Maximizing the functional performance outcomes of patients undergoing rehabilitation by maximizing their overall health and wellbeing

Abstract

To maximize the performance of an athlete, a team of experts work together to ensure each athlete achieves the maximal benefit from their prescribed exercise conditioning programs. In addition to the exercise specialists, the athlete's team frequently includes psychologists (who address performance anxiety, stress, and depression), counselors (who address smoking cessation, reduction or elimination of alcohol consumption if necessary, weight optimization, and optimal sleep), and nutritionists (who address optimal nutrition and body mass attributes). Such a collaborative approach has become standard practice for athletes aiming to excel in their sports. Despite unequivocal and compelling evidence, this paradigm has only weakly been transferred to the needs of patients participating in rehabilitation programs. These individuals, like the athlete, also need to achieve their highest level of functional performance and recovery for carrying out their activities of daily living, managing the needs of their families, and often returning to work. This article reviews the evidence-based literature and the implications of this multifaceted approach in rehabilitation programs. The augmented benefits to exercise training and conditioning (prescriptive activity/exercise and less sitting) along with their 'effect sizes' are described in the rehabilitation context, in conjunction with smoking cessation, reduced harmful alcohol consumption, optimal nutrition, optimal body mass, manageable stress, and optimal sleep. These factors can be viewed as physical performance enhancers both in individuals participating in rehabilitation whose aim is maximal performance and recovery and in athletes aiming for maximal performance in their sports. Thus, without targeted attention to these lifestyle factors, rehabilitation outcomes cannot be maximized. The evidence presented in this article has implications for health professionals including physical therapists and others who are practicing in rehabilitation settings and those working with individuals in need in the community.