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INTRODUCTION TO PHYSICAL MEDICINE AND REHABILITATION AND ITS EVOLUTION Dr Muhammad Fahim

INTRODUCTION TO PHYSICAL MEDICINE AND REHABILITATION AND ITS EVOLUTION Dr Muhammad Fahim MBBS, FCPS (Resident PM&R). Objective of presentation. To introduce speciality of PM&R History of its evolution Statistics in Pakistan. What is physical medicine and rehabilitation.

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INTRODUCTION TO PHYSICAL MEDICINE AND REHABILITATION AND ITS EVOLUTION Dr Muhammad Fahim

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  1. INTRODUCTION TO PHYSICAL MEDICINE AND REHABILITATION AND ITS EVOLUTION Dr Muhammad Fahim MBBS, FCPS (Resident PM&R)

  2. Objective of presentation • To introduce speciality of PM&R • History of its evolution • Statistics in Pakistan

  3. What is physical medicine and rehabilitation Medical speciality that emphasizes prevention, diagnosis and treatment of patients who experience limitations in function resulting from any disease process, injury or trauma

  4. What is physical medicine and rehabilitation (cont…) • Rehabilitation physician utilizes medications, injections, physical modalities, exercises and education to the patient needs http://www.aapmr.org

  5. What are the mission and motto of PM&R • To promote person’s quality of life and functional outcomes through a dynamic team oriented approach • Traditional medical approach ‘’adds years to life’’ while PM&R in its true spirits ‘’ adds life to the years’’

  6. What are the mission and motto of PM&R (cont…) • To achieve this noble goal a team approach is required • Rehabilitation physician plays role of team leader, as facilitator and monitors the team work • Other valuable team members include the physical therapist (PT), occupational therapist (OT), speech and language pathologist, respiratory therapist, nurse and others http:// World Health .Net3’ ‘’ physiatric personality

  7. Case example

  8. DVT/Pulmonary thromboembolism Pneumonia Pressure sore Patient with SCI Urinary tract infections Postural hypotension Neuropathic pain Spasticity Autonomic dysreflexia

  9. Which medical conditions are treated by rehabilitation physician • Primary care provider to a person with disabilities ( offer comprehensive care for persons with diverse medical conditions

  10. Traumatic brain injury Spinal cord injuries Amputations Stroke Arthritis (Rheumatoid arthritis, osteoarthritis) Multiple sclerosis Fibromyalgia Industrial injuries Neuromuscular diseases Pain disorders (Neck. low back pain) Neuropathies Orthopaedic injuries Burns complications Cancer complications Sports injuries Common conditions treated by rehabilitation physician

  11. Hospice and Palliative Medicine Neuromuscular Medicine Pain Medicine Pediatric Rehabilitation Spinal Cord Injury Medicine Sports Medicine Cardiopulmonary rehabilitation Musculoskeletal pain management Rheumatological rehabilitation Amputee care Electrodiagnostics medicine Traumatic brain injury (TBI) Sub specialities in PM&R

  12. History of PM&R

  13. History of PM&R (CONT…)

  14. History of PM&R (CONT…)

  15. History of PM&R (CONT…)

  16. History of PM&R (CONT…)

  17. History of PM&R (CONT…)

  18. History of PM&R (CONT…)

  19. What are requirements to become specialist in PM&R • MBBS degree/one year house job/PMDC Registration • FCPS Part first exam ( medicine or surgery and allied) • Four year residency/training in CPSP recognized institutes • Two research articles or Dissertation • FCPS Part second exam

  20. Recognized institutes for FCPS training in Pakistan • Armed forces institute of rehabilitation medicine (AFIRM), Rawalpindi • Department of physical medicine and rehabilitation, Mayo hospital Lahore • Institute of physical medicine and rehabilitation, Dow university of health sciences, Karachi

  21. Recognized institutes for FCPS training in Pakistan (cont…) • Unfortunately KPK and Baluchistan lack training institutes recognized by CPSP for FCPS training in PM&R

  22. Why there are few Rehabilitation physicians in Pakistan • PM&R Curriculum not included in the syllabus of MBBS ( So under graduate students not aware of this speciality) • Lack of training institutes

  23. Conclusion • Like a true friend, Rehabilitation physician must be an optimistic spirit, a team player and who gives life to the immortal words of William Arthur ward ( 1880-1967) • A true friend knows your weakness but shows you your strength; feels your fears but fortifies your faith; sees your anxieties but frees your spirit; ( most importantly) recognizes your disabilities but emphasizes your possibilities

  24. Recommendations • Due to law and order conditions and war and terrorists activities, the burden of disabilities is increasing day by day • Common encountered disabilities are amputations, spinal cord injuries and traumatic brain injuries • To manage these conditions a team work is required

  25. Recommendations (cont…) • Just four specialist in physical medicine and rehabilitation (In whole country) are not sufficient to manage this burden of disability • What we need is more training institutes, PM&R course to be included at MBBS level

  26. Thank you

  27. Questions?

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