There are seven principles of rehabilitation; principles are the foundation upon which rehabilitation is based. This mnemonic may help you remember the principles of rehabilitation: ATC IS IT.
- A: Avoid aggravation. It is important not to aggravate the injury during the rehabilitation process. Therapeutic exercise, if administered incorrectly or without good judgment, has the potential to exacerbate the injury, that is, make it worse. The primary concern of the therapeutic exercise program is to advance the injured individual gradually and steadily and to keep setbacks to a minimum.
- T: Timing. The therapeutic exercise portion of the rehabilitation program should begin as soon as possible—that is, as soon as it can occur without causing aggravation. The sooner patients can begin the exercise portion of the rehabilitation program, the sooner they can return to full activity. Following injury, rest is sometimes necessary, but too much rest can actually be detrimental to recovery.
- C: Compliance. Without a compliant patient, the rehabilitation program will not be successful. To ensure compliance, it is important to inform the patient of the content of the program and the expected course of rehabilitation. Patients are more compliant when they are better aware of the program they will be following, the work they will have to do, and the components of the rehabilitation process.
- I: Individualization. Each person responds differently to an injury and to the subsequent rehabilitation program. Expecting a patient to progress in the same way as the last patient you had with a similar injury will be frustrating for both you and the patient. It is first necessary to recognize that each person is different. It is also important to realize that even though an injury may seem the same in type and severity as another, undetectable differences can change an individual’s response to it. Individual physiological and chemical differences profoundly affect a patient’s specific responses to an injury.
- S: Specific sequencing. A therapeutic exercise program should follow a specific sequence of events. This specific sequence is determined by the body’s physiological healing response and is briefly addressed in the next section of this chapter.
- I: Intensity. The intensity level of the therapeutic exercise program must challenge the patient and the injured area but at the same time must not cause aggravation. Knowing when to increase intensity without overtaxing the injury requires observation of the patient’s response and consideration of the healing process.
- T: Total patient. You must consider the total patient in the rehabilitation process. It is important for the unaffected areas of the body to stay finely tuned. This means keeping the cardiovascular system at a preinjury level and maintaining range of motion, strength, coordination, and muscle endurance of the uninjured limbs and joints. The whole body must be the focus of the rehabilitation program, not just the injured area. Remember that the total patient must be ready for return to normal activity or competition; providing the patient with a program to keep the uninvolved areas in peak condition, rather than just rehabilitating the injured area, will help you better prepare the patient physically and psychologically for when the injured area is completely rehabilitated.