1. Rehabilitation Medicine 1
Dr. G.M.Rommers
Department of Rehabilitation Medicine

2. Rehabilitation Medicine
• Rehabilitation Medicine is a branch of medicine which aims
to enhance and restore functional ability and quality of life
to those with physical impairments or disabilities.

3. What is fun in rehabilitation medicine?

4. What is fun in rehabilitation medicine?

5. What is fun in rehabilitation medicine?
• Different
• Total person concept
• Functioning

6. What is fun in rehabilitation medicine?
• Long ongoing contact
• Young and (very) old
• Technical solutions

7. Brinkhuis

8. What is fun in rehabilitation medicine?
• Real care
• After hospital a lot of work to
be done!
• Cure is not always possible

9. Participation or Handicap?
neutral language
• “politically correct”
• correct use
– intervention
– opportunity
–positive aspects

10. Leprocy Stroke Spinal cord
10

11. Universal Model vs. Minority Model
Everyone may have disability Certain impairment groups
Continuum Categorical
Multi-dimensional Uni-dimensional

12. ICF Components
Body Functions Activities Environmental
& & Factors
Structures Participation
Functions Capacity Barriers
Structures Performance Facilitators

13. ICF
Health Condition
(disorder/disease)

14. ICF
Health Condition
(disorder/disease)
Body Activities Participation
function&structure (Limitation) (Restriction)
(Impairment)

15. ICF
Health Condition
(disorder/disease)
Body Activities Participation
function&structure (Limitation) (Restriction)
(Impairment)
Environmental Personal
Factors Factors

16. ICF
Health Condition
(disorder/disease)
Body Activities Participation
function&structure (Limitation) (Restriction)
(Impairment)
Environmental Personal
Factors Factors

17. Vascular pathology / Diabetes Mellitus
500.000 people
with Diabetes in the
Netherlands
In 2020: 800.000

18. Entrance into the Healthcare system

19. General Practitioner
• GP visits in basic insurance
• Referral to paramedic and
podiatry treatment in local
area
• Referral to A&E Hospital and
Referral to Nursing Home
• Community care
• Local Council facilities
• National Alarm 1-1-2

20. Hospital (Footcare)
• Team approach towards
diabetic foot
• Frequent control of patient
• Case management
• Shoe prescription
• Funding by insurance
company

21. Hospital (Amputation)
• Preoperative screening by Spec PRM
• Functional approach
• Dialogue with Surgeon about operation
and preferred level of amputation
• Post operative stump formation
• Post operative paramedic treatment
• Referral for Post Hospital treatment
• Hospital period approx. 10 - 14 days

22. Rehabilitation Center
• 8000 admissions annually
• 42000 outpatients annually
• 15% of all amputees are
admitted to the Rehab Center

23. Community
• Local council for primary care
• Funding by local government
• Not the same in every local
council across the country
• Help; mobility items and
home adaptations
• New adaptations
• Domotica

24. Walking aids
Picure: ANP
• Presentation of a special beach rollator. Testers were elderly
people from the special care home : Sint Jacob in de Hout from
Overveen. There was a special beach race against people with an
ordinary rollator.
MC 2007

25. Take home message
• What is rehabilitation medicine?
• What makes rehabilitation medicine different
• Participation or handicap
• ICF components
• How to deal with a diabetic foot
• Community care