Author(s)

Fukumi Hiragami¹, Carol Ann Macdonald²

¹Research Institute of Health and Welfare, Kibi International University, Okayama, Japan.
²Johannesburg, South Africa.

This article critically examines the integration of the biopsychosocial (BPS) model of rehabilitation medicine with Cultural-Historical Activity Theory (CHAT) to propose a hybrid framework for culturally sensitive, contextually grounded rehabilitation practice. Building on Wade and Halligan’s expansion of the BPS model and Engeström’s Activity System model, the authors argue that health, disability, and recovery are best understood as dynamic, multidimensional processes embedded in social, cultural, and historical contexts. The paper contrasts the biomedical and biopsychosocial models, explores the application of CHAT to rehabilitation, and highlights cross-cultural differences, particularly between Western and Japanese rehabilitation paradigms. It shows that constructs like “independence” and “role restoration” are culturally mediated and that models of patient autonomy differ widely across systems. The integration of Wade’s structural insights with Engeström’s systemic analysis enables a more comprehensive account of rehabilitation as an evolving, socially mediated activity. The hybrid model is proposed not only as a conceptual scaffold for practice but also as a foundation for future research into the dynamic, culturally specific pathways of rehabilitation, patient engagement, and system transformation. Directions for future research are outlined, emphasizing the need for cross-cultural validation, systemic analysis of contradictions, and adaptive innovation in rehabilitation settings.

Rehabilitation Medicine, Biomedical Model, Biopsychosocial Model, Cultural Historical Activity Theory

Hiragami, F. and Macdonald, C.A. (2025) The Biopsychosocial Model in Rehabilitation Medicine and the Contribution of Cultural Historical Activity Theory. Open Journal of Social Sciences, 13, 315-347. doi: 10.4236/jss.2025.136022.