Vocational Rehabilitation for Individuals with Disabilities

CONTENTS
Introduction
Planning of Vocational Rehabilitation
Hand functions
Functional position
PT management of disabled hand
Vocational Rehabilitation
Procedure of Rehabilitation
Examples
INTRODUCTION
“ It is a process that assists individuals with impairments to overcome their handicap
and try to reintegrate them into society in to a job or vocation using their residual
physical and intellectual capacities
.1 ”
Or
Vocational rehabilitation is by definition a multidisciplinary intervention in a
process linked to the facilitation of return to work or to the prevention of loss of the
work.
2”
Usually done by a Vocational therapist, a member of socio-vocational team.
Identification of right job for individuals with respect to their residual abilities.
Vocational evaluation requires knowledge of condition of patient, their
medical history, observations, inventories and checklists where required
.
1.
S. Sunder; Textbook of Rehabilitation; 3
rd
 edition
2.
Gobelet C, Luthi F, Al-Khodairy AT, Chamberlain MA. Vocational rehabilitation: a multidisciplinary intervention. 
Disabil Rehabil
. 2007;29(17):1405-1410.
doi:10.1080/09638280701315060
REHAB PLANNING
Vocational rehab cannot be completed without assessment of hand
functions.
Cortical and sensory areas of brain reveals a quite sizeable area for
the hand.
Major share of thumb is represented in the brain.
Assessment for a successful vocational rehabilitation requires
careful observation of achievements, personality of individuals,
intelligence, aptitudes and personal interests of various differently
abled patients.
1.
S. Sunder; Textbook of Rehabilitation; 3
rd
 edition
2.
Gobelet C, Luthi F, Al-Khodairy AT, Chamberlain MA. Vocational rehabilitation: a multidisciplinary intervention. 
Disabil Rehabil
. 2007;29(17):1405-1410.
doi:10.1080/09638280701315060
HAND FUNCTIONS
1.
S. Sunder; Textbook of Rehabilitation; 3
rd
 edition
2.
Gobelet C, Luthi F, Al-Khodairy AT, Chamberlain MA. Vocational rehabilitation: a multidisciplinary intervention. 
Disabil Rehabil
. 2007;29(17):1405-1410.
doi:10.1080/09638280701315060
1.
S. Sunder; Textbook of Rehabilitation; 3
rd
 edition
2.
Gobelet C, Luthi F, Al-Khodairy AT, Chamberlain MA. Vocational rehabilitation: a multidisciplinary intervention. 
Disabil Rehabil
. 2007;29(17):1405-1410.
doi:10.1080/09638280701315060
Basic hand movements involved in the functions are:
1.
S. Sunder; Textbook of Rehabilitation; 3
rd
 edition
2.
Gobelet C, Luthi F, Al-Khodairy AT, Chamberlain MA. Vocational rehabilitation: a multidisciplinary intervention. 
Disabil Rehabil
. 2007;29(17):1405-1410.
doi:10.1080/09638280701315060
FUNCTIONAL POSITION
Best position of hand movement.
Wrist in 20 degree extension and 10
degree of ulnar deviation
45 degree flexion at
metacarpophalangeal joint
30 degree flexion at proximal and
interphalangeal joint.
 Thumb in midway opposition.
Preservation of normal transverse
and longitudinal arches.
1.
S. Sunder; Textbook of Rehabilitation; 3
rd
 edition
2.
Gobelet C, Luthi F, Al-Khodairy AT, Chamberlain MA. Vocational rehabilitation: a multidisciplinary intervention. 
Disabil Rehabil
. 2007;29(17):1405-1410.
doi:10.1080/09638280701315060
PINCHES/ PRECISION
THREE JAW CHUCK PINCH
LATERAL PINCH
 
 
TIP PINCH / TIP
TO TIP PINCH
1.
S. Sunder; Textbook of Rehabilitation; 3
rd
 edition
2.
Gobelet C, Luthi F, Al-Khodairy AT, Chamberlain MA. Vocational rehabilitation: a multidisciplinary intervention. 
Disabil Rehabil
. 2007;29(17):1405-1410.
doi:10.1080/09638280701315060
GRIPS OR GRASPS
CYLINDRICAL
 
