THE SCIENTIFIC BACKGROUND OF PHYSICAL AND REHABILITATION MEDICINE: SPECIFICITY OF A CLINICAL SCIENCE

Physical Medicine and Rehabilitation is a medical speciality that is still seeking a clear definition of its contents. This uncertainty blurs its scientific identity. Does it only focus on individual behaviours, perceptions, and relationships, or on organs, too (if so, which ones)? This dichotomic view of a medical speciality reflects the drift of most medical specialities towards a reductionist model of the person as a biological object. This approach matches the consolidated paradigms of chemical-physical research to be applied to the human body and excludes the intangible person-world relationships from “truly scientific” interests without reason. However, the person-world interaction does exist, and it reflects motivations and values that are highly individual and influenced by cultural and social factors. During or after a disease or trauma, motivations and the capacities for resilience, learning and adaptation make highly variable the relationship between the focal damage and treatment on one side and disability and recovery on the other side. Therefore, the rehabilitation process needs specific knowledge and techniques. It is crucial to respect four specificities: the variables to be analysed, their measurement models, the trial designs and the statistics applied. This approach may make Physical and Rehabilitation Medicine emerge as a sound scientific speciality.