Describing rehabilitation interventions

Rehabilitation is an effective process for reducing the morbidity and sometimes the mortality associated with many illnesses. This statement is supported by much evidence, but there is less evidence to support most specific actions undertaken in rehabilitation. In part this is inevitable because there are so many interventions. However the lack of an adequate system to classify and describe the complex interventions that constitute rehabilitation is also a great hindrance. This is in marked contrast to the detailed specification used in pharmacological research and reasonable description available for some surgical interventions. This editorial puts forward a classification system that is derived from two models relevant to rehabilitation: the World Health Organization's International Classification of Functioning model of illness and a model of rehabilitation described here. Interventions may be described in terms of the situations where these actions are applied, the immediate goals of any action, the level at which the intervention acts, the actions involved, the knowledge and skills needed to give the treatment, any specific equipment used, and any concomitant actions that may be necessary. In addition the context of the interventions should be described: the underlying theory or principles guiding actions, and the organization of the service internally, and in relation to other related services.