||Re/habilitation - Holistic Approach Oriented by #Functionics
-- Underlying Concepts --
This site was created hastily for PT and OT students in 2004
when the author was teaching in a school of rehabilitation. So far
it is English and Japanese link collection and bulletin boards. We have
a lot of similar sites, so he needs originality, creativity, and background
philosophy for the sake of students, too.
The idea of top page, lists of principles and purposes, are
the result of many years of practice and presentation of his belief in
summary, so now the author has to explain them at least. English came first,
and the Japanese equivalence is its translation.
We began clinical practice right after graduation in 1981,
at a municipal mother-child training center for the handicapped in Kishiwada
City, Osaka. Although small, it was a fulfilling environment for us freshmen.
Of course we are proud of having worked since September 1981 before the
Bobath Hospital was founded in 1982. We worked supervised by Mr. Katsumasa
Kii, as well as Dr. Paul D. Andrew who wished to work both as a practitioner
After coming back to Gifu, the author worked with senior citizens
most of times. He experienced some geriatric health facilities and/or day
care facilities under nursing insurance system started in Japan in 2000.
Wherever he worked, he was a first therapist.
These principles he writes here, are necessary expression
for us clinicians though sound to be unusual. He studied the field of technique
starting that of the Bobaths, who impressed him by their flexible ideas
Three Practical Principles
1. A therapist is the true #Terran. (* people on the Earth in Latin)
Therapists easily stand for daily life. "Before professional,
be a man, ordinary citizen," it is often said, but a citizen is not
free from prejudices. Japanese live amid cultural prejudices as well as
having inferior complexity with Westerners, and superior complexity with
the developing countries. Working with sympathy for a person with disabilities,
or a weak person makes us free from biases. Dedicated days for the sake
of weak others are enough to try our humanity and completely change our
personality. Global citizenship is right before us.
2. From learning of disability into #Functionics
International Classification of Functioning, Disability,
and Health (ICF) was published in 2001 after revising International Classification
of Impairments, Disabilities, and Handicaps published in 1980. The beta-1
draft (1997) and beta-2 were open on the Internet to download and the discussion
among experts were very hot.
As the attached document IMPORTANT with beta-1 draft 1997 shows us that the main change is to focus
on more positive aspects rather that the 1980 Classification may have connoted
negative meanings. For example, according to the Classification of Impairments,
Disabilities, and Handicaps, we assess negative factors resulting in more
severe evaluation than reality. Classification of "Functioning,"
by the author's understanding, is that hard efforts including prognosis
or capacity looking for brighter aspects in people who have to live with
difficulties seem to have resulted in terminology change, and the 180 degree
It needs to creating not the learning of disability but the
'learning of functioning,' so the author calls for *functionics to have been created if difficult by a single person. Being aware of the
big change of principles, we keep studying and make use of it for our clinical
Problematique Accessibility in Japan, and functional environment © ErgoD.org Hida Project
The author has cared functional environment throughout his
career. A health professional living in a guild society of systematic learning,
suffering how to treat for the sake of patients and clients from whom s/he
learn, then s/he will become a problem-solving scientist. His first
work place was habilitation center of child-mother training supervised
by an OT most skillful to hand-make chairs, devices, or toys. Two
freshmen started working bedside training along the pioneering age of Bobath
Hospital experiencing to see Mr. Katsumasa Kii's work including hospital
designing once a week. The author had a chance to taking part in Japan
Ergonomics Society Convention on behalf of Dr. Paul D. Andrew and served
the first research committee chief. He remembers visited years after the
Hospital on his own wheelchair -- he bought to check accessibility issues
in Japan -- in the end of 20th century. He has cared functional environment
after devoting himself to senior citizens and re/habilitation of daily
life, of community based. His personal revision made to ICF table, which was inspired by WFOT document,
reflects problems in Japan.
１．Table 1. An overview of ICF, p. 11 International Classification of Functioning, Disability, and Health
(ICF), World Health Organization 2001
２．"IMPORTANT," ICIDH-2 (International Classification of Impairments, Disabilities,
and Handicap -2) Beta-1 Draft for Field Trials, WHO June 1997
３．International Classification of Functioning, Disability, and Health (ICF, WHO)
3. From dependence on others, through autonomy, to independence, (independent personality, and function)
From the bottom of our heart, with compassionate love,
Their love again in turn, spreads to their family and
It's a literal, not syllabical, translation
from his Japanese poem below; the principle of development and education:
他律から 自律をば経て 独立へ (独立人格、独立機能)
Four Fundamental Purposes
1. Newly-Established (after wars) self-Re-education based inValuable Effectiveness (NERVE)
The acronym NERVE does not only seek for integrating various neuro-physiological
approaches but notices the innovation and effectiveness of every approach.
The idea came to the author in 1994 when he visited the second time to
the U.S. alone for 5 weeks. In summary, aiming at an invaluable effectiveness
is our daily practice, and we have to treat clients with respect and target
for the best result if treatment time is limited or working under disadvantageous
conditions. This expression shows the attitude of the author as a clinician,
and of course the appreciation and respect for our forerunner therapists
who developed the treatment rapidly especially after wars.
2. Personality Education based on sound individualism accompanying professional
The issue of medicine and ethics is old and new. Hippocrates
of Cos, who is also an origin of the work of therapists, is called the
Father of Medicine, not only began the scientific medicine, but have done
a lot. Hippocratic Oath, attributed to earlier than him, is one of the most famous document, by
which many people urge that professionals should swear ethical conduct
as well as physicians.
It is an essential principle to be a human before expert
in modern days of cultural crises. The need of Humanitarian Education,
Personality Education is to clarify what is not sufficient in terms of
technique. It is never forced by others, but the autonomy and self-regulation
as a human who protect the independence and dignity of weak and suffering
3. Dedicate us to what is the most important.
Therapists, especially the author who is a physical therapist,
cares too much for physical functions. He intended to involve psychological
factors or life in general from the beginning, but found only "intended
to" afterwards. As we name rehabilitation or habilitation every effort
to restore and keep the "dignity" of people with disabilities,
we have to focus on dignified and diverse human themselves. The author
reaffirms with caution.
4. Therapists for Eco-Health
Copyright © Holistic Approach Hida, 2004 -