Physical Medicine and Rehabilitation

An Introduction

PM&R Interest Group at

UMDNJ-New Jersey Medical Schoolhttp://njms.pbwiki.com/PMRIG

*All images may be subjected to copyright by their original owners

njms.pbwiki.com/PMRIG

Basics

• Physical Medicine and Rehabilitationo PM&R

• related terminologyo physiatry / physiatrist (fiz•zee•AT•trist)

o rehabilitation medicineo interventional physiatry

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What is PM&R?

"Branch of medicine emphasizing prevention, diagnosis, and treatment of

disorders – particularly related to nerves, muscles, and bones – that may produce

temporary or permanent impairment."

- American Academy of PM&R

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In Other Words…

"Rehabilitation physicians are nerve, muscle, and bone experts who treat injuries or illnesses that affect how you move."

- American Academy of PM&R

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Another Laymen’s Definition

"A branch of medicine which aims to enhance and restore functional ability and

quality of life to those with physical impairments or disabilities."

- Wikipedia.org

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Quick Clarification

• Impairmento anatomical or physiological dysfunction

• Disabilityo unable to perform a human activity

• Handicap o unable to meet a societal role

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A Very Brief History

established: approved as med specialty in 1947

consolidated & expanded: post-WWII

defined: principles formulated during post-WWI

origin: as early as heat/cold modalities used for health benefits

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Common Conditions

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Evaluation

physical exam and imaging

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Evaluation

nerve conduction study

electromyography

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Problem List

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Problem ListSome Solutions

Orthoses

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Some Solutions

electrical stimulation

thickening mix

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Some Solutions

Gait Training

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Some Solutions

botox

manualtherapy

baclofenpump

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Some Solutions

heat/cold

transcutaneous electrical nerve stimulation

watertherapy

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Some Solutions

prostheses

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Goal

-= Overall Enhancement =-

Maximizeo Independenceo Dignityo Quality of Life

physical psychological

social vocationaleducational

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Task at Hand

1. Optimize Function

2. Pain Relief

3. Prevent & Manage Complications

4. Coordinate Care

above all,

5. Educate Patients

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Day in the Life of a

Physiatrist…

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Practice Settings

InpatientHospital Unit

Free-Standing Rehab

Acute Rehab

Nursing Home OutpatientHospital Clinic

Free-Standing Rehab

Acute Rehab

Private Office

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Sample Inpatient Experience

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Sample Outpatient Experience

• Amputee• Wound Care• Spasticity• Musculoskeletal• Stroke

• EMG & NCS• Pain• Ortho-Rehab• Spine• General• Pediatric• Arthritis• Fibromyalgia• Spina Bifida

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Interdisciplinary Team

Medical Professionals

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Interdisciplinary Team (cont’d)

Allied Health Professionals

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TransitionalPreliminary

PM&R Residency

Categorical PGY-

1

PGY-

2

PGY-

3

PGY-

4

Option A Option B Option C

Fellowship

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Fellowships

Electrodiagnostic Medicine

Hospice and Palliative Medicine*

Interventional Spine

Neuromuscular Medicine*

Pain Medicine*

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Fellowships (cont’d)

Pediatric Rehabilitation*

Spinal Cord Injury*

Sports Medicine*

Traumatic Brain Injury

Stroke

etc…

* denotes sub-specializations formally recognized by AAPMR

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Lots of Work Ahead

Aging Population

Decreasing Injury Mortality

High Healthcare Costs

Innovative Technology

New Applications

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Additional Resources

American Academy of Physical Medicine & Rehabilitation

www.aapmr.org

Association of Academic Physiatrists

www.physiatry.org

Archives of Physical Medicine and Rehabilitation

www.archives-pmr.org

American Congress of Rehabilitation Medicine

www.acrm.org