Physical medicine and rehabilitation, also known as physiatry,[1] is a branch of medicine that aims to enhance and restore functional ability and quality of life to people with physical impairments or disabilities. This can include conditions such as spinal cord injuries, brain injuries, strokes, as well as pain or disability due to muscle, ligament or nerve damage.[2] A physician having completed training in this field may be referred to as a physiatrist.[citation needed]
Physical medicine and rehabilitation encompasses a variety of clinical settings and patient populations.[citation needed]
In hospital settings, physiatrists commonly treat patients who have had an amputation, spinal cord injury, stroke, traumatic brain injury, and other debilitating injuries or conditions. In treating these patients, physiatrists lead an interdisciplinary team of physical, occupational, recreational and speech therapists, nurses, psychologists, and social workers.[citation needed]
In outpatient settings, physiatrists treat patients with muscle and joint injuries, pain syndromes, non-healing wounds, and other disabling conditions. Physiatrists are trained to perform injections into joints or muscle as a pain treatment option. Physiatrists are also trained in nerve conduction studies and electromyography.[3]
History
During the first half of the 20th century, two unofficial specialties, physical medicine and rehabilitation medicine, developed separately, but in practice both treated similar patient populations consisting of those with disabling injuries. Frank H. Krusen was a pioneer of physical medicine, which emphasized the use of physical agents, such as hydrotherapy and hyperbaric oxygen, at Temple University and then at Mayo Clinic and it was he that coined the term 'physiatry' in 1938. Rehabilitation medicine gained prominence during both World Wars in the treatment of injured soldiers and laborers. Howard A. Rusk, an internal medicine physician from Missouri, became a pioneer of rehabilitation medicine after being appointed to rehabilitate airmen during World War II. In 1944, the Baruch Committee, commissioned by philanthropist Bernard Baruch, defined the specialty as a combination of the two fields and laid the framework for its acceptance as an official medical specialty. The committee also distributed funds to establish training and research programs across the nation. The specialty that came to be known as physical medicine and rehabilitation in the United States was officially established in 1947, when an independent Board of Physical Medicine was established under the authority of the American Board of Medical Specialties. In 1949, at the insistence of Dr. Rusk and others, the specialty incorporated rehabilitation medicine and changed its name to Physical Medicine and Rehabilitation.[4][5]
Treatment
The major goal of physical medicine and rehabilitation treatment is to help a person function optimally within the limitations placed upon them by a disabling impairment or disease process for which there is no known cure. The emphasis is not on the full restoration to the premorbid level of function, but rather the optimization of the quality of life for those not able to achieve full restoration. A team approach to chronic conditions is emphasized to coordinate care of patients. Comprehensive rehabilitation is provided by specialists in this field, who act as facilitators, team leaders, and medical experts for rehabilitation.[citation needed]
In rehabilitation, goal setting is often used by the clinical care team to provide the team and the person undergoing rehabilitation for an acquired disability a direction to work towards.[6] Very low quality evidence indicates that goal setting may lead to a higher quality of life for the person with the disability, and it not clear if goal setting used in this context reduces or increases re-hospitalization or death.[6]
Not only must a physiatrist have medical knowledge regarding a patient's condition, but they also need to have practical knowledge regarding it as well. This involves issues such as: what type of wheelchair best suits the patient, what type of prosthetic would fit best, does their current house layout accommodate their handicap well, and other every day complications that their patients might have.[3]
Training
In the United States, residency training for physical medicine and rehabilitation is four years long, including an intern year of general medical training. There are 83 programs in the United States accredited by the Accreditation Council for Graduate Medical Education, in 28 states.[7]
Specifics of training differs from program to program but all residents must obtain the same fundamental skills. Residents are trained in the inpatient setting to take care of multiple types of rehabilitation including: spinal cord injury, traumatic brain injury, stroke, orthopedic injuries, cancer, cerebral palsy, burn, pediatric rehab, and other disabling injuries. The residents are also trained in the outpatient setting to know how to take care of the chronic conditions patients have following their inpatient stay. During training, residents are instructed on how to properly perform several diagnostic procedures which include electromyography, nerve conduction studies and also procedures such as joint injections and trigger point injections.[3]
Subspecialties
Seven accredited sub-specializations are recognized in the United States:[8]
^"physical medicine" in the American Heritage Dictionary
^"What is Physiatry? - HSS". Hss.edu. Retrieved 2012-10-20.
^ abcLee, Peter K. W. (2011). "Defining Physiatry and Future Scope of Rehabilitation Medicine". Annals of Rehabilitation Medicine. 35 (4): 445–449. doi:10.5535/arm.2011.35.4.445. PMC3309231. PMID 22506158.
