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SPECIAL ARTICLE Open access
European Journal of Physical and Rehabilitation Medicine 2024 April;60(2):182-9
DOI: 10.23736/S1973-9087.24.08309-6
Copyright © 2024 THE AUTHORS
This is an open access article distributed under the terms of the CC BY-NC-ND 4.0 license which allows users to copy and distribute the manuscript, as long as this is not done for commercial purposes and further does not permit distribution of the manuscript if it is changed or edited in any way, and as long as the user gives appropriate credits to the original author(s) and the source (with a link to the formal publication through the relevant DOI) and provides a link to the license.
language: English
Physical and Rehabilitation Medicine: say relational or functional, not holistic
Luigi TESIO 1, Stefano SCARANO 1, 2 ✉, Antonio CARONNI 1, 2
1 Department of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy; 2 Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
Modern medicine tends to privilege disciplines promising “objective“ laws governing body parts (from molecules to organs). Studies on a person’s illness and disability are (apparently) confined to “subjectivity.” The Specialty of Physical and Rehabilitation Medicine is often regarded as a humanitarian approach, belonging at best to the family of “soft,” “qualitative,” or “quasi-experimental” sciences. This specialty often claims specificity by labelling itself as “functional” and “holistic.” However, it is shown here that the former term is acceptable, yet redundant, and the second misleading. When human behaviors and perceptions are at stake, “function” indicates a person’s relationship with the outer world (already tackled by the definitional term “physical” from the Greek “physis”). The word “holistic” emphasizes mind-body unity and person-environment interdependence but, in current usage, overshadows the complementary need for an analytic, experimental approach to any function. Medicine aims at fighting disease and disability in single persons. This endeavor requires knowing body parts and mechanisms and understanding how interventions on “parts” affect the “whole.” This understanding rests on the experimental method. For instance, returning to a given societal role (participation) may require restoration of walking (activity), which may require reinforcement of weakened muscular groups (impairment). Working only on holistic bio-psycho-social “wholes” may miss the therapeutic mission of medicine.
KEY WORDS: Rehabilitation; Physical and rehabilitation medicine; Holistic health