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 Table of Contents  
THE SCOPE OF PHYSICAL AND REHABILITATION MEDICINE
Year : 2019  |  Volume : 2  |  Issue : 2  |  Page : 6

Executive Summary


1 Department of Physical Medicine, Rehabilitation and Sports Medicine, School of Medicine, University of Puerto Rico, Puerto Rico, San Juan, PR, USA
2 Department of Rehabilitation Medicine, Hannover Medical School, Hannover, Germany

Date of Web Publication11-Jun-2019

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2349-7904.259363

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How to cite this article:
Frontera WR, Gutenbrunner C, Nugraha B. Executive Summary. J Int Soc Phys Rehabil Med 2019;2, Suppl S1:6

How to cite this URL:
Frontera WR, Gutenbrunner C, Nugraha B. Executive Summary. J Int Soc Phys Rehabil Med [serial online] 2019 [cited 2019 Jul 22];2, Suppl S1:6. Available from: http://www.jisprm.org/text.asp?2019/2/2/6/259363



This book describes and discusses the nature and scope of the medical specialty of Physical and Rehabilitation Medicine (PRM) which is a medical specialty well established in many parts of the world. Different from other medical specialties, PRM does not focus on an organ or organ system alone but aims at improving functioning of persons with health conditions experiencing disability. This definition of the specialty implies a broad spectrum of tasks and requires a broad scope of competencies.

PRM is conceptually based on the World Health Organization's (WHO) Model of Functioning, Disability, and Health (ICF) and uses rehabilitation as its core health strategy. This includes two important approaches: (1) the diagnosis and treatment of health condition associated with limitations of activities and participation restrictions and (2) the improvement and maintenance of functioning defined as the interaction of a person with a health condition and the environment. Thus, PRM integrates the traditional medical and the rehabilitation approaches that are relevant for persons with disabilities, patients with acute disease, after trauma and/or surgery as well as persons with chronic health conditions.

Epidemiological studies have shown that the number of persons living with disabilities has increased over time. The World Report on Disability published by the WHO and the World Bank has shown that, worldwide, around 1 billion people experience some level of disability. This represents around 15% of the population of the world. The rate of disability is higher in low-income countries and increases with age. Thus, the rise in life expectancy will also increase the need for rehabilitation. In this context, the role of PRM in the health system has become very important and the need for PRM will continue to increase.

Because of the above, it is important to understand why rehabilitation is defined as a health strategy (together with the preventive, curative, and supportive strategies). Further, rehabilitation is also defined as a set of measures that assist people experiencing disability to achieve and maintain optimal functioning in interaction with the environment. As a medical specialty, PRM applies a wide range of rehabilitation interventions, ranging from medicines (including injections), physical treatments, assistive technology, and psychosocial interventions. Because of the complexity of interventions and multifaceted goals, PRM mostly works in multi-professional teams together with Physiotherapist, Occupational Therapists, Speech and Language Therapists, Prosthetists and Orthotists, Psychotherapists, and Social Workers. PRM specialists work in different settings including hospitals, postacute care facilities such as specialized rehabilitation centers and highly specialized rehabilitation units (e.g. for spinal cord injury and traumatic brain injury), ambulatory clinics, and primary care and community-based settings.

Clinical services in PRM are relevant for persons with a wide range of health conditions including neurological conditions (such as stroke, brain injury, spinal cord injury, and neuromuscular disorders), musculoskeletal disorders (e.g. low back pain, neck problems, fractures, arthritis, and other musculoskeletal disorders of the upper and lower limb), limb amputations, cardiac and pulmonary disorders, cancer, pediatric conditions (e.g. cerebral palsy, spina bifida scoliosis juvenile rheumatoid arthritis, leukemia), and geriatric conditions (falls, hip fractures, and sarcopenia).

For all these health conditions, a wide range of diagnostic tools needs to be available. This includes tests for body function and activities as well as assessment questionnaires to evaluate participation, quality of life, and relevant contextual factors. Diagnostics in PRM also includes imaging techniques and laboratory testing to analyze body structures and function and diagnosing underlying pathologies.

It has been shown in many scientific studies that outcomes of rehabilitation concern not only improvements in disease activity and symptoms (such as pain, muscle strength, cardiac performance, and lung function) but also activities (such as mobility, activities of daily living, and self-care). PRM programs support participation (e.g. return-to-work and social integration) and may improve quality of life of persons with chronic health conditions and permanent impairments. Finally, rehabilitation is associated with substantial economic benefits to society by reducing health costs and increasing productivity.

Prof. Walter R. Frontera, MD, PhD, FRCP

Prof. Christoph Gutenbrunner, MD, PhD, FRCP

Boya Nugraha, MS, PhD






 

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