 
• CHARACTERISTICS OF THE SERVICE; AND 
• WHERE THE SERVICE IS PROVIDED.
THESE CATEGORIES ARE IMPORTANT FOR PLANNING SERVICES, BUDGETING, SETTING UP COST CENTRES
AND REPORTING ACTIVITY. THE FRAMEWORK OUTLINES FIVE SECTORS – ACUTE CARE REHABILITATION,
REHABILITATION FACILITY/UNIT REHABILITATION, AMBULATORY COMMUNITY REHABILITATION, HOME
CARE REHABILITATION AND LONG-TERM CARE FACILITY REHABILITATION. 
 6. DISCIPLINES 

• REHABILITATION PROVIDERS CONTRIBUTE TO HEALTH SERVICES ACROSS THE SERVICE

CONTINUUM. THE CORE REHABILITATION DISCIPLINES WHOSE WORK IS GENERALLY DEVOTED TO
THE VARIOUS ASPECTS OF REHABILITATION ARE AUDIOLOGY, OCCUPATIONAL THERAPY,
PHYSIATRY, PHYSIOTHERAPY, RECREATION THERAPY AND SPEECH LANGUAGE PATHOLOGY.
EXAMPLES OF ANCILLARY DISCIPLINES WHOSE PRIMARY FOCUS IS NOT ALWAYS THE
REHABILITATION PROCESS BUT WHICH MAY BE INVOLVED IN A PERSON’S REHABILITATION
JOURNEY ARE: EARLY INTERVENTION, MEDICINE, NURSING, NUTRITION, ORTHOTICS, PHARMACY,
PROSTHETICS, PSYCHOLOGY, RESPIRATORY THERAPY, SOCIAL WORK AND SPIRITUAL CARE. THIS
FRAMEWORK IS MEANT TO GUIDE ALL WORK OF THE CORE DISCIPLINES, AS WELL AS THE WORK OF
ANCILLARY DISCIPLINES WHEN THEY ARE INVOLVED IN REHABILITATION SERVICES OR PROGRAMS.
 7. ICF CONCEPTUAL MODEL 

