Rehabilitation Therapy


Physical medicine and rehabilitation, also known as physiatry, 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. 

Physical medicine and rehabilitation encompasses a variety of clinical settings and patient populations.

In hospital settings, physiatrists commonly treat patients who have had an : 

  • amputation
  • spinal cord injury
  • stroke
  • traumatic brain injury
  •  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.

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.

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.

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. 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.

Not only must a physiatrist know medical knowledge regarding a patient's condition, but they also need to know 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.

Subspecialties
Seven accredited sub-specializations are recognized in the United States:

  • Neuromuscular medicine
  • Pain medicine
  • Pediatric rehabilitation medicine
  • Spinal cord injury
  • Sports medicine
  • Brain injury
  • Hospice and palliative medicine

Fellowship training for other unaccredited subspecialties within the field include the following:

  • Musculoskeletal/Spine
  • Stroke
  • Multiple sclerosis
  • Neurorehabilitation
  • Electrodiagnostic medicine
  • Cancer rehabilitation
  • Occupational and environmental medicine

INTERESTING FACT
DURING THE FIRST HALF OF THE 20TH CENTURY, TWO UNOFFICAIL SPECIALITIES, PHYSICAL MEDICINE AND REHABILITATION MEDICINE, DEVELOPED SEPARATELY, BUT IN PRACTICE BOTH TREATED SIMILAR PATIENT POPULATIONS CONSISTING OF THOSE WITH DISABLING INJURIES....Read More