Defining paediatric neurorehabilitation: You cannot improve what you cannot characterize

Abstract

Neurorehabilitation is the primary therapy for neurological impairment in children, yet its potential to achieve change remains incompletely understood and probably underestimated. Understanding 'the difference neurorehabilitation can make' against a background of neurological repair and recovery as well as ongoing neurological development is an enormous challenge, exacerbated to no small extent by the lack of a 'common currency' for the description and measurement of the neurorehabilitation services a child is receiving. This review addresses attempts to parse neurorehabilitation treatment content in theoretically and mechanistically valid ways that might help address this challenge.

FIGURE 1

The process of specifying a rehabilitation treatment using the Rehabilitation Treatment Specification System. The treatment is divided into distinct treatment components, each with an operationally defined target and a set of corresponding ingredients. The mechanisms of action that link the selection of ingredients to their corresponding targets are at variable and evolving levels of precision, ranging from manipulation of specific physiologic processes to ‘learning by doing’.