According to the World Health Organization, 2.4 billion people around the world are living with a health condition that would benefit from rehabilitation, and yet, less than 50% of these people are receiving the care and treatment they deserve. As life expectancy rises globally, medical professionals are urgently working to prepare the next generation of rehabilitation specialists. Physical therapists, occupational therapists, and speech language pathologists are all critical parts of the rehabilitation process, as are the researchers and academics who drive the development of new tools, redefine approaches, and provide the evidence to support the considerable work these practitioner’s handle.
As the world changes, it’s clear that rehabilitation must change as well, if only to keep up. At the MGH Institute of Health Professions, faculty – and, in turn, students – operate with a multi-dimensional approach.
For Yuchao Wang, DPT ’24, this two-pronged mindset has driven his studies, and drew him to study physical therapy at the IHP. Here, he and his professors agree that research and science should drive clinical decision making. But it hasn’t always been this way.
“I’ve observed that as time passes, rehabilitation has become more evidence-based than ever before. It’s literature and current research that informs clinical decisions, and it’s an increase in interdisciplinary communication across the care team that makes this informed decision-making possible,” Wang shared.
“This communication extends to even include engineers, and those who are creating new tools to assist in rehabilitation. It’s this research-based approach that allows us as clinicians to push patients to get better, instead of waiting for them to get better. All of this comes together to improve patient outcomes.”
Professor Teresa Jacobson Kimberley, Director of the Brain Recovery Lab and PhD in Rehabilitation Sciences, agrees, and points to the ways that technology and new research findings have informed – and progressed – rehabilitative care.
“In the last several years, rehabilitation approaches have evolved as new research and technology has informed treatment. We have new measurement tools like activity trackers and disease specific tests to help us use data to help predict recovery trajectory and inform therapy,” Dr. Kimberley said.
“Importantly, there are innovations on the horizon that go beyond what I could have imagined when I first started out as a PT. As an example, we now can apply brain stimulation in conjunction with therapy to help facilitate how the brain recovers.”
Laura Plummer, Interim Co-Dean, Chair, Associate Professor in the IHP’s Physical Therapy program, notes that rehabilitation has changed in response to technology and that clinical care has evolved to become more evidence based.
“There have been amazing advances in physical therapy rehabilitation over the past decade, and with new research and evidence, the profession has published more clinical practice guidelines for conditions that required physical therapy care,” she said.
“In our field, we’re using technology more than ever before and these new tools were created based on research, and are now integrated into clinical practice.”
From an occupational therapy perspective, patient-centered care approaches have seen renewed dedication over recent decades, says Regina Doherty, Chair and Professor of the Occupational Therapy program.
“Occupational therapy has always been rooted in meaningful activity and participation, but the field of rehabilitation science now has a shared value on true patient and family-centered care, addressing what matters most to clients, targeting interventions and technologies to improve quality of life.”
She too noted the role of research and evidence in rehabilitation and the role of occupational therapy in wellness and health outcomes.
“Evidence-based care, technology development, implementation science, and stakeholder engagement have all led to improved outcomes with recent studies documenting that occupational therapy services can decrease healthcare costs and maintain health,” she observed. “These days, there is a broader commitment to interprofessional and interdisciplinary collaborations expanding OT services for clients with disability and non-disability related needs to advance health, wellness, and social participation with groups, communities and populations.”
While physical and occupational therapy are most thought of, speech language pathology plays a critical role in the “big three” areas of rehabilitation.
“In recent years, rehabilitation for speech and language ‘disorders’ in children has increasingly pivoted to a strengths-based perspective that recognizes a wider range of variability in behaviors that we see in ‘typical’ and ‘atypical’ development,” said Marjorie Nicholas, Interim Co-Dean, Chair, Professor of the Communication Sciences and Disorders program. “Our students learn more about how to determine whether a speech or language behavior is a difference rather than a disorder."
“In adult rehabilitation for speech, voice, language, cognitive, and swallowing disorders, the field has benefitted from an inter-professional practice perspective to focus more on life participation and functional recovery and less on just fixing impairments of body structure or functions.”
Looking ahead, the field of rehabilitation will continue to evolve in response to the needs of those it serves. Experts at IHP predict significant change is on the horizon, especially in the way technology can catalyze patient improvements and what science can tell us about the intricacies of how the body and brain operate.