• THE FRAMEWORK ACCEPTS THE

INTERNATIONAL CLASSIFICATION OF
FUNCTIONING, DISABILITY AND HEALTH (ICF)
(WORLD HEALTH ORGANIZATION, 2001) AS THE
SOURCE OF A STANDARD LANGUAGE AND
DESCRIPTION OF HUMAN HEALTH AND
FUNCTIONING. IT IS A BIOPSYCHOSOCIAL
APPROACH TO HEALTH, MEANING THAT
BIOLOGICAL, PSYCHOLOGICAL AND SOCIAL
FACTORS ARE ALL RECOGNIZED AS
INFLUENCERS OF HEALTH.
 8. KEY COMPONENTS 
THE THREE KEY COMPONENTS UNDERPINNING THE FRAMEWORK – THE HEALTH CONTINUUM; THE
SERVICE CONTINUUM; AND NEEDS IDENTIFICATION AND SERVICE DELIVERY PARAMETERS, ARE
UNIQUELY IDENTIFIABLE ELEMENTS THAT ARE DISTINCTIVE AND NECESSARY FUNCTIONS IN THE
OPERATION OF REHABILITATION SERVICES. THEY ARE DEPICTED IN THE FRAMEWORK PICTURE THROUGH
THEIR SUB ELEMENTS.
8.1. HEALTH CONTINUUM
• BEING HEALTHY ACHIEVING HEALTH AND PREVENTING OCCURRENCE OF INJURIES, RISK FACTORS,
ILLNESS, CHRONIC CONDITIONS AND RESULTING DISABILITIES. 
• GETTING BETTER CARE RELATED TO ACUTE ILLNESS OR INJURY.  
• LIVING WELL WITH ILLNESS/DISABILITY CARE AND SUPPORT RELATED TO CHRONIC OR RECURRENT
ILLNESS OR DISABILITY.  
• END OF LIFE CARE AND SUPPORT THAT AIMS TO RELIEVE SUFFERING AND IMPROVE QUALITY OF
LIVING WITH OR DYING FROM ADVANCED ILLNESS OR BEREAVEMENT. 
• 8.2. SERVICE CONTINUUM
• HEALTH PROMOTION IS THE PROCESS THAT ENABLES PEOPLE TO INCREASE CONTROL OVER AND IMPROVE THEIR HEALTH. IT
INCLUDES ACTIVITIES THAT ENCOURAGE HEALTHY DEVELOPMENT, HEALTHY LIFESTYLES, HEALTHY AGING, SELF-
MANAGEMENT OR ADVANCED CARE PLANNING
• PRIMARY AND SECONDARY PREVENTION. PRIMARY REHABILITATION CONCEPTUAL FRAMEWORK - 17 PREVENTION IS DIRECTED
TOWARDS PREVENTING THE INITIAL OCCURRENCE OF A DELAY OR CONCERN, DISEASE, INJURY OR CONDITION. SECONDARY
PREVENTION IS FOCUSED ON THOSE WITH CHRONIC ILLNESS AND A HISTORY OF ACUTE EXACERBATION IN ORDER TO PREVENT
OR DELAY FUTURE DISEASE, EXACERBATION OR INJURY
• ACUTE CARE ACUTE TREATMENT IS FOR ILLNESS THAT IS OF ABRUPT ONSET, RELATIVELY SHORT DURATION, RAPIDLY
PROGRESSIVE AND IN NEED OF URGENT CARE.
• CHRONIC DISEASE MANAGEMENT INCLUDES POPULATION HEALTH PRINCIPLES AND PLACES AN EMPHASIS ON BOTH CHRONIC
DISEASE PREVENTION AND MANAGEMENT. 
• REHABILITATION IS A GOAL-ORIENTED AND OFTEN TIME LIMITED PROCESS, WHICH ENABLES INDIVIDUALS WITH IMPAIRMENTS,
ACTIVITY LIMITATIONS AND PARTICIPATION RESTRICTIONS TO IDENTIFY AND REACH THEIR OPTIMAL PHYSICAL, MENTAL AND
SOCIAL FUNCTIONAL LEVEL THROUGH A CLIENT-FOCUSED PARTNERSHIP WITH FAMILY, PROVIDERS AND THE COMMUNITY
• COMMUNITY REINTEGRATION INCLUDES ADDRESSING ISSUES RELATED TO HEALTH MANAGEMENT, LIFE ROLES, SOCIAL
NETWORKS, ENVIRONMENT, COMMUNICATIONS, MOBILITY AND CAREGIVER SUPPORT. IT MAY INCLUDE CASE COORDINATION,
COMMUNITY OR HOME REHABILITATION, DAY PROGRAMS, HOME SUPPORT AND REFERRALS TO COMMUNITY BASED
ORGANIZATION AND RESOURCES. 
• SUPPORTIVE LIVING PROVIDES CARE AND SUPPORT IN HOME ENVIRONMENT, SUPPORTED LIVING ENVIRONMENTS (E.G. GROUP
CARE HOMES, ASSISTED LIVING) OR FACILITY-BASED CARE (LONG TERM CARE FACILITIES). 
• PALLIATIVE CARE PROMOTES DYING WITH COMFORT AND DIGNITY. THIS CARE IS PROVIDED THROUGH HOME-BASED SERVICES,
HOSPICE SERVICES AND PERSONAL CARE SERVICES. 
• 8.3. NEEDS IDENTIFICATION AND SERVICE DELIVERY PARAMETERS

