Functional restoration is not an act, It is a process which will take time There is no fast cure. It involves not only the injured person but the family, dependants, the employer, social services and many other agencies, all of whom have a part to play in the functional restoration process. A functional restoration/musculoskeletal disorder centre is but one part of that process. The aim is to create independence, to prevent dependence and to give the patient the opportunity to take control of their lives.
AlphaCares Functional Restoration Centres will treat those patients who have chronic or intractable musculoskeletal disorder usually, but not necessarily, following:-
- industrial injury
- road traffic accident
- other accident
These problems will, in the main, have been identified by a multidisciplinary assessment prior to joining the individually prepared programme for functional restoration. The preparation and agreement of the individual programme is done as part of the team approach. The multidisciplinary team will clearly take the lead in recommending the details and review dates, but the programme will only have chance of success if the patient and his or her family (together with the insurance company or case manager if the patient is referred by an insurance company) are involved in its preparation. A holistic approach to the programme is the cornerstone and all parties have to be committed to it. Once agreed it requires sympathetic implementation.
The preparation of the functional restoration programme will focus on outcomes and how they are to be measured.
This is an important aspect of treatment because it necessitates the determination of milestones in the programme. These not only give the patient something to focus on, encouraging success and stimulating progress but also provide the insurance company, general practitioner, consultant or case manager with dates against which to measure progress.
Multidisciplinary biopsychosocial rehabilitation does change lives for the better The progress may be slow but it is essential to monitor, record and encourage all aspects of progress, no matter how small. The stimulus from small successes will increase as more improvement is noticed and maintained.
The need to measure outcomes is indisputable Validated measures and questionnaires will be used as will self report measures, which will include mood (depressive symptoms), musculoskeletal disorder, beliefs (fear or anxiety, self efficacy, musculoskeletal disorder control), coping strategies (catastrophising, active coping, diversion) disability and medication use (analgesics and psychotropics). Over reliance on self-reporting measures will be avoided. Patient specific measures will be developed. Functional measures, which are demonstrably measurable such as physical function (observed walking or stair climbing times) and observed behaviour will be extensively used. AlphaCare will be constantly vigilant in its search for acceptable and recognised scales and will only use those for which validatory evidence is available and meet the standards promulgated by the Musculoskeletal Disorder Association and The Royal College of Anaesthetists and the British Society for Rehabilitation Medicine and the National Institute for Health and Clinical Excellence.
Functional restoration is a process, that can take time. AlphaCare will therefore, be providing follow-up services (including out-reach) and post discharge assessments, which will provide continuity of care for those able to go home but require regular or top up therapy.