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Physical medicine and rehabilitation

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Physical medicine and rehabilitation (PM&R), or physiatry, is a branch of medicine dealing with functional restoration of a person affected by physical disability. A physician who has completed training in this field is referred to as a physiatrist (fizz eye' a trist). In order to be a physiatrist in the United States, one must complete four years of medical school, one year of internship and three years of residency.

First Department of Physical Medicine was established at Mayo Clinic in 1936

History

The term 'Physiatry' was coined by Dr. Frank H. Krusen in 1938. The term was accepted by the American Medical Association in 1946. The field grew notably in response to the demand for sophisticated rehabilitation techniques for the large number of injured soldiers returning from World War II.

Scope of the field

Physical medicine and rehabilitation involves the management of disorders that alter the function and performance of the patient. Emphasis is placed on the optimization of function through the combined use of medications, physical modalities, and experiential training approaches. Electrodiagnostics are used to diagnose and provide prognosis for various neuromuscular disorders.

Common conditions that are treated by physiatrists include amputation, spinal cord injury, sports injury, stroke, musculoskletal pain syndromes such as low back pain, fibromyalgia and traumatic brain injury. Cardiopulmonary rehabilitation involves optimizing function in those afflicted with heart or lung disease. Chronic pain management is achieved through multidisciplinary approach involving psychologists, physical therapists, occupational therapists, and interventional procedures when indicated.

Philosophy

The major concern of the field is the ability of the person to function optimally within the limitations placed upon them by a 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 who may not be able to achieve full restoration. A team approach to chronic conditions is emphasized, using transdisciplinary team meetings to coordinate care of the patients.

File:IMG 0085-1-.JPG
Pediatric physiatrists manage conditions such as cerebral palsy, spina bifida and Duchenne's muscular dystrophy

Subspecialty

Six formal sub-specializations are recognized by the field in the United States: pain medicine, pediatric rehabilitation, spinal cord injury medicine, neuromuscular medicine, sports medicine, and hospice and palliative medicine. Many in the field also subspecialize in areas of amputee care, musculoskeletal medicine, electrodiagnostics, traumatic brain injury (TBI), and cardiopulmonary rehabilitation.

Residencies in the United States

There are no clear rankings among PM&R residencies, but a dozen or so well reputed programs in the United States would include

There are approximately 350 total positions available via the National Resident Matching Program (NRMP) per year.

Notable Rehabilitation Hospitals in the United States

In addition to those associated with elite PM&R residency programs, notable US rehabilitation hospitals, many of which are teaching hospitals, include:

Two main textbooks often used by those in the specialty are Physical Medicine and Rehabilitation: Principles and Practice by Joel DeLisa and Physical Medicine and Rehabilitation Medicine by Randall Braddom. Useful handbooks for medical students and residents include PM&R Secrets by Mark Young, Brian O'Young and Steven Stiens, and PM&R Pocketpedia by Howard Choi and colleagues.

Book Reference

  • Joel DeLisa (2004). Physical Medicine and Rehabilitation: Principles and Practice. Lippincott Williams & Wilkins. ISBN 0-7817-4130-0.
  • Randall Braddom (2006). Physical Medicine and Rehabilitation. WB Saunders. ISBN 978-1416026105.
  • Bryan J. O'Young, Mark A. Young, Steven A. Stiens (2002). Physical Medicine and Rehabilitation Secrets. Hanley & Belfus. ISBN 1-56053-437-0.{{cite book}}: CS1 maint: multiple names: authors list (link)
  • Howard Choi, Ross Sugar, David E. Fish, Matthew Shatzer, Brian Krabak (2003). Physical Medicine and Rehabilitation Pocketpedia. Lippincott Williams & Wilkins. ISBN 0-7817-4433-4.{{cite book}}: CS1 maint: multiple names: authors list (link)

Journals

The two main journals of the PM&R field are Archives of Physical Medicine and Rehabilitation and American Journal of Physical Medicine and Rehabilitation. Starting January 2009, the Archives will be replaced with a new, yet-to-be-named medical journal.[1]

Individual Residency Programs

Notes

  1. ^ from aapmr website accessed 18 Jan 2007

References

Organizations

Additional Resources


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