^Verville, Richard (2009). War, Politics, and Philanthropy: The History of Rehabilitation Medicine. Lanham, Maryland: University Press of America. ISBN978-0-7618-4594-2.
^Dillingham, Timothy R. (2002). "Physiatry, physical medicine, and rehabilitation: historical development and military roles". Physical Medicine and Rehabilitation Clinics of North America. 13 (1): 1–16, v. doi:10.1016/S1047-9651(03)00069-X. PMID 11878077.
^ abLevack, William M. M.; Weatherall, Mark; Hay-Smith, E. Jean C.; Dean, Sarah G.; McPherson, Kathryn; Siegert, Richard J. (2015-07-20). "Goal setting and strategies to enhance goal pursuit for adults with acquired disability participating in rehabilitation". The Cochrane Database of Systematic Reviews. 2015 (7): CD009727. doi:10.1002/14651858.CD009727.pub2. hdl:10292/9134. ISSN 1469-493X. PMC8941379. PMID 26189709.
^"A Step by Step Guide to Applying for a PM&R Residency". American Academy of Physical Medicine and Rehabilitation. Retrieved 16 February 2018.
^"Physical Medicine and Rehabilitation". Accreditation Council for Graduate Medical Education. Retrieved 13 May 2016.
^"Roadmap to a fellowship - American Academy of Physical Medicine and Rehabilitation" (PDF). AAPM&R. Retrieved 2018-01-13.
External links
Wikimedia Commons has media related to Physical medicine and rehabilitation.
What Is PM&R? gives a physical medicine and rehabilitation resident's description of the specialty and its appeal as a physician
January 31, 2023
physical, medicine, rehabilitation, physical, medicine, rehabilitation, redirect, here, journal, journal, examples, perspective, this, article, deal, primarily, with, united, states, represent, worldwide, view, subject, improve, this, article, discuss, issue, . PM amp R and Physical medicine amp rehabilitation redirect here For the journal see PM amp R journal The examples and perspective in this article deal primarily with the United States and do not represent a worldwide view of the subject You may improve this article discuss the issue on the talk page or create a new article as appropriate February 2018 Learn how and when to remove this template message Physical medicine and rehabilitation also known as physiatry 1 is a branch of medicine that aims to enhance and restore functional ability and quality of life to people with physical impairments or disabilities This can include conditions such as spinal cord injuries brain injuries strokes as well as pain or disability due to muscle ligament or nerve damage 2 A physician having completed training in this field may be referred to as a physiatrist citation needed Physical medicine and rehabilitationPhysiatrist assessing a patientOccupationNamesPhysicianSynonymsPhysiatrics physiatry rehabilitation medicine physical and rehabilitation medicine PRM Pronunciation f ɪ ˈ z aɪ e t r i Activity sectorsMedicineDescriptionEducation requiredDoctor of Medicine MD Doctor of Osteopathic Medicine DO Bachelor of Medicine Bachelor of Surgery MBBS MBChB Contents 1 Scope of the field 2 History 3 Treatment 4 Training 4 1 Subspecialties 5 See also 6 References 7 External linksScope of the fieldPhysical medicine and rehabilitation encompasses a variety of clinical settings and patient populations citation needed In hospital settings physiatrists commonly treat patients who have had an amputation spinal cord injury stroke traumatic brain injury and other debilitating injuries or conditions In treating these patients physiatrists lead an interdisciplinary team of physical occupational recreational and speech therapists nurses psychologists and social workers citation needed In outpatient settings physiatrists treat patients with muscle and joint injuries pain syndromes non healing wounds and other disabling conditions Physiatrists are trained to perform injections into joints or muscle as a pain treatment option Physiatrists are also trained in nerve conduction studies and electromyography 3 HistoryDuring the first half of the 20th century two unofficial specialties physical medicine and rehabilitation medicine developed separately but in practice both treated similar patient populations consisting of those with disabling injuries Frank H Krusen was a pioneer of physical medicine which emphasized the use of physical agents such as hydrotherapy and hyperbaric oxygen at Temple University and then at Mayo Clinic and it was he that coined the term physiatry in 1938 Rehabilitation medicine gained prominence during both World Wars in the treatment of injured soldiers and laborers Howard A Rusk an internal medicine physician from Missouri became a pioneer of rehabilitation medicine after being appointed to rehabilitate airmen during World War II In 1944 the Baruch Committee commissioned by philanthropist Bernard Baruch defined the specialty as a combination of the two fields and laid the framework for its acceptance as an official medical specialty The committee also distributed funds to establish training and research programs across the nation The specialty that came to be known as physical medicine and rehabilitation in the United States was officially established in 1947 when an independent Board of Physical Medicine was established