What’s PM&R ?

Specialty area of Physical Medicine and Rehabilitation

“Physical Medicine and Rehabilitation (PM&R) is a specialty area in medicine, which is concerned with restoring and maintaining the optimal functional ability of individuals experiencing or those having the risk of disability by involving their interaction with the environment”.

PM&R is an exclusive specialty area of medicine; unlike the other specialty areas dealing only with the diagnosis and treatment, it encompasses various strategies from acute hospital care to care in the community.

Capabilities of Physical Medicine and Rehabilitation Specialists:
  • Medical examination to establish the diagnosis
  • Assessment of functional capacity and potential of improvement
  • Assessment of activity and attendance and also contextual factors
  • Planning for rehabilitation program
  • Knowledge, experience and practice of medical and physical therapies
  • Assessment of outcomes and measurements
  • Prevention and treatment of complications
  • Determination of the disease course/state of well-being and the outcomes of rehabilitation
  • Knowledge of rehabilitation technologies
  • Skills of team dynamics and leadership
  • Training skills
  • Knowledge of social security system and medical-legal issues about disability

Practice Area of Physical Medicine and Rehabilitation Specialists:

1- Medical procedures
  • Drug administration to improve or restore the body structures and/or function (i.e. pain management, treatment of inflammation, improving muscle tonus, improving cognitive functions, enhancing physical performance)
  • Practical applications involving injections and alternative routes of drug administration
  • Assessment and review of interventions
  • Determination of prognosis
2- Physical therapies    
  • Manual therapy techniques for reversible joint stiffness and related soft tissue dysfunctions
  • Kinesiotherapy and exercise therapy
  • Electrotherapy (medical treatments using electrical energy)
  • Other therapies including ultrasonography, heat and cold applications, phototherapy (i.e. laser therapy), hydrotherapy and balneotherapy (spas), diathermia (deep heating), massage therapy and lymphatic therapy (manual lymphatic drainage)
3- Occupational therapy
  • Examination of daily activities and occupational activities and supporting disabled limbs (i.e. use of brace)
  • Teaching the patient skills on how to overcome the barriers in daily life activities (i.e. adjusting for special activities)
  • Education for functional disability and cognitive activities
  • Increasing motivation
4- Speech therapy and language therapies within the context of complicated special rehabilitation programs

5- Dysphagia (difficulty in swallowing) treatment

6- Neurophysiological interventions

7- Disability equipment, adjunctive technology, prosthesis, orthosis, technical supports and aids

8- Patient education


Diseases managed by Physical Medicine and Rehabilitation Specialists:

Painful conditions
  • Arthritis
  • Musculoskeletal pains (neck and back pain)
  • Fibromyalgia, myofascial pain syndrome, chronic pain syndrome
Injuries
  • Spinal cord injuries
  • Traumatic pain syndrome
  • Sports Injuries
  • Work-related musculoskeletal injuries
Other conditions requiring rehabilitation
  • Amputations
  • Stroke
  • Cancer rehabilitation
  • Cardiac rehabilitation
  • Pediatric rehabilitation
  • Geriatric rehabilitation
Other Diseases
  • Osteoporosis
  • Post-polio syndrome
  • Multiple sclerosis

References:
  1. Gutenbrunner C, Ward AB, Chamberlain MA. White book on Physical and Rehabilitation Medicine in Europe. J Rehabil Med. 2007;(45 Suppl):6-47.
  2. Stucki G, Melvin J.The International Classification of Functioning, Disability and Health: a unifying model for the conceptual description of physical and rehabilitation medicine.J Rehabil Med 2007;39(4):286-92.
  3. American Academy of Physical Medicine & Rehabilitation (AAPMR). Conditions & Treatment. http://www.aapmr.org/condtreat.htm.
  4. Özcan O. Özerk Bir Uzmanlık Olarak FTR ve FTR Uzmanının Rolü. In: Beyazova M, Gökçe-Kutsal Y (eds). Fiziksel Tıp ve Rehabilitasyon. Güneş Kitabevi, Ankara, 2000;12-7.