Abstract
The field of rehabilitation remains captive to the black-box problem: our inability
to characterize treatments in a systematic fashion across diagnoses, settings, and
disciplines, so as to identify and disseminate the active ingredients of those treatments.
In this article, we describe the Rehabilitation Treatment Specification System (RTSS),
by which any treatment employed in rehabilitation may be characterized, and ultimately
classified according to shared properties, via the 3 elements of treatment theory:
targets, ingredients, and (hypothesized) mechanisms of action. We discuss important
concepts in the RTSS such as the distinction between treatments and treatment components,
which consist of 1 target and its associated ingredients; and the distinction between
targets, which are the direct effects of treatment, and aims, which are downstream
or distal effects. The RTSS includes 3 groups of mutually exclusive treatment components:
Organ Functions, Skills and Habits, and Representations. The last of these comprises
not only thoughts and feelings, but also internal representations underlying volitional
action; the RTSS addresses the concept of volition (effort) as a critical element
for many rehabilitation treatments. We have developed an algorithm for treatment specification
which is illustrated and described in brief. The RTSS stands to benefit the field
in numerous ways by supplying a coherent, theory-based framework encompassing all
rehabilitation treatments. Using a common framework, researchers will be able to test
systematically the effects of specific ingredients on specific targets; and their
work will be more readily replicated and translated into clinical practice.
Keywords
List of abbreviations:
ICF (International Classification of Functioning, Disability and Health), RTSS (Rehabilitation Treatment Specification System), RTT (rehabilitation treatment taxonomy)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: September 26, 2018
Footnotes
Supported by Patient Centered Outcomes Research Institute (contract number ME-1403-14083).
Disclosures: none.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