SPHERICAL
HOOK
INTRINSIC PLUS
LATERAL PREHENSION
1.
S. Sunder; Textbook of Rehabilitation; 3
rd
 edition
2.
Gobelet C, Luthi F, Al-Khodairy AT, Chamberlain MA. Vocational rehabilitation: a multidisciplinary intervention. 
Disabil Rehabil
. 2007;29(17):1405-1410.
doi:10.1080/09638280701315060
PT MANAGEMENT OF DISABLED HAND
1. Sensory re-education
technique, by using similar
materials used by patients
priory in life and making
them guess the material
with eyes closed with
repetitions.
1.
S. Sunder; Textbook of Rehabilitation; 3
rd
 edition
2.
Gobelet C, Luthi F, Al-Khodairy AT, Chamberlain MA. Vocational rehabilitation: a multidisciplinary intervention. 
Disabil Rehabil
. 2007;29(17):1405-1410.
doi:10.1080/09638280701315060
PT MANAGEMENT OF DISABLED HAND
 
2. Mirror therapy widely
used these days to improve
hand functions
Patients with hemiplegia or
hemiparesis are often rendered with
this therapy in which normal limb is
placed in-front of mirror and disabled
limb at the back and is asked to
perform the same function as being
performed by the sound limb.
1.
S. Sunder; Textbook of Rehabilitation; 3
rd
 edition
2.
Gobelet C, Luthi F, Al-Khodairy AT, Chamberlain MA. Vocational rehabilitation: a multidisciplinary intervention. 
Disabil Rehabil
. 2007;29(17):1405-1410.
doi:10.1080/09638280701315060
PT MANAGEMENT OF DISABLED HAND
3. Motor re-education
by planning of
activities for patients
and asking them to
perform
independently. This
may also include
passive ROM exercises,
active- assisted ROM
exercises and various
task dependent
regimes to be
followed.
1.
S. Sunder; Textbook of Rehabilitation; 3
rd
 edition
2.
Gobelet C, Luthi F, Al-Khodairy AT, Chamberlain MA. Vocational rehabilitation: a multidisciplinary intervention. 
Disabil Rehabil
. 2007;29(17):1405-1410.
doi:10.1080/09638280701315060
VOCATIONAL REHABILITATION
Basic principles of vocational rehabilitation include:
 counselling by a professional counsellor
 providing empathy to patients
 allocation of work on the basis of individual’s ability, aptitude, skills,
interest and needs.
 home based employment for patients  who are home bound
 assistance to be provided to patients who are looking for self
employment.
1.
S. Sunder; Textbook of Rehabilitation; 3
rd
 edition
2.
Gobelet C, Luthi F, Al-Khodairy AT, Chamberlain MA. Vocational rehabilitation: a multidisciplinary intervention. 
Disabil Rehabil
. 2007;29(17):1405-1410.
doi:10.1080/09638280701315060
VOCATIONAL REHABILITATION
1.
S. Sunder; Textbook of Rehabilitation; 3
rd
 edition
2.
Gobelet C, Luthi F, Al-Khodairy AT, Chamberlain MA. Vocational rehabilitation: a multidisciplinary intervention. 
Disabil Rehabil
. 2007;29(17):1405-1410.
doi:10.1080/09638280701315060
PROCEDURE OF REHABILITATION
Disability evaluation by Vocational Rehabilitation Team
Counselling and Mental preparation of patient for job
Training of patients for job selected
Analysis of job on the basis of patient’s capabilities
Placement and modifications of job area and house
Timely review of job and individual’s satisfaction and needs
EXAMPLES
Vocational rehabilitation centres in India are
working continuously with patients of:
 Cerebral Palsy
 Autism
 Stroke
 Motor Neuron Disease
 Chronic arthritis
 Rheumatoid Arthritis
Neurodevelopmental Disorders
Spinal Cord Injury
 Blind, Deaf or Differently abled children
1.
S. Sunder; Textbook of Rehabilitation; 3
rd
 edition
2.
Gobelet C, Luthi F, Al-Khodairy AT, Chamberlain MA. Vocational rehabilitation: a multidisciplinary intervention. 
Disabil Rehabil
. 2007;29(17):1405-1410.
doi:10.1080/09638280701315060
Vocational rehabilitation of individuals suffering from
paraplegia rendered with a work of stitching with
training by Indian NGOs.
Vocational rehabilitation centre in India for CP and
Autistic Children for vocational training.
Vocational rehabilitation of Cancer
survivors in India
A vocational training centre in Chennai training
individuals with lower limb paralysis to weave clothes
for small scale industries
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Vocational rehabilitation is a multidisciplinary process aimed at helping individuals with disabilities reintegrate into society through job placement. This involves assessing hand functions, planning rehabilitation, and identifying suitable vocations based on individual abilities. Rehabilitation planning is crucial and involves evaluating hand functions through observation of achievements, personality traits, intelligence, and interests. Basic hand movements play a key role in rehabilitation, including expression, sensation, manipulation, and support. Vocational rehabilitation is essential for enabling individuals with disabilities to utilize their residual capacities and secure employment opportunities.

