18. Physical Medical & Rehab

Physiatry (define)

Specialty focused on function & quality of life — "3rd phase of medicine"

Impairment (define)

Loss / abnormality of anatomic structure, organ, or system function

Rehab (define)

Applying treatment, therapy, equipment to transport person with disability → Person with improved functional skill & performance

Physical therapist (define)

Promote, maintain, restore health through physical intervention & education to address conditions that limit person's ability to move

Occupational therapist (define)

Promote, maintain, restore health through occupations / ADLs — Bathing, dressing, eating

Speech-language pathologist (define)

Focus on impairments in auditory/reading comprehension, verbal/written expression, cognitive communication disorders, swallowing disorders

EX: Diet modification, safe swallow strategies

Differences of components of physiatry assessment

CC: Impairment, activity limitation, barriers

HPI: Life impact

PLOF/CLOF: Transfers, ambulation, assistance

Exam: Focus on quantifying impairment & activity limitation

Testing modalities used in physiatry

Imaging (XR/CT/MRI), electromyography, nerve conduction studies

Modalities of physiatry

- Referral to PT, OT, SLP

- Physical agents: Heat, cool, US, electrotherapy, compression

- Medications: Topicals, PO

- Injections: TPI, CSI (corticosteroid injection), ESI, botox, RFA

How is progress monitored with PMR?

Function outcome measures: Berg Balance Scale, Stroke impact scale, TUG test, 10 meter walk test

MCC of prosthetics & location

Vascular/diabetes (90%) — LE

Goals of prosthetics

Contracture prevention & limb volume management