Rethinking Movement: From Capacity to Context

Area of Science:

• Rehabilitation Science
• Movement Science
• Disability Studies

Background:

• Clinical mobility assessments often fail to capture real-world performance and influencing factors.
• Current rehabilitation focuses on capacity, not actual real-life mobility.
• Spinal cord injury (SCI) exemplifies limitations in current mobility evaluation.

Purpose of the Study:

• To explore the dual role of movement in rehabilitation: as an outcome and a biomarker.
• To propose a new conceptualization of mobility that includes environmental, psychological, and behavioral factors.
• To highlight the shortcomings of capacity-based assessments in understanding real-world mobility.

Main Methods:

• Literature review framed within the International Classification of Functioning, Disability and Health (ICF).
• Analysis of current approaches using spinal cord injury as a case example.
• Integration of predictive modeling, pilot data, and lived experience insights.

Main Results:

• Clinical capacity measures do not fully represent real-world mobility performance.
• Environmental, psychological, and behavioral factors significantly influence mobility.
• A new mobility conceptualization is needed to capture real-life performance.

Conclusions:

• Rehabilitation should move beyond capacity to assess and promote real-world mobility.
• A context-aware, performance-focused approach is crucial for recovery and adaptation.
• Integrating diverse data sources enhances understanding of mobility in individuals with SCI and other conditions.