[The importance of the adaptation period in medical rehabilitation in attaining definitive work capacity]. / Vaznost perioda adaptacije u medicinskoj rehabilitaciji za postizanje definitivne radne sposobnosti.

ABSTRACT

Medical rehabilitation may bring functional improvement up to a level permitted by damages of the locomotor system, especially by those of the joints. At the start of rehabilitation the restricted motions are initially very painful and provoke an intensive protective spasm. In the course of rehabilitation the range of motions becomes more extensive, motions are less and less painful, until finally the pain disappears. The final condition which is medically considered as definite is the contracture due to damages of the joints and periarticular tissues. The process of rehabilitation includes a period of worker's adjustment to the new conditions. The worker learns to use the damaged part of the body in a different manner by means of adaptation, substitution and other mechanisms of adjustment. That is a period of voluntary control of the damaged parts, and yet some certain tenderness or pain is present. Adaptation is supposed to develop new neural patterns, a new sequence and coordination of motions, and consequently new motion schemes. So voluntary use of the damaged body part is substituted by automatic and painless control. Definite evaluation of working capacity and residual working ability is possible only after the period of adaptation.