Journal of Rehabilitation Medicine 51-4inkOmslag | Page 10
J Rehabil Med 2019; 51: 244–247
SPECIAL REPORT
A EUROPEAN ACADEMY OF REHABILITATION MEDICINE ACADEMIC DEBATE:
DESCRIBING EXPERIENCED HEALTH ON THE BASIS OF THE WHO’S MODEL OF
FUNCTIONING (ICF) OR ON THE THEORY OF SOCIAL PRODUCTIVITY
Carlotte KIEKENS, MD 1,2 , Jean-Pierre DIDIER, MD, PhD 3 , Antti MALMIVAARI, MD, PhD 4,5 , Stefano NEGRINI, MD 6,7 and
Christoph GUTENBRUNNER, MD, PhD 8
From the 1 University Hospitals Leuven, Department of Physical and Rehabilitation Medicine, Leuven, Belgium, 2 KU Leuven – University
of Leuven, Department of Development and Regeneration, Leuven, Belgium, 3 Université de Bourgogne Franche Comté, Dijon, France,
4
Centre for Health and Social Economics, National Institute for Health and Welfare, 5 Orton Orthopaedic Hospital, Scientific Unit, Helsinki,
Finland, 6 Department of Clinical and Experimental Sciences, University of Brescia, Brescia, 7 IRCCS Fondazione Don Gnocchi, Milan,
Italy and 8 Department of Rehabilitation Medicine, Hannover Medical School, Hannover, Germany
The first Academic Debate was held within the Eu-
ropean Academy of Rehabilitation Medicine (EARM)
in Budapest in 2016. The question debated was: is
it possible to provide a theory neutral framework to
describe the lived experience of health or is there
an appropriate theory to understand what constitute
the most relevant factors in health (and well-being).
First the link between the International Classifica-
tion of Functioning, Disability and Health (ICF) and
rehabilitation as a key health strategy was explai-
ned. It was then argued that supplementing the ICF
by theory-based approaches (e.g. a theory of social
productivity) may advance explanations with regard
to participation and links with health and well-being.
Thirdly, it was recalled that one of the strengths of
the ICF is exactly being “theory neutral”. There was
no doubt that there is a need for scientific theories to
describe functioning and health. The theory of social
productivity seems to be an important contribution
towards this goal. However, the definition of well-
being in relation to the operationalization of functio-
ning and health needs to be further developed. The
conclusion cannot be an “either-or” (classification
vs theory). Projects should be set up both to further
develop the ICF and to refine (or develop new) theo-
ries.
Key words: rehabilitation; International Classification of
Functioning, Disability and Health; well-being; social produc-
tivity.
Accepted Jan 30, 2019; Epub ahead of print Feb 15, 2019
J Rehabil Med 2019; 51: 244–247
Correspondence address: Carlotte Kiekens, University Hospitals Leu-
ven, Department of Physical and Rehabilitation Medicine, Leuven, Bel-
gium: E-mail: [email protected]
A
cademic Debates within the European Academy of
Rehabilitation Medicine (EARM) are structured
discussions between 2 experts taking a different posi-
tion with regard to a single relevant topic in the field of
Rehabilitation Medicine (1). Based on an initiative by
Bengt H. Sjölund and Gerold Stucki in the Foresight
Committee and a decision of the General Assembly
in 2015, the first Academic Debate was held within
the European Academy of Rehabilitation Medicine
LAY ABSTRACT
In the European Academy of Rehabilitation Medicine a
debate was held on whether it is possible to describe
the lived experience of health in a neutral way, or if
we need theories to understand what the most relevant
factors of health (and well-being) are. This was illustra-
ted with the case of creating better social relationships
by being productive, for example through work. The in-
ternational Classification of Functioning, Disability and
Health (ICF) provides a framework and classification to
describe health and functioning and is “theory neutral”
over cultures. However, ICF should be further developed
and scientific theories are needed to be able to better
measure, describe and explain health, functioning and
well-being. The debate raised important questions that
require more study and discussions.
(EARM) in Budapest on 1 September 2016. The topic
of the debate was the description of health using the
conceptual framework of the International Classifica-
tion of Functioning, Disability and Health (ICF) and the
theory of social productivity. It was based on the article
entitled “Olle Höök Lectureship 2015: The World Health
Organization’s paradigm shift and implementation of the
International Classification of Functioning, Disability
and Health in Rehabilitation” by Gerold Stucki (2),
the paper entitled “Fair opportunities, social producti-
vity and well-being in disability: towards a theoretical
foundation” by Johannes Siegrist & Christine Fekete
(3), and the commentary “Reply to ‘fair opportunities,
social productivity and well-being in disability: towards
a theoretical foundation’” by Jerome Bickenbach (4).
All academicians could contribute to the debate. In
addition, Johannes Siegrist and Jerome Bickenbach were
invited. Carlotte Kiekens volunteered to prepare a report
(together with Christoph Gutenbrunner). All members
of the Academy were asked to send further comments
after the debate (Stefano Negrini responded to this call).
AN ESSAY, A THEORY AND A
COMMENTARY
The debate was introduced by Gerold Stucki sum-
marizing the essay based on the Olle Höök lecture he
This is an open access article under the CC BY-NC license. www.medicaljournals.se/jrm
doi: 10.2340/16501977-2533
Journal Compilation © 2019 Foundation of Rehabilitation Information. ISSN 1650-1977