From ancient Greece to the cognitive revolution: A comprehensive view of physical rehabilitation sciences

ABSTRACT

The development of rehabilitation has traditionally focused on measurements of motor disorders and measurements of the improvements produced during the therapeutic process; however, physical rehabilitation sciences have not focused on understanding the philosophical and scientific principles in clinical intervention and how they are interrelated. The main aim of this paper is to explain the foundation stones of the disciplines of physical therapy, occupational therapy, and speech/language therapy in recovery from motor disorder. To reach our goals, the mechanistic view and how it is integrated into physical rehabilitation will first be explained. Next, a classification into mechanistic therapy based on an old version (automaton model) and a technological version (cyborg model) will be shown. Then, it will be shown how physical rehabilitation sciences found a new perspective in motor recovery, which is based on functionalism, during the cognitive revolution in the 1960s. Through this cognitive theory, physical rehabilitation incorporated into motor recovery of those therapeutic strategies that solicit the activation of the brain and/or symbolic processing; aspects that were not taken into account in mechanistic therapy. In addition, a classification into functionalist rehabilitation based on a computational therapy and a brain therapy will be shown. At the end of the article, the methodological principles in physical rehabilitation sciences will be explained. It will allow us to go deeper into the differences and similarities between therapeutic mechanism and therapeutic functionalism.

KEYWORDS:

• Functionalist rehabilitation
• history of physical rehabilitation
• mechanistic rehabilitation
• physical rehabilitation sciences
• philosophy of physical rehabilitation

Acknowledgments

We thank David Gil Pinillos (working therapist), María De la Carrera Lantarón (occupational therapy), Mercedes Martínez Campos (occupational therapist), Óscar De Castro Nieto (psychologist), Raúl Guerra de la Montaña (physiotherapist), and Varinia García Sierra (speech therapist) for helping in reading and discussion about the classification of physical rehabilitation under mechanistic paradigm.

Declaration of interest

The author reports no declaration of interest.

Notes

¹ Descartes considered that the most basic elements of the human being were the mind and the body, each completely separate from the other.

² As a consequence of the theoretical principles of some singular therapies such as the Bobath concept and the Motor Relearning Programme, these therapies cannot simply be classified as mechanistic rehabilitation. Their therapeutic approaches must include some assumption of cognitive rehabilitation. This double classification is independent of the internal consistency of their theories.

³ The implementation of some of these new devices implies that mechanistic therapy is incorporating a computational view to rehabilitation. It will be extensively explained below.

⁴ This feature is attenuated in the functionalist approach because some therapeutic agents are self-generated by the person as, for instance, the mental practice.