under the authority of the American Board of Medical Specialties In 1949 at the insistence of Dr Rusk and others the specialty incorporated rehabilitation medicine and changed its name to Physical Medicine and Rehabilitation 4 5 TreatmentThe major goal of physical medicine and rehabilitation treatment is to help a person function optimally within the limitations placed upon them by a disabling impairment or disease process for which there is no known cure The emphasis is not on the full restoration to the premorbid level of function but rather the optimization of the quality of life for those not able to achieve full restoration A team approach to chronic conditions is emphasized to coordinate care of patients Comprehensive rehabilitation is provided by specialists in this field who act as facilitators team leaders and medical experts for rehabilitation citation needed In rehabilitation goal setting is often used by the clinical care team to provide the team and the person undergoing rehabilitation for an acquired disability a direction to work towards 6 Very low quality evidence indicates that goal setting may lead to a higher quality of life for the person with the disability and it not clear if goal setting used in this context reduces or increases re hospitalization or death 6 Not only must a physiatrist have medical knowledge regarding a patient s condition but they also need to have practical knowledge regarding it as well This involves issues such as what type of wheelchair best suits the patient what type of prosthetic would fit best does their current house layout accommodate their handicap well and other every day complications that their patients might have 3 TrainingIn the United States residency training for physical medicine and rehabilitation is four years long including an intern year of general medical training There are 83 programs in the United States accredited by the Accreditation Council for Graduate Medical Education in 28 states 7 Specifics of training differs from program to program but all residents must obtain the same fundamental skills Residents are trained in the inpatient setting to take care of multiple types of rehabilitation including spinal cord injury traumatic brain injury stroke orthopedic injuries cancer cerebral palsy burn pediatric rehab and other disabling injuries The residents are also trained in the outpatient setting to know how to take care of the chronic conditions patients have following their inpatient stay During training residents are instructed on how to properly perform several diagnostic procedures which include electromyography nerve conduction studies and also procedures such as joint injections and trigger point injections 3 Subspecialties Seven accredited sub specializations are recognized in the United States 8 Neuromuscular medicine Pain medicine Pediatric rehabilitation medicine Spinal cord injury Sports medicine Brain injury Hospice and palliative medicineFellowship training for other unaccredited subspecialties within the field include the following 9 Musculoskeletal Spine Stroke Multiple sclerosis Neurorehabilitation Electrodiagnostic medicine Cancer rehabilitation Occupational and environmental medicineSee alsoAmerican Osteopathic Board of Physical Medicine and Rehabilitation American Academy of Physical Medicine and RehabilitationReferences physical medicine in the American Heritage Dictionary What is Physiatry HSS Hss edu Retrieved 2012 10 20 a b c Lee Peter K W 2011 Defining Physiatry and Future Scope of Rehabilitation Medicine Annals of Rehabilitation Medicine 35 4 445 449 doi 10 5535 arm 2011 35 4 445 PMC 3309231 PMID 22506158 Verville Richard 2009 War Politics and Philanthropy The History of Rehabilitation Medicine Lanham Maryland University Press of America ISBN 978 0 7618 4594 2 Dillingham Timothy R 2002 Physiatry physical medicine and rehabilitation historical development and military roles Physical Medicine and Rehabilitation Clinics of North America 13 1 1 16 v doi 10 1016 S1047 9651 03 00069 X PMID 11878077 a b Levack William M M Weatherall Mark Hay Smith E Jean C Dean Sarah G McPherson Kathryn Siegert Richard J 2015 07 20 Goal setting and strategies to enhance goal pursuit for adults with acquired disability participating in rehabilitation The Cochrane Database of Systematic Reviews 2015 7 CD009727 doi 10 1002 14651858 CD009727 pub2 hdl 10292 9134 ISSN 1469 493X PMC 8941379 PMID 26189709 A Step by Step Guide to Applying for a PM amp R Residency American Academy of Physical Medicine and Rehabilitation Retrieved 16 February 2018 Physical Medicine and Rehabilitation Accreditation Council for Graduate Medical Education Retrieved 13 May 2016 Roadmap to a fellowship American Academy of Physical Medicine and Rehabilitation PDF AAPM amp R Retrieved 2018 01 13 External links Wikimedia Commons has media related to Physical medicine and rehabilitation What Is PM amp R gives a physical medicine and rehabilitation resident s description of the specialty and its appeal as a physician Retrieved from https en wikipedia org w index php title Physical medicine and rehabilitation amp oldid 1119279474, wikipedia, wiki, book, books, library,
