Welcome to colleges9.in
Physical Medicine and Rehabilitation - Medical

Physical medicine and rehabilitation (PM&R) or physiatry), or Rehabilitation Medicine is a branch of medicine which aims to enhance and restore functional ability and quality of life to those with physical impairments or disabilities. A physician who has completed training in this field is referred to as a physiatrist or Rehab Medicine Specialist. 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. Physiatrists specialize in restoring optimal function to people with injuries to the muscles, bones, tissues, and nervous system (such as stroke patients).

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, physical training with therapeutic exercise, movement & activities modification, adaptive equipment and assistive device, orthotics (braces), prosthesis, and experiential training approaches.

Physical Medicine & Rehabilitation physicians may also perform electrodiagnostics which are used to provide nervous system functional information for diagnosis and prognosis for various neuromuscular disorders. The common electrodiagnostic tests performed by physiatrists are nerve conduction studies (NCS) and needle electromyographies (EMG). The nerve conduction study involves electrical stimulation to peripheral nerves, and the nerves' responses are measured including such things as onset latency, amplitude, and conduction velocity. Needle electromyography requires needle electrode insertion into the muscles to detect the electrical potential generated from muscle fibers. Abnormal electrical potentials, such as fibrillation potential or positive sharp waves, detected by EMG needles indicate the presence of muscle fibers that have abnormal nerve supplies.

Common conditions that are treated by physiatrists include amputation, spinal cord injury, sports injury, stroke, musculoskeletal 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 a multidisciplinary approach involving psychologists, physical therapists, occupational therapists, chiropractors, and interventional procedures when indicated. In addition to the previous methodology, stroke is often treated with the help of a speech therapist and recreational therapist when possible.

The major concern that PM&R deals with as a medical field is the ability of a 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 to coordinate care of patients. Comprehensive Rehabilitation is provided by specialists in this field, who act as a facilitator, team leader, and medical expert for rehabilitation.

Subspecialty:

Six formal sub-specializations are recognized by the field in the United States:

  • Hospice and Palliative Medicine
  • Neuromuscular Medicine
  • Pain Medicine
  • Pediatric Rehabilitation
  • Spinal Cord Injury Medicine
  • Sports Medicine

In India apart from the above fields

  • Musculoskeletal Pain management
  • Intervention physiatry
  • Rehabilitation Surgery
  • Rheumatologic Rehabilitation
  • Obesity and other Lifestyle disease modifications
  • Cardio-Pulmonary Rehabilitation also being trained and practiced by Rehab Medicine Specialists.

Many in the field also sub specialize in the care of patients with amputations, musculoskeletal medicine, electrodiagnostics, traumatic brain injury (TBI), and cardiopulmonary rehabilitation.