IN ORDER TO IDENTIFY HOW REHABILITATION OR OTHER SERVICES CAN ASSIST, THE

NEEDS OF THE INDIVIDUAL OR POPULATION MUST BE UNDERSTOOD. A DYNAMIC
BALANCE IS CONTINUALLY SOUGHT BETWEEN SCREENING, ASSESSMENT AND PROVISION
OF INTERVENTIONAL SERVICES. CERTAIN LEVELS OF SERVICE (UNIVERSAL AND
TARGETED REHABILITATION SERVICE LEVELS) MAY BE PROVIDED EFFECTIVELY WITHOUT
THE NEED FOR SCREENING, ASSESSMENT OR SPECIALIZED INTERVENTIONS.
8.3.1 SCREENING AND/OR ASSESSMENT
SCREENING IS A HIGH LEVEL NEEDS IDENTIFICATION PROCESS THAT GATHERS SALIENT
BITS OF INFORMATION THAT ARE SUFFICIENT ENOUGH TO GUIDE THE REHABILITATION
PROVIDER IN MAKING RECOMMENDATIONS TO THE INDIVIDUAL OR FOR THE POPULATION
ASSESSMENT IS THE REHABILITATION PROCESS FOR GATHERING IN-DEPTH INFORMATION
TO IDENTIFY THE INDIVIDUAL’S STRENGTHS AND NEEDS RELATED TO BODY FUNCTION,
BODY STRUCTURE, ACTIVITY AND PARTICIPATION, TO UNDERSTAND THE INDIVIDUAL’S
GOALS AND THEN TO DETERMINE APPROPRIATE SERVICES AND INTERVENTIONS BASED
ON THESE. 
8.3.2 REHABILITATION SERVICE PARAMETERS
TO OPTIMIZE OUTCOMES AND PROMOTE EFFICIENCY, CHOOSING THE MOST APPROPRIATE
REHABILITATION INTERVENTION TYPE AND REHABILITATION SERVICE LEVEL IS A KEY
STEP IN NEEDS IDENTIFICATION AND SERVICE MATCHING. 
• REHABILITATION INTERVENTION TYPES PROMOTION, PREVENTION, TREATMENT, CARE
AND CASE MANAGEMENT ARE REHABILITATION INTERVENTION TYPES EVIDENT IN
REHABILITATION PRACTICE. 
•  REHABILITATION SERVICE LEVELS
8.3.3 SERVICE PATHWAY
• A SERVICE PATHWAY OUTLINES THE GENERAL STEPS PEOPLE MAY EXPECT TO TAKE FOR A GIVEN
CONDITION OR NEED ALONG THE HEALTH AND SERVICE CONTINUUMS. A PATHWAY ALSO OUTLINES THE
SERVICE EXPECTATIONS FROM REHABILITATION PROVIDERS AND OTHER TEAM MEMBERS. EACH
PATHWAY IS AN ORGANIZED, EVIDENCE-INFORMED SERVICE OUTLINE. THERE ARE CLEAR ENTRY AND
EXIT POINTS WITHIN AN ORGANIZED SYSTEM OF SERVICE DELIVERY
8.3.4 POPULATION HEALTH NEEDS AND SYSTEM LINKAGES
• IN SYSTEM LEVEL SERVICE PLANNING, PART OF THE NEEDS IDENTIFICATION PROCESS INVOLVES: 
•  UNDERSTANDING THE POPULATION-BASED DRIVERS FOR A SERVICE OR PROGRAM;  
• IDENTIFYING REQUIRED LINKAGES FOR REFERRALS ACROSS THE SERVICE CONTINUUM;  
• IDENTIFYING CRITERIA FOR REFERRAL BASED ON STANDARDS THAT ARE EVIDENCE-INFORMED;
NUMBER OF INDIVIDUALS SERVED CLINICAL E.G., DIRECT CLIENT CARE (1:1, GROUP), COLLABORATIVE
SERVICE TARGETED SERVICES E.G., IN SERVICES, WORKSHOPS, CONSULTING UNIVERSAL SERVICES E.G.,
PUBLIC MESSAGES STAFF TIME/ SERVICE INTENSITY REHABILITATION CONCEPTUAL FRAMEWORK - 23 
• DEVELOPING A CLEAR REFERRAL PROCESS WITH ACCOMPANYING INFRASTRUCTURE TO SUPPORT THE
PROCESS AND GET THE RIGHT PEOPLE TO THE RIGHT SERVICE AT THE RIGHT TIME; AND 
• DEVELOPING CLEAR CRITERIA FOR IDENTIFYING PRIORITY ACCESS OR URGENCY, SERVICE INTENSITY,
FREQUENCY AND LEVEL OF SPECIALIZATION REQUIRED. 
THANK YOU