भौतिक चिकित्सा र पूनर्स्थापना
Physical medicine र rehabilitation (PM&R) or physiatry is a branch of medicine dealing with functional restoration of a person affected by physical disability.
A physician who has completed training in this field is referred to as a physiatrist (fizz ee at' trist). In order to be a physiatrist in the United States, one must complete four years of medical school, one year of internship र three years of residency.
History [सम्पादन गर्ने]
PM&R is a relatively young specialty. Among the early pioneers of the field include Dr. Frank Krusen who developed the Department of Physical Medicine at the Mayo Clinic in 1936. PM&R was recognized as a medical specialty by the American Board of Medical Specialties र the American Medical Association in 1947. The field expanded rapidly owing in large part to World War II, when many soldiers with servere disability returned to the United States र physicians were necessary to treat र manage chronic debilitating conditions. Polio epidemic in the early 1950s also helped establish the value of physiatrists in management of neuromuscular disorders. Advances that allowed longer survival from disorders as varied as spinal cord injury र stroke led to greater role of physiatrists in managing these chronic conditions. This specialty's research base is still evolving.
Scope of the Field [सम्पादन गर्ने]
Physical medicine र rehabilitation involves the management of disorders that alter the function र performance of the patient. Emphasis is placed on the optimization of function through the combined use of medications, physical modalities, र experiential training approaches. Electrodiagnostics are used to diagnose र provide prognosis for various neuromuscular disorders.
Common conditions that are treated by physiatrists include amputation, spinal cord injury, sports injury, stroke, र traumatic brain injury. Cardiopulmonary rehabilitation involves optimizing function in those afflicted with heart or lung disease. Chronic pain management is achieved through multidisciplinary approach involving psychologist, physical therapist, occupational therapist, र interventional procedures when indicated.
Philosophy [सम्पादन गर्ने]
The major concern of the field is the ability of the person to function optimally within the limitations placed upon them by a disease process for which there is no known cure. The general 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, using transdisciplinary team meetings to coordinate care of the patients.
Subspecialty [सम्पादन गर्ने]
Three formal sub-specializations are recognized by the field in the United States: pain medicine (in conjunction with anesthesiology, neurology र psychiatry), pediatric rehabilitation, र spinal cord injury (SCI) medicine. A new formal sub-specialty based on post-residency fellowship training in neuromuscular medicine is set to commence in 2008, in conjunction with neurology. Many in the field also subspecialize in areas of amputee care, musculoskeletal medicine, electrodiagnostics, traumatic brain injury (TBI), cardiopulmonary rehabilitation र neuromuscular disorders.
Residencies in the United States [सम्पादन गर्ने]
There are no clear rankings among PM&R residencies, but among the elite programs in the United States include
- Rehabilitation Institute of Chicago (RIC) at Northwestern University
- Kessler Institute for Rehabilitation (UMDNJ: New Jersey Medical School)
- University of Washington Program
- Mayo Clinic Program
- The Institute for Rehabilitation र Research at Baylor College of Medicine/UT Houston
There are approximately 350 total positions available via the National Resident Matching Program (NRMP) per year. This specialty's competitiveness would likely be considered to be on par with neurology or pediatrics according to the 2006 match data from the NRMP. PM&R residencies will likely become more competitive र be more recognized as the population ages र technology relating to rehabilitation becomes more advanced.
Notable Rehabilitation Hospitals in the United States [सम्पादन गर्ने]
In addition to those associated with elite PM&R residency programs, notable rehabilitation hospitals in the United States include:
- Craig Hospital in Denver, Colorado
- Moss Rehabilitation Hospital in Philadelphia, Pennsylvania
- Rancho Los Amigos National Rehabilitation Center in Downey, California
- Shepard Hospital in Atlanta, Georgia
- Spaulding Rehabilitation Hospital in Boston, Massachusetts
Popular Textbooks [सम्पादन गर्ने]
Two main textbooks often used by those in the specialty are Physical Medicine र Rehabilitation: Principles र Practice by Joel DeLisa र Physical Medicine र Rehabilitation Medicine by Randall Braddom. Useful handbooks for medical students र residents include PM&R Secrets by Mark Young, Brian O'Young र Steven Stiens, र PM&R Pocketpedia by Howard Choi र colleagues.
Book Reference [सम्पादन गर्ने]
- Joel DeLisa (2004), Physical Medicine र Rehabilitation: Principles र Practice, Lippincott Williams & Wilkins, ISBN 0-7817-4130-0
- Randall Braddom (2000), Physical Medicine र Rehabilitation, WB Saunders, ISBN 0-7216-8076-3
- Bryan J. O'Young, Mark A. Young, Steven A. Stiens (2002), Physical Medicine र Rehabilitation Secrets, Hanley & Belfus, ISBN 1-56053-437-0
- Howard Choi, Ross Sugar, David E. Fish, Matthew Shatzer, Brian Krabak (2003), Physical Medicine र Rehabilitation Pocketpedia, Lippincott Williams & Wilkins, ISBN 0-7817-4433-4
Journals [सम्पादन गर्ने]
The two main journals of the PM&R field are Archives of Physical Medicine र Rehabilitation र American Journal of Physical Medicine र Rehabilitation.
Individual Residency Programs [सम्पादन गर्ने]
Organizations [सम्पादन गर्ने]
- American Academy of Physical Medicine र Rehabilitation National medical society, has a PM&R resident/medical student mentoring feature
- American Board of Physical Medicine र Rehabilitation ABMS recognized entity for board certification in PM&R
- An On-Line PM&R Journal Club (via JournalReview.org)
- Association of Academic Physiatrists Organization consisting largely of those with interests in academic PM&R
- StudentDoctor.Net Student mentoring site, has a PM&R forum
- Physical Medicine र Rehabilitation - eMedicine Journal medical reference
- Canadian Association of Physical Medicine र Rehabilitation - Canadian National PM&R Medical Society
- International Society of Physical Medicine र Rehabilitation
- American Association of Neuromuscular र Electrodiagnostic Medicine - National medical society comprised primarily of physiatrists र neurologists who perform electrodiagnostic studies (eg. electromyography र nerve conduction studies) र provide medical care to individuals with neuromuscular disorders.
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