  • Vocational Rehabilitation
  • Disability
  • Rehabilitation Planning
  • Hand Functions
  • Multidisciplinary Intervention

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  1. VOCATIONAL REHABILITATION

  2. CONTENTS Introduction Planning of Vocational Rehabilitation Hand functions Functional position PT management of disabled hand Vocational Rehabilitation Procedure of Rehabilitation Examples

  3. INTRODUCTION It is a process that assists individuals with impairments to overcome their handicap and try to reintegrate them into society in to a job or vocation using their residual physical and intellectual capacities.1 Or Vocational rehabilitation is by definition a multidisciplinary intervention in a process linked to the facilitation of return to work or to the prevention of loss of the work.2 Usually done by a Vocational therapist, a member of socio-vocational team. Identification of right job for individuals with respect to their residual abilities. Vocational evaluation requires knowledge of condition of patient, their medical history, observations, inventories and checklists where required. S. Sunder; Textbook of Rehabilitation; 3rd edition Gobelet C, Luthi F, Al-Khodairy AT, Chamberlain MA. Vocational rehabilitation: a multidisciplinary intervention.Disabil Rehabil. 2007;29(17):1405-1410. doi:10.1080/09638280701315060 1. 2.

  4. REHAB PLANNING Vocational rehab cannot be completed without assessment of hand functions. Cortical and sensory areas of brain reveals a quite sizeable area for the hand. Major share of thumb is represented in the brain. Assessment for a successful vocational rehabilitation requires careful observation of achievements, personality of individuals, intelligence, aptitudes and personal interests of various differently abled patients. S. Sunder; Textbook of Rehabilitation; 3rd edition Gobelet C, Luthi F, Al-Khodairy AT, Chamberlain MA. Vocational rehabilitation: a multidisciplinary intervention.Disabil Rehabil. 2007;29(17):1405-1410. doi:10.1080/09638280701315060 1. 2.

  5. HAND FUNCTIONS S. Sunder; Textbook of Rehabilitation; 3rd edition Gobelet C, Luthi F, Al-Khodairy AT, Chamberlain MA. Vocational rehabilitation: a multidisciplinary intervention.Disabil Rehabil. 2007;29(17):1405-1410. doi:10.1080/09638280701315060 1. 2.

  6. S. Sunder; Textbook of Rehabilitation; 3rd edition Gobelet C, Luthi F, Al-Khodairy AT, Chamberlain MA. Vocational rehabilitation: a multidisciplinary intervention.Disabil Rehabil. 2007;29(17):1405-1410. doi:10.1080/09638280701315060 1. 2.

  7. Basic hand movements involved in the functions are: Expression Sensation Stabilization Manipulation Daily living tool Release Protection Support S. Sunder; Textbook of Rehabilitation; 3rd edition Gobelet C, Luthi F, Al-Khodairy AT, Chamberlain MA. Vocational rehabilitation: a multidisciplinary intervention.Disabil Rehabil. 2007;29(17):1405-1410. doi:10.1080/09638280701315060 1. 2.

  8. FUNCTIONAL POSITION Best position of hand movement. Wrist in 20 degree extension and 10 degree of ulnar deviation 45 degree flexion at metacarpophalangeal joint 30 degree flexion at proximal and interphalangeal joint. Thumb in midway opposition. Preservation of normal transverse and longitudinal arches. S. Sunder; Textbook of Rehabilitation; 3rd edition Gobelet C, Luthi F, Al-Khodairy AT, Chamberlain MA. Vocational rehabilitation: a multidisciplinary intervention.Disabil Rehabil. 2007;29(17):1405-1410. doi:10.1080/09638280701315060 1. 2.

  9. PINCHES/ PRECISION LATERAL PINCH THREE JAW CHUCK PINCH TIP PINCH / TIP TO TIP PINCH S. Sunder; Textbook of Rehabilitation; 3rd edition Gobelet C, Luthi F, Al-Khodairy AT, Chamberlain MA. Vocational rehabilitation: a multidisciplinary intervention.Disabil Rehabil. 2007;29(17):1405-1410. doi:10.1080/09638280701315060 1. 2.

