II anniversary of our book: Stroke rehabilitation: an activity based approach

It is 2 years since I and Vasanthan (with great deal of contribution from V. Prakash) released our book stroke rehabilitation: an activity based approach. I still consider it to be my best achievement in terms of scholarly work, even though when I read it, I find the language to be pedestrian.
So what is the book about? Well it is evidence based stroke rehabilitation with non-linearity ideas implemented within the task oriented paradigm.

The ICF model of functioning tells us that function of humans is in 3 levels body level, at the activity and participation level.  Importance to context was given its due diligence and the made clear the multifactoral nature of the influencing factors. Influencing factors were shown in a complex manner influencing each other rather than in a straight line.

Above picture shows- model of influencing factors of activity and participation in stroke. © Stroke Rehabilitation: A Functional Activity Based Approach, K. Hariohm

One of the assumptions I made when I read this was these influencing factors will influence each other in a complex non-linear manner. This was the time we were learning dynamic theory and I interpreted this model as non-linear model. (Well as Vasanthan always accused me – I always interpreted science as I like it or according to my bias rather than looking at it objectively.).
At the same time motor control ideas and motor behavior ideas were also pointing towards a dynamic perspective.

The Venn diagram shows where we have derived our ideas from for our book-as principle of treatment.

Our model within the task oriented paradigm shifted (as you can imagine- we have to be within task oriented paradigm as that is what is evidence pointing towards). We started to look at the system as non-linear system with inseparable subsystems. Even though it looks like the system is made up of many subsystems with unique function, my contention was it behaved as one unit and not separately.  Even though all this mumbo jumbo language is confusing to some it is in reality very simple.
The human system has many sub-systems- the motor, sensory, cognitive, cardio-pulmonary etc., while doing a function all of them act together rather than as individual systems.
What this lead to change in our model of stroke rehabilitation? Well, as you know task oriented treatment is the evidence based proven model, but the problem is definition what task to choose and whether the underlying impairments were to be treated.
Most of the text we read at that time –we started with Carr and Sheppards MRP and moved to other models and around 2005 we were with Anne shumway cooks motor control theory and practice- were not in tune with our changing perception.  The idea we were evolving at that time was- you don’t need to treat the underlying impairment- as I said earlier the subsystems in a non-linear complex system cannot function independent of the whole system. We also thought meaningful ask which are patient centric are the “task” to be selected rather than anything.
So, we started writing our book starting around 1999. Vasanth was dead against writing it as he wanted to find evidence for what I was saying rather than model validation. Well, we went ahead and when I finished one chapter I send it to 3 publishers got reply from 2 and one of them was willing to publish it- The Atlantic publishers (just grateful to those guys). We wrote our book for issues in Indian setting- example in sit to stand- deep knee flexion activities, in and out of an auto etc. Even though writing a book is such a pain it felt good when it was released 10-27-2013.    

If you want to read more about stroke rehabilitation with evidence and the underlying motor control and behavioural ideas-

AMAZON.IN
http://www.amazon.in/Stroke-Rehabilitation-Functional-Activity-Approach/dp/8126918543     

For international shipping

http://www.indianbooks.co.in/bookmart/stroke-rehabilitation-a-functional-activity-based-approach.html?currency=USD                for international shipping
U READ- http://www.uread.com/book/stroke-rehabilitation-k-hariohm-r/9788126918546          

Or mail me: hariohm@hotmal.com