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Response to Precision Rehabilitation: Optimizing Function, Adding Value to Health Care

  • R. James Cotton
    Affiliations
    Department of Physical Medicine and Rehabilitation, Northwestern University; Shirley Ryan AbilityLab, Chicago, Illinois
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  • Richard L. Segal (Rick)
    Affiliations
    Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, South Carolina
    Department of Rehabilitation Sciences, College of Health Professions, Medical University of South Carolina, Charleston, South Carolina
    National Center of Neuromodulation for Rehabilitation, Medical University of South Carolina, Charleston, South Carolina
    NIH/NICHD/NCMRR Medical Rehabilitation Research Resource Network National Coordinating Center, Charleston, South Carolina
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  • Bryant A. Seamon
    Affiliations
    Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, South Carolina
    Department of Rehabilitation Sciences, College of Health Professions, Medical University of South Carolina, Charleston, South Carolina
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  • Amrita Sahu
    Affiliations
    Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pennsylvania
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  • Michelle M. McLeod
    Affiliations
    National Center of Neuromodulation for Rehabilitation (NC NM4R), Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, South Carolina
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  • Randal D. Davis
    Affiliations
    Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, South Carolina
    National Center of Neuromodulation for Rehabilitation, Medical University of South Carolina, Charleston, South Carolina
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  • Sharon Landesman Ramey
    Affiliations
    Fralin Biomedical Research Institute, Virginia Tech, Roanoke, Virginia
    VTC School of Medicine, Roanoke, Virginia
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      We commend French et al
      • French MA
      • et al.
      Precision rehabilitation: optimizing function, adding value to health care.
      on their excellent timely contribution to the evolving field of precision medicine with a strong focus on functional real-world outcomes. In June 2021 our National Institutes of Health Medical Rehabilitation Research Resource Network hosted a Precision Rehabilitation conference that endorsed many topics well delineated by French et al. Among these are the need for greater standardization and precision in measuring function, more frequent and longitudinal assessments, use of more varied study designs and heterogeneous patient populations, and strategic use of technology advances (electronic health records, wearable devices). Their emphasis on prediction, innovation in big-data analytical approaches, and collaborative team science is commendable but seriously limited by omitting 3 salient topics from the retreat and subsequent discussions: (1) the value of patients as active collaborators, (2) the potential high effect of genomics and biomarkers, and (3) the need for a unifying transdisciplinary framework to guide research and practice. We write this letter to stimulate further dialogue and inspire innovation.
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        Precision rehabilitation: optimizing function, adding value to health care.
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      Linked Article

      • Response to Letter to the Editor Regarding “Precision Rehabilitation: Optimizing Function, Adding Value to Health Care”
        Archives of Physical Medicine and Rehabilitation
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          We thank the authors of this Letter to the Editor for their interest in our article and the Editors for the invitation to respond. We agree on the need for a unifying conceptual framework and the value that this would add to guiding precision rehabilitation. We also support the need to include patients as active collaborators and recognize the potential role of genetics in precision medicine. However, we do wish to underscore the importance of careful measurement and monitoring of whole-person function as the core of precision rehabilitation.
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