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Fig. 1
Wider
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The game
In Fig. 2a and b, the y-axis represents the less-to-more
gradient of physicality of means, ranging from treatment from inside the body, on body parts to treatment
from outside the body, on a person. Although some of the
latter treatments may well appear to address only body
Fig. 2
E
I
From inside
the body
Physical means
From outside
the body
(a)
J
C
Rehabilitation goal
Biological functioning
within the body
From inside
the body
b
h
Physical means
From outside
the body
(b)
Biological functioning
within the body
Rehabilitation goal
+
Whole person functioning
in the outer world
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A cautionary note
(1) The 10 therapeutic and 10 diagnostic procedures
selected are just examples of a countless number of
procedures that might fall within the same quadrants.
(2) The proposed coordinates of the circles are clearly
semiquantitative and largely questionable. For example, within the top-left quadrant of Fig. 1a, two
therapeutic procedures may be equally physical but
one may be considered more rehabilitative than the
other if the former is expected to be more directly
related, compared with the latter, to an improvement
in persons behaviour. The same holds for the
diagnostic procedures in Fig. 1b, if one procedure is
expected to test more behavioural, less organ-bound
functions than the other. Of course, there may be
procedures that straddle several quadrants. Both the
coordinates and the match between circles and
procedures only reflect the authors opinion.
(3) The specific top-right procedures are not the only
ones in which PRM professionals are competent; the
same procedures may well be practised by other
specialists. Specificity is not an all-or-nothing attribute; yet this is not a good reason to not seek a
clearer discrimination.
Conclusion
Value judgment
05
610
1114
1418
Unacceptable
Insufficient, improvement unlikely
Sufficient, might improve
Good, can understand
PRM language
1920
Pathologist
Surgeon Anaesthesiologist
Internist Neurologist
Gerontologist specialist in sports
medicine specialist in Industrial/
Occupational Medicine
Psychiatrist Physiatrist
Take-home points
Acknowledgements
Conflicts of interest
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References
Franchignoni F, Salaffi F, Tesio L (2012). How should we use the visual analogue
scale (VAS) in rehabilitation outcomes? I: how much of what? The seductive
VAS numbers are not true measures. J Rehabil Med 44:798799.
Gutenbrunner C, Meyer T, Melvin J, Stucki G (2011). Towards a conceptual description of physical and rehabilitation medicine. J Rehabil Med 43:
760764.
Stucki G, Melvin J (2007). The international classification of functioning, disability
and health: a unifying model for the conceptual description of physical and
rehabilitation medicine. J Rehabil Med 39:286292.
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Specialization in medicine
Lajos Kullmann, Gusztav Barczi Faculty of Special Education, Eotvos Lorand
University of Sciences, Budapest, Hungary
Correspondence to Lajos Kullmann, Gusztav Barczi Faculty of Special Education,
Eotvos Lorand University of Sciences, Ecseri ut 3, 1097 Budapest, Hungary
Tel: + 36 30 962 3314; fax: + 36 1 348 3187;
e-mail: lajos.kullmann@barczi.elte.hu.
Received 9 January 2013 Accepted 12 January 2013
Copyright Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
Acknowledgements
Conflicts of interest
References
Copyright Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.