White Book on Physical and Rehabilitation Medicine (PRM) in Europe. Chapter 1. Definitions and concepts of PRM.

In the context of the White Book of Physical and Rehabilitation Medicine (PRM) in Europe, this paper deals with the definitions and concepts relevant for PRM. Physical and Rehabilitation Medicine is the primary medical specialty responsible for the prevention, medical diagnosis, treatment and rehabilitation management of persons of all ages with disabling health conditions and their co-morbidities, specifically addressing their impairments and activity limitations in order to facilitate their physical and cognitive functioning (including behavior), participation (including quality of life) and modifying personal and environmental factors. To arrive to this PRM definition we need to consider a conceptual description of it. Several fundamental aspects must be observed namely functioning, disability and rehabilitation. These definitions include and are presented in this chapter: - Functioning: all that human bodies do and the actions that people perform. In the International Classification of Functioning, Disability and Health (ICF), functioning is operationalized in terms of functioning domains, and these domains are partitioned into the dimensions of Body Functions and Structures, Activities and Participation; - Disability: the problem a person has performing the actions that he or she needs and wants to do, because of how an underlying health condition - a disease, injury or even ageing - affects his or her performance in his or her actual environment; - Rehabilitation: a set of measures that assist individuals, who experience or are likely to experience disability, to achieve and maintain optimum functioning in interaction with their environments. The ICF definition of disability clearly distinguishes between problems that result entirely from the underlying health condition (capacity) from problems arising from the interaction between capacity and the environment and personal factors (performance). This paper approaches all these concepts that are essential to the understanding of the PRM strategy to evaluate disability and implement interventions that may lead to the improvement of functioning and health.