Moss Rehabilitation Research Institute, Elkins Park, PA.
Arch Phys Med Rehabil. 2014 Jan;95(1 Suppl):S17-23.e2. doi: 10.1016/j.apmr.2013.02.029.
Scientific theory is crucial to the advancement of clinical research. The breadth of rehabilitation treatment requires that many different theoretical perspectives be incorporated into the design and testing of treatment interventions. In this article, the 2 broad classes of theory relevant to rehabilitation research and practice are defined, and their distinct but complementary contributions to research and clinical practice are explored. These theory classes are referred to as treatment theories (theories about how to effect change in clinical targets) and enablement theories (theories about how changes in a proximal clinical target will influence distal clinical aims). Treatment theories provide the tools for inducing clinical change but do not specify how far reaching the ultimate impact of the change will be. Enablement theories model the impact of changes on other areas of function but provide no insight as to how treatment can create functional change. Treatment theories are more critical in the early stages of treatment development, whereas enablement theories become increasingly relevant in specifying the clinical significance and practical effectiveness of more mature treatments. Understanding the differences in the questions these theory classes address and how to combine their insights is crucial for effective research development and clinical practice.
科学理论对临床研究的进展至关重要。康复治疗的广泛性要求将许多不同的理论观点纳入治疗干预措施的设计和测试中。在本文中，定义了与康复研究和实践相关的 2 类广泛的理论，并探讨了它们对研究和临床实践的独特但互补的贡献。这些理论类别被称为治疗理论（关于如何影响临床目标变化的理论）和赋能理论（关于近端临床目标变化将如何影响远端临床目标的理论）。治疗理论提供了诱导临床变化的工具，但不能指定变化的最终影响范围有多大。赋能理论模拟了变化对其他功能领域的影响，但不能说明治疗如何产生功能变化。治疗理论在治疗开发的早期阶段更为关键，而赋能理论在指定更成熟治疗的临床意义和实际效果方面变得越来越重要。了解这些理论类别所解决问题的差异以及如何结合它们的见解，对于有效的研究开发和临床实践至关重要。
