חירות בטיפול הפיזיותרפי: היבט נוסף של תפקוד, מוגבלות ובריאות

Towards the end of the 20th century, health systems changed their approach to health and illness. They switched from the medical model to the bio-psycho-social model - which calls for health promotion, wellbeing, and prevention, and a more person-centered model. One expression of this change is the model depicted in the International Classification of Functioning Disability and Health (ICF), upon which the F-words model was developed. The latter consists of six terms relevant for the treatment of children (Function, Family, Fitness, Fun, Friends, and Future). The combination of both models creates an opportunity for a holistic perspective about health, function, and disability. This combined model encourages families and healthcare providers of persons with disabilities to acknowledge the diverse and universal needs of this population. In addition, it examines ways to encourage participation and development in an appropriate cultural environment, together with friends, including fun experiences, along with support for the promotion of functioning, activity, and fitness. The model aims to contemplate the day-to-day present and looks at the future and everything that it entails. It was suggested that a seventh term be added to the F-word model: freedom, which has significance for everyone, and in regard to all health situations In this perspective article, we examine the meaning of freedom in the context of physiotherapy intervention for persons with disabilities, contemplating the experiences and perspectives of children with physical disabilities and those of parents of children with physical disabilities. We discuss how freedom is embedded in the physiotherapy treatment in the different domains of the ICF model, and how freedom is included among the F-words. Moreover, supported by quotes from focus groups with children with motor disabilities and with parents of children with motor disabilities, we suggest that physiotherapy treatment serves as an opportunity for the promotion of the patient’s freedom, underscoring the importance of adding this component when treating all individuals. We recommend adding freedom as the seventh F-word to the model, symbolized by the addition of “freedom wings” to the model’s illustration.