the science

Our commitment to scientific rigor through functional contextualism drives our pursuit of evidence-based solutions for addressing complex human problems.

The Human Rehabilitation Framework (HRF)

The HRF is an initial working technology proof of concept prototype developed by the IOCH, purposefully crafted for advanced clinical reasoning in working with movement and pain problems. Its aim is to embrace the intricacies of the human experience, facilitating comprehensive, individualized care. The HRF moves beyond the conventional reliance on diagnoses and protocol-based strategies to offer an in-depth patient case management approach using a unified biopsychosocial language to bridge communication across multiple disciplines. Grounded in Applied Evolutionary Science and Network Theory, the HRF's construction cohesively aligns with the philosophy of functional contextualism, championing scientific rigor and precision.

Overview of HRF Benefits

  • Personalized Care through Network Sciences: Data-driven analytics tailor treatments to each patient's unique biopsychosocial processes. Supported by software that pragmatically moves the rehabilitation field into precision medicine and value-based care.

  • Embraces Applied Evolutionary Science: Embraces the contemporary multilevel selection theory of evolutionary science and prosocial behavior.

  • Coherent and Comprehensive Perspective built on Functional Contextualism: Emphasizes understanding of the individual's history and multiple levels of context for greater precision in individualized care.

  • Incorporation of Psychological Flexibility Processes: Encourages individual level growth of the client and clinician toward adaptability and responsiveness.

  • Emphasis on Biological Behavior: Embraces looking at health and life as biological behavior and adopting the behavior tradition of analysis and interventional perspective in the broader healthcare landscape.

  • Transdisciplinary and Software Technology Synthesis: Encourages collaboration across healthcare disciplines through a shared transdisciplinary language and supported by Process-Based Biopsychosocial Case Management Suite (PBB-CMS) software technology.

  • Embraces Biopsychosocial History and Context: Integrates a multilevel perspective of genetics, biologic behavior, and environment. Proactively addresses preventive measures and immediate health concerns to provide foresight and immediate insight, ensuring comprehensive care.

Clinical Overview of the HRF

The Human Rehabilitation Framework (HRF)

White Paper

1. Introduction

There is a global recognition for the need to transition from a biomedical model to a biopsychosocial (BPS) model of clinical practice that is relevant to rehabilitation and to treatment of pain and movement problems. Specific to pain, numerous national and international organizations including the International Association of Study of Pain (IASP), the World Health Organization (WHO), the International Olympic Committee (IOC), and the United States Department of Defense Veterans Affairs have made clear in their mission statements that there is a need for unified language regarding the basic understanding of pain mechanisms and the integration of BPS approaches in healthcare for the treatment of pain.1-3

The current biomedical model and the educational frameworks which support all major professional healthcare education systems have major knowledge deficits in the mechanisms and models of pain treatment, particularly the application of the BPS model of health to pain.4-6

Beyond pain, rehabilitation professions ranging from physical therapists, occupational therapists, athletic trainers, chiropractors, psychologists, physicians, to every level of the care team, lack a coherent comprehensive clinical framework that is transdisciplinary in nature. Across the domains of orthopedics, sports medicine, neurology, oncology, pediatrics, geriatrics, cardiopulmonary, integumentary, and their numerous subdomains, no frameworks exist that are shared across disciplines or domains.

Despite recognizing these gaps in knowledge, acceptance, and integration of BPS-based models for clinical practice is virtually non-existent in both private practices and hospital-based systems.7,8 Multiple healthcare disciplines have failed to transition due to concerns of limited incentives for adoption of the BPS model with current reimbursement models, the impact of the BPS model on workload, and inadequate resource availability for developing competence in BPS care.

Due to the poor acceptance of BPS-based models, healthcare consumers and medical providers have limited options and knowledge related to finding providers who utilize the BPS model.

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