  10. GRIPS OR GRASPS CYLINDRICAL SPHERICAL INTRINSIC PLUS LATERAL PREHENSION HOOK S. Sunder; Textbook of Rehabilitation; 3rd edition Gobelet C, Luthi F, Al-Khodairy AT, Chamberlain MA. Vocational rehabilitation: a multidisciplinary intervention.Disabil Rehabil. 2007;29(17):1405-1410. doi:10.1080/09638280701315060 1. 2.

  11. PT MANAGEMENT OF DISABLED HAND 1. Sensory re-education technique, by using similar materials used by patients priory in life and making them guess the material with eyes closed with repetitions. S. Sunder; Textbook of Rehabilitation; 3rd edition Gobelet C, Luthi F, Al-Khodairy AT, Chamberlain MA. Vocational rehabilitation: a multidisciplinary intervention.Disabil Rehabil. 2007;29(17):1405-1410. doi:10.1080/09638280701315060 1. 2.

  12. PT MANAGEMENT OF DISABLED HAND 2. Mirror therapy widely used these days to improve hand functions Patients with hemiplegia or hemiparesis are often rendered with this therapy in which normal limb is placed in-front of mirror and disabled limb at the back and is asked to perform the same function as being performed by the sound limb. S. Sunder; Textbook of Rehabilitation; 3rd edition Gobelet C, Luthi F, Al-Khodairy AT, Chamberlain MA. Vocational rehabilitation: a multidisciplinary intervention.Disabil Rehabil. 2007;29(17):1405-1410. doi:10.1080/09638280701315060 1. 2.

  13. PT MANAGEMENT OF DISABLED HAND 3. Motor re-education by planning of activities for patients and asking them to perform independently. This may also include passive ROM exercises, active- assisted ROM exercises and various task dependent regimes to be followed. S. Sunder; Textbook of Rehabilitation; 3rd edition Gobelet C, Luthi F, Al-Khodairy AT, Chamberlain MA. Vocational rehabilitation: a multidisciplinary intervention.Disabil Rehabil. 2007;29(17):1405-1410. doi:10.1080/09638280701315060 1. 2.

  14. VOCATIONAL REHABILITATION Basic principles of vocational rehabilitation include: counselling by a professional counsellor providing empathy to patients allocation of work on the basis of individual s ability, aptitude, skills, interest and needs. home based employment for patients who are home bound assistance to be provided to patients who are looking for self employment. S. Sunder; Textbook of Rehabilitation; 3rd edition Gobelet C, Luthi F, Al-Khodairy AT, Chamberlain MA. Vocational rehabilitation: a multidisciplinary intervention.Disabil Rehabil. 2007;29(17):1405-1410. doi:10.1080/09638280701315060 1. 2.

  15. VOCATIONAL REHABILITATION S. Sunder; Textbook of Rehabilitation; 3rd edition Gobelet C, Luthi F, Al-Khodairy AT, Chamberlain MA. Vocational rehabilitation: a multidisciplinary intervention.Disabil Rehabil. 2007;29(17):1405-1410. doi:10.1080/09638280701315060 1. 2.

  16. PROCEDURE OF REHABILITATION Disability evaluation by Vocational Rehabilitation Team Counselling and Mental preparation of patient for job Training of patients for job selected Analysis of job on the basis of patient s capabilities Placement and modifications of job area and house Timely review of job and individual s satisfaction and needs

  17. EXAMPLES Vocational rehabilitation centres in India are working continuously with patients of: Cerebral Palsy Autism Stroke Motor Neuron Disease Chronic arthritis Rheumatoid Arthritis Neurodevelopmental Disorders Spinal Cord Injury Blind, Deaf or Differently abled children S. Sunder; Textbook of Rehabilitation; 3rd edition Gobelet C, Luthi F, Al-Khodairy AT, Chamberlain MA. Vocational rehabilitation: a multidisciplinary intervention.Disabil Rehabil. 2007;29(17):1405-1410. doi:10.1080/09638280701315060 1. 2.

  18. Vocational rehabilitation of individuals suffering from paraplegia rendered with a work of stitching with training by Indian NGOs.

  19. Vocational rehabilitation centre in India for CP and Autistic Children for vocational training.

  20. Vocational rehabilitation of Cancer survivors in India

  21. A vocational training centre in Chennai training individuals with lower limb paralysis to weave clothes for small scale industries

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