title: Towards an ecologically grounded functional practice in rehabilitation.
abstract: According to the International Classification of Functioning, Disability and Health, effective rehabilitation requires interventions that go beyond minimizing pathological conditions and associated symptoms. The scope of practice must include promoting an individual's activity within relevant contexts. We argue that best practice requires decisions that are not only evidence-based but also theory-based. Perception and action theories are essential for interpreting evidence and clinical phenomena as well as for developing new interventions. It is our contention that rehabilitation goals can best be achieved if inspired by the ecological approach to perception and action, an approach that focuses on the dynamics of interacting constraints of performer, task and environment. This contrasts with organism-limited motor control theories that have important influence in clinical practice. Parallels between such theories and the medical model of care highlight their fundamental inconsistency with the current understanding of functioning. We contend that incorporating ecological principles into rehabilitation research and practice can help advance our understanding of the complexity of action and provide better grounding for the development of effective functional practice. Implications and initial suggestions for an ecologically grounded functional practice are outlined.
authors.affiliation: Departament of Physical Therapy, EEFFTO, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627 Campus - Pampulha, Belo Horizonte, MG CEP 31270-901, Brazil. Electronic address: danielavvaz@gmail.com.
authors.forename: Daniela Virgínia
authors.initials: DV
authors.lastname: Vaz
authors.affiliation: Department of Psychology, McMicken College of Arts & Sciences, University of Cincinnati, P.O. Box 210376, 4150M Edwards 1 Bldg, Cincinnati, OH 45221-0376, United States. Electronic address: paula.silva@uc.edu.
authors.forename: Paula Lanna
authors.initials: PL
authors.lastname: Silva
authors.affiliation: Department of Occupational Therapy, EEFFTO, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627 Campus - Pampulha, Belo Horizonte, MG CEP 31270-901, Brazil. Electronic address: mcmancini@ufmg.br.
authors.forename: Marisa Cotta
authors.initials: MC
authors.lastname: Mancini
authors.affiliation: Department of Psychology and Center for the Ecological Study of Perception and Action, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT 06269-1020, United States. Electronic address: claudia.carello@uconn.edu.
authors.forename: Claudia
authors.initials: C
authors.lastname: Carello
authors.affiliation: Center for the Ecological Study of Perception and Action, University of Connecticut, Doctor of Physical Therapy Program, Dept. of Kinesiology, Neag School of Education, 358 Mansfield Road, Unit 2101, Storrs, CT 06269-2101, United States. Electronic address: jeffrey.kinsella-shaw@uconn.edu.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Kinsella-Shaw
mesh_terms: D006233:Persons with Disabilities / Q000534:rehabilitation; D055317:Evidence-Based Practice; D006040:Goals; D006801:Humans; D064702:International Classification of Functioning, Disability and Health; D010465:Perception; D011214:Practice, Psychological; D012046:Rehabilitation / Q000379:methods* / Q000523:psychology*
keywords: Action; Ecological psychology; ICF; Perception; Rehabilitation