Physical Medicine and Rehabilitation An Introduction PM&R Interest Group at UMDNJ-New Jersey Medical...

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


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


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


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


Quick Clarification

• Impairmento anatomical or physiological dysfunction

• Disabilityo unable to perform a human activity

• Handicap o unable to meet a societal role


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


Common Conditions


Evaluation

physical exam and imaging


Evaluation

nerve conduction study

electromyography


Problem List


Problem ListSome Solutions

Orthoses


Some Solutions

electrical stimulation

thickening mix


Some Solutions

Gait Training


Some Solutions

botox

manualtherapy

baclofenpump


Some Solutions

heat/cold

transcutaneous electrical nerve stimulation

watertherapy


Some Solutions

prostheses


Goal

-= Overall Enhancement =-

Maximizeo Independenceo Dignityo Quality of Life

physical psychological

social vocationaleducational


Task at Hand

1. Optimize Function

2. Pain Relief

3. Prevent & Manage Complications

4. Coordinate Care

above all,

5. Educate Patients


Day in the Life of a

Physiatrist…


Practice Settings

InpatientHospital Unit

Free-Standing Rehab

Acute Rehab

Nursing Home OutpatientHospital Clinic

Free-Standing Rehab

Acute Rehab

Private Office


Sample Inpatient Experience


Sample Outpatient Experience

• Amputee• Wound Care• Spasticity• Musculoskeletal• Stroke

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


Interdisciplinary Team

Medical Professionals


Interdisciplinary Team (cont’d)

Allied Health Professionals


TransitionalPreliminary

PM&R Residency

Categorical PGY-

1

PGY-

2

PGY-

3

PGY-

4

Option A Option B Option C

Fellowship


Fellowships

Electrodiagnostic Medicine

Hospice and Palliative Medicine*

Interventional Spine

Neuromuscular Medicine*

Pain Medicine*


Fellowships (cont’d)

Pediatric Rehabilitation*

Spinal Cord Injury*

Sports Medicine*

Traumatic Brain Injury

Stroke

etc…

* denotes sub-specializations formally recognized by AAPMR


Lots of Work Ahead

Aging Population

Decreasing Injury Mortality

High Healthcare Costs

Innovative Technology

New Applications


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

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