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Re/habilitation - Holistic Approach Oriented by #Functionics
-- Underlying Concepts --
          Introduction

   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 and researcher.
   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 and humanitarianism:

         
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 change.
    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 practice.

    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.

Reference:
   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 society.

      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)
              心からなる 慈愛を込めて
              その慈愛また 家庭へ社会へ


         
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 training

    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 people.

 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

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