Physical Medicine and Rehabilitation An Introduction PMR Interest

Physical Medicine and Rehabilitation An Introduction PM&R Interest Group at UMDNJ-New Jersey Medical School http: //njms. pbwiki. com/PMRIG *All images may be subjected to copyright by their original owners

Basics • Physical Medicine and Rehabilitation o PM&R • related terminology o o o physiatry / physiatrist (fiz • zee • AT • trist) rehabilitation medicine interventional physiatry njms. pbwiki. com/PMRIG

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 njms. pbwiki. com/PMRIG

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 njms. pbwiki. com/PMRIG

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 njms. pbwiki. com/PMRIG

Quick Clarification • Impairment o anatomical or physiological dysfunction • Disability o unable to perform a human activity • Handicap o unable to meet a societal role njms. pbwiki. com/PMRIG

A Very Brief History origin: as early as heat/cold modalities used for health benefits defined: principles formulated during post-WWI consolidated & expanded: post-WWII established: approved as med specialty in 1947 njms. pbwiki. com/PMRIG

Common Conditions njms. pbwiki. com/PMRIG

Evaluation physical exam and imaging njms. pbwiki. com/PMRIG

Evaluation electromyography nerve conduction study njms. pbwiki. com/PMRIG

Problem List • • • Neurogenic Bladder Malnutrition Dysphagia Ventilation Constipation Pain • • • Skin Breakdown Heterotopic Ossification Gait Dysfunction Seizures Depression Insomnia Deep Vein Thrombosis Radiculopathy Spasticity and Contracture Permanent Impairment njms. pbwiki. com/PMRIG

Some Problem Solutions List • • • Neurogenic Bladder • Skin Breakdown Malnutrition • Heterotopic Ossification Dysphagia • Gait Dysfunction Ventilation • Seizures Orthoses Constipation • Depression Pain • Insomnia • Deep Vein Thrombosis • Radiculopathy • Spasticity and Contracture • Permanent Impairment njms. pbwiki. com/PMRIG

Some Solutions • • • Neurogenic Bladder Malnutrition Dysphagia Ventilation Constipation Pain • Skin Breakdown • Heterotopic Ossification electrical • Gait Dysfunction • Seizures stimulation • Depression • Insomnia • Deep Vein Thrombosis • Radiculopathy thickening • Spasticity and Contracture • Permanent mix Impairment njms. pbwiki. com/PMRIG

Some Solutions • • • Neurogenic Bladder Malnutrition Dysphagia Ventilation Constipation Gait Pain • Skin Breakdown • Heterotopic Ossification • Gait Dysfunction • Seizures • Depression Training • Insomnia • Deep Vein Thrombosis • Radiculopathy • Spasticity and Contracture • Permanent Impairment njms. pbwiki. com/PMRIG

Some Solutions • • • Neurogenic Bladder • Skin Breakdown Malnutritionbaclofen • Heterotopic Ossification botox Dysphagia pump • Gait Dysfunction Ventilation • Seizures Constipation • Depression manual Pain • Insomnia therapy • Deep Vein Thrombosis • Radiculopathy • Spasticity and Contracture • Permanent Impairment njms. pbwiki. com/PMRIG

Some Solutions • • • Neurogenic Bladder Malnutrition Dysphagia Ventilation Constipation Pain • Skin Breakdown • Heterotopic Ossification • Gait Dysfunction heat/cold • Seizures • Depression water • Insomnia therapy • Deep Vein Thrombosis • Radiculopathy transcutaneous • Spasticity and Contracture electrical nerve • Permanent Impairment stimulation njms. pbwiki. com/PMRIG

Some Solutions • • Skin Breakdown • Heterotopic Ossification • Gait Dysfunction • Seizures • Depression • Insomnia • Deep Vein Thrombosis prostheses • Radiculopathy • Spasticity and Contracture • Permanent Impairment Neurogenic Bladder Malnutrition Dysphagia Ventilation Constipation Pain njms. pbwiki. com/PMRIG

Goal -= Overall Enhancement =Maximize o Independence o Dignity o Quality of Life physical psychological social vocational educational njms. pbwiki. com/PMRIG

Task at Hand 1. 2. 3. 4. Optimize Function Pain Relief Prevent & Manage Complications Coordinate Care above all, 5. Educate Patients njms. pbwiki. com/PMRIG

Day in the Life of a Physiatrist… njms. pbwiki. com/PMRIG

Practice Settings Inpatient Hospital Unit Free-Standing Rehab Acute Rehab Nursing Home n a / d r o Outpatient Hospital Clinic Free-Standing Rehab Acute Rehab Private Office njms. pbwiki. com/PMRIG

Sample Inpatient Experience • • • Spinal cord Traumatic Brain Stroke Polytrauma Pediatric • • • Burn Cancer Transplant Orthopedic Pulmonary Chronic Neurology Disorder (e. g. , MS) • Complex Medical Disorders njms. pbwiki. com/PMRIG

Sample Outpatient Experience • • • Amputee Wound Care Spasticity Musculoskeletal Stroke • • • EMG & NCS Pain Ortho-Rehab Spine General Pediatric Arthritis Fibromyalgia Spina Bifida njms. pbwiki. com/PMRIG

Interdisciplinary Team Medical Professionals • • Critical Care Intensive Medicine General Surgery Neurology • • Neurosurgery Orthopedics Psychiatry Urology njms. pbwiki. com/PMRIG

Interdisciplinary Team (cont’d) Allied Health Professionals • • Dietetic Rehabilitation Nurse Occupational Therapy Recreational Therapy • • • Physical Therapy Prosthetics & Orthotics Psychology Respiratory Therapy Social Worker Speech & Language Therapy • Vocational Counseling njms. pbwiki. com/PMRIG

PM&R Residency Option A Option B Categorical Preliminary Option C Transitional PGY-1 PGY-2 PGY-3 PGY-4 Fellowship njms. pbwiki. com/PMRIG

Fellowships Electrodiagnostic Medicine Hospice and Palliative Medicine* Interventional Spine Neuromuscular Medicine* Pain Medicine* njms. pbwiki. com/PMRIG

Fellowships (cont’d) Pediatric Rehabilitation* Spinal Cord Injury* Sports Medicine* Traumatic Brain Injury Stroke etc… * denotes sub-specializations formally recognized by AAPMR njms. pbwiki. com/PMRIG

Lots of Work Ahead Aging Population Decreasing Injury Mortality High Healthcare Costs Innovative Technology New Applications njms. pbwiki. com/PMRIG

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 njms. pbwiki. com/PMRIG