Chapter One: Introduction to Designing a Rehabilitation Program

LEARNING OBJECTIVES

INTRODUCTION

In many cases the biggest challenge to the inexperienced rehabilitation specialist is designing, implementing, and progressing the rehabilitation program. What are the appropriate rehabilitation modalities that should be used for a Grade II ankle sprain? Would passive or active range of motion be more effective? Can strengthening exercises be implanted the first day, or should it wait until day 7? Would ice, ultrasound, electrical stimulation, or a combination of these modalities be beneficial before or after exercise? Unlike the evaluation process, which is clearly delineated into a specific step-by-step process, the rehabilitation process is rarely defined in such a straightforward manner. The initial chapter of this text is designed to provide the learner with a clearly delineated process to follow to design a comprehensive, functional evaluation plan that allows for continual assessment and modification throughout the entire rehabilitation process.

OVERVIEW OF THE EVALUATION PROCESS

Any good rehabilitation plan must begin with a thorough, well-designed evaluation. Whether the evaluator follows the HIPS, HOPS, or HOPER model of injury evaluation (Table 1-1), the results will be the same.^1–5

The evaluation process is ongoing, meaning that after the initial evaluation the patient should be re evaluated after the first treatment to determine if the treatment is on path to meet the goals set forth by the clinician and patient. The patient has to be evaluated prior to and after each additional treatment to determine whether the rehabilitation plan is working or needs to be changed completely, modified, or progressed to more difficult activities. The evaluation process can be divided into several key parts, as demonstrated in Box 1-1.¹