Function is widely defined as whatever somebody needs to do in their life. It is a purpose, task, or activity that needs to be fulfilled by an individual to carry out their everyday lives.The twin goals of a successful rehabilitation programme are REDUCING DISTRESS and INCREASING FUNCTION.

The goal of the D2M Functional Rehabilitation Programme is to provide functionally relevant and personalised rehabilitation. The programme uses evidence-based techniques, combining physical and psychosocial interventions, that engage the whole body and are task-specific. D2M’s services are intended to help active people rebuild, reclaim, and rediscover their full potential.

D2M’s Functional Rehabilitation Programme is a different model of rehabilitation compared to standard physiotherapy services, which typically charge an hourly rate and are delivered in a clinic facility.

The D2M Functional Rehabilitation Programme offers a multi-dimensional package of care with a clear start, review, and end points (rather than a per-session cost). Crucially, the D2M Functional Rehabilitation Programme work takes place in environment-specific locations such as the home, workplace, gym, park, or other specific settings, like rock climbing walls.

This approach helps the clinician understand and address psychological and social factors, such as fear avoidance beliefs/behaviours, in meaningful environments, which is often difficult to simulate in a clinic room setting.

The service is for active people who have suffered severe orthopaedic and / or polytrauma injury. Those we work with have often already completed the majority or all of their surgical input, in-patient therapy, and acute rehabilitation.

The D2M Functional Rehabilitation Programme often is provided to those who have already completed and had a plateau with standard input but have still haven’t been able to resume their physically demanding jobs, hobbies, or daily lives.

• Musculoskeletal injuries
• Complex persistent pain conditions
• Orthopaedic trauma and surgery
• Multiple injury and trauma

• Return to work for physically demanding tasks or environments
• Return to regular physical activity for hobbies, leisure, or sport, including outdoor walking
• Return to day-to-day functional activity to enhance independence and quality of life
• Improved self-management strategies and coping confidence

Support is provided for occupations such as engineering and manufacturing, agricultural and outdoor work, health care providers, emergency services and rescue personnel, and sport, recreation and leisure professionals.

Specific examples of reactional activities clients have returned to include riding their motorbike, outdoor walking and rock climbing.

A client is considered ready to refer if they meet criteria such as:

• Having completed tests/surgery (excluding metalwork removal) and being able to fully weight bear.
• Nearing completion of standard therapy.
• Having a relatively stable pain state that allows them to complete functional tests during the assessment.
• Having unmet goals for work or leisure, often resulting in them asking, “is this it?”.
• Long-term goals involving a return to physical activities, job tasks, or unusual environments.
• A readiness to engage in an active rehabilitation approach and being motivated to reach goals.

Clients who are not ready and should NOT be referred include those:

• Still having tests/surgery (excluding metalwork removal), including non or partial weight bearing.
• Early in standard therapy, or if current goals can be met by standard therapy.
• Having acute and severe pain and/or active pathology (e.g., CRPS) requiring stabilisation before rehab.
• Having very high levels of psychological distress requiring psychological management before rehab.
• Unlikely to be able to complete the assessment (e.g., bed bound due to extent of disability).
• Having no significant physical demands for work or leisure.

The D2M Functional Rehabilitation Programme journey consists of three phases:

1. REBUILD: Focuses on rebuilding movement foundations, managing symptoms, and rapid improvements in movement and confidence. It is the most intense phase, usually lasting 4 months, with weekly or fortnightly sessions of 2-3 hours.

2. RECLAIM: Progress slows considerably compared to the REBUILD phase. This phase focuses on re-evaluating goals, fine-tuning specific problems, and rationalising the programme to fit rehab in with real-life needs like returning to work. It lasts about 4 months, with sessions likely being fortnightly then monthly.

3. REDISCOVER: This final phase aims to sustain progress and gain independence. It ensures the client has the tools needed for self-management and confidence to continue without “medical/therapy” support. This phase lasts about 3 months, with monthly sessions.

Treatment coverage includes Liverpool, Leeds, Manchester, Sheffield, Newcastle, Matlock, Nottingham, Leicester, London, Birmingham, Milton Keynes, Oxford, Cardiff and Southampton.

If you have a referral in another area, please reach out to us to see if we can support your client.

The D2M Functional Rehabilitation Programme collects detailed outcome measures to monitor progress. 2019 service outcome data showed positive progress:

• Quality of Life: The average Musculoskeletal Health Questionnaire (MSK-HQ) score improved by 9 points from assessment to re-assessment.
• Goal Achievement: The average score for overall goals improved from 3/10 at initial assessment to 8/10 at re-assessment.
• Return to Work: At the final re-assessment, all clients had returned to work in some capacity, compared to 88% of referrals not working at initial assessment.