Precision Rehabilitation: Optimizing Function, Adding Value to Health Care

Margaret A French; Ryan T Roemmich; Kelly Daley; Meghan Beier; Sharon Penttinen; Preeti Raghavan; Peter Searson; Stephen Wegener; Pablo Celnik

doi:10.1016/j.apmr.2022.01.154

Precision Rehabilitation: Optimizing Function, Adding Value to Health Care

Arch Phys Med Rehabil. 2022 Jun;103(6):1233-1239. doi: 10.1016/j.apmr.2022.01.154. Epub 2022 Feb 15.

Authors

Margaret A French¹, Ryan T Roemmich², Kelly Daley¹, Meghan Beier¹, Sharon Penttinen³, Preeti Raghavan¹, Peter Searson⁴, Stephen Wegener¹, Pablo Celnik⁵

Affiliations

¹ Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD.
² Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD; Kennedy Krieger Institute, Center for Movement Studies, Baltimore, MD.
³ Technology Innovation Center, Johns Hopkins Medicine, Baltimore, MD.
⁴ Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD; Institute of Nanobiotechnology, Johns Hopkins University, Baltimore, MD, United States.
⁵ Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: pcelnik@jhmi.edu.

PMID: 35181267
DOI: 10.1016/j.apmr.2022.01.154

Abstract

Precision medicine efforts are underway in many medical disciplines; however, the power of precision rehabilitation has not yet been explored. Precision medicine aims to deliver the right intervention, at the right time, in the right setting, for the right person, ultimately bolstering the value of the care that we provide. To date, precision medicine efforts have rarely focused on function at the level of a person, but precision rehabilitation is poised to change this and bring the focus on function to the broader precision medicine enterprise. To do this, subgroups of individuals must be identified based on their level of function via precise measurement of their abilities in the physical, cognitive, and psychosocial domains. Adoption of electronic health records, advances in data storage and analytics, and improved measurement technology make this shift possible. Here we detail critical components of the precision rehabilitation framework, including (1) the synergistic use of various study designs, (2) the need for standardized functional measurements, (3) the importance of precise and longitudinal measures of function, (4) the utility of comprehensive databases, (5) the importance of predictive analyses, and (6) the need for system and team science. Precision rehabilitation has the potential to revolutionize clinical care, optimize function for all individuals, and magnify the value of rehabilitation in health care; however, to reap the benefits of precision rehabilitation, the rehabilitation community must actively pursue this shift.

Keywords: Personalized medicine; Precision medicine; Rehabilitation.

MeSH terms

Delivery of Health Care*
Humans
Precision Medicine*