Physical medicine and rehabilitation

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Physical and rehabilitation treatment , also known as physiatry , is a branch of medicine that aims to improve and restore functional and quality of life for those with physical or disability. A doctor who has completed training in this field may be referred to as a physiotherapist. Specialist Physiatrists in restoring optimal function for people with injuries to the muscles, bones, ligaments, or nervous system.

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In hospitals, physiatrics usually treat patients with amputations, spinal cord injuries, strokes, traumatic brain injury, and other debilitating injuries. In treating these patients, physiatrists lead interdisciplinary teams of physical, occupational, recreational and speech therapy, nurses, psychologists, and social workers. In an outpatient setting, physiatric also treats patients with muscle and joint injuries, pain syndromes, non-cure wounds, and other disabling conditions. Physiatric is trained to perform intramuscular and interarticular injections as well as studies of nerve conduction.

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History

During the first half of the 20th century, two unofficial specializations, physical drugs and rehabilitation drugs, developed separately, but in practice both treat the same patient population consisting of those with crippling injuries. Frank H. Krusen is a pioneer in physical medicine, which emphasizes the use of physical agents, such as hydrotherapy and hyperbaric oxygen, at Temple University and later at the Mayo Clinic and it was he who coined the term 'physiatry' in 1938. Drug rehabilitation became famous during both World Wars in treatment of soldiers and wounded workers. Howard A. Rusk, an internist in Missouri, became a pioneer in rehabilitation treatment after being appointed to rehabilitate pilots during World War II. In 1944, the Baruch Committee, commissioned by philanthropist Bernard Baruch, defined the specialization as a combination of two fields and laid the framework for its acceptance as an official medical specialty. The committee also distributed funds to conduct training and research programs throughout the country. The specialty that came to be known as physical medicine and rehabilitation in the United States was formally established in 1947, when an independent Physical Council of Medicine was established under the authority of the Council of Medical Specialties of America. In 1949, at Dr.'s urging. Rusk and others, a special rehabilitation drug was included and changed its name to Physical Treatment and Rehabilitation.

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Treatment

The main concern that physical treatment and address rehabilitation is a person's ability to function optimally within the limitations placed on them by discharge disorders or disease processes with no known cure. The emphasis is not on full recovery to premorbid function levels, but rather the optimization of quality of life for those unable to achieve full restoration. The team's approach to chronic conditions is emphasized to coordinate patient care. Comprehensive rehabilitation is provided by specialists in this field, who act as facilitators, team leaders, and medical experts for rehabilitation.

In rehabilitation, goal setting is often used by clinical care teams to provide teams and people undergoing rehabilitation to get disability as the direction to go. Very low quality evidence suggests that goal setting can lead to a higher quality of life for people with disabilities, and it is not clear whether the goal setting used in this context reduces or increases inpatient returns or deaths.

Not only should a physiotherapist know the medical knowledge of the patient's condition, but they also need to know the relevant/practical knowledge about it as well. This involves a problem such as: what type of wheelchair is best suited for the patient, which type of prosthetic is most suitable, whether their current home layout accommodates their disability well, and other daily complications that their patients may experience.

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Training

In the United States, residency training for physical medicine and rehabilitation is four years, including an apprenticeship. There are 83 programs in the United States that are accredited by the Board of Accreditation for Post-Graduate Education, in 28 states.

Specific training differs from program to program but the basic knowledge gained is more or less the same. Residents trained in inpatient settings treat various types of rehabilitation including: spinal cord injury, traumatic brain injury, stroke, orthopedics, cancer, cerebral palsy, burns, pediatric rehabilitation, and other deactivation injuries. Residents are also trained in outpatient settings to find out how to treat a patient's chronic condition after hospitalization. During the training, residents were instructed on how to perform some good diagnostic procedures that included electromyography and neural conduction studies as well as procedures such as joint injection and trigger point injection.

Sub-specialization

Seven accredited sub-specialties are recognized in the United States:

• Neuromuscular medicine
• Pain Medication
• Pediatric rehab medicine
• spinal cord injury
• Drugs
• Brain injury
• Hospice and palliative medicine

Fellowship training for other non-accredited subspecialists in this field includes:

• Musculoskeletal/Spine
• Stroke
• Multiple sclerosis
• Neurorehabilitation
• Electrodiagnostic drugs
• Cancer rehabilitation
• Occupational and environmental drugs

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See also

• American Osteopathic Board of Physical Medicine and Rehabilitation

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References

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External links

• Media related to Physical treatment and rehabilitation at Wikimedia Commons
• What is PM & R? provide a description of physical medicine and the rehabilitation of the population about its specialization and appeal as a doctor

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