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Physical medicine and 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 and three years of residency.

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Very Lucrative PM&R position in Beautiful South Carolina need is for Intraventional PM&R :: South Carolina :: CompHealth Inc
Job 9110927 PM&R needed in South Carolina, MD or DO, New Graduates or Experienced, Metro Area, Solo start up position , No Overhead, Lucrative Financial Package, Full Benefits. Great place to raise
Very Lucrative PM&R position in Beautiful South Carolina need is for Intraventional PM&R :: South Carolina :: CompHealth Inc
Job 9110664 PM&R needed in South Carolina, MD or DO, New Graduates or Experienced, Metro Area, Very Solid MSG, No Overhead, Lucrative Financial Package, Full Benefits. Great place to raise a family
Great opportunity for PM&R - Stroke Director in a major Metro Area of Ohio :: Ohio :: CompHealth Inc
Job 917560 PM&R - Stroke Director Position consists of clinical, teaching, and research. The doctor can live in one of the most desired US cities with diverse culture, fine dining at five star restaurants,

Clinical Rehabilitation current issue

Effect of Warm-Supplementing Kidney Yang (WSKY) added to risperidone on quality of life in patients with schizophrenia: a randomized controlled trial
Chen, Z.-h., Wang, G.-h., Wang, X.-p., Huo, Y.-x., Yang, M.-h., Li, L., Mei, H.-b.Objective: To evaluate the quality of life, efficacy and safety of Warm-Supplementing Kidney Yang (WSKY) added to risperidone in patients with schizophrenia.Design: A randomized controlled trial.Setting: The outpatient and inpatient departments of three hospitals.Subjects: One hundred and twenty patients with clinically diagnosed schizophrenia with predominantly negative symptoms were included in the study.Intervention: All 120 patients were randomly assigned to double-blind treatment with WSKY group (n = 60) or placebo group (n = 60) added to risperidone for eight weeks.Main measure: The efficacy measures included the World Health Organization Quality of Life Scale (WHOQOL-100), the Positive and Negative Syndrome Scale (PANSS), the Social Disability Screening Schedule and the Hamilton Rating Scale for Depression. Safety and tolerability were assessed throughout the trial.Results: The scores of quality of life in the WSKY group showed statistically significant improvement at the end-point of treatment compared with those in the placebo group (WSKY, increasing 40.5 (29.4); placebo, increasing 14.4 (27.1); F =24.900, P<0.001), while the scores of social function and depression symptoms also showed statistically significant improvement. The response rates for the WHOQOL-100 total scores were 50.0% for the WSKY group versus 31.7% for placebo group ( 2 = 4.172, P=0.041). There were no significant differences in the safety/tolerability measures between the WSKY group and the placebo group during treatment.Conclusions: The results suggest that WSKY added to risperidone significantly improved the quality of life, social function, depression symptom compared with placebo added to risperidone.
Effectiveness of a video-based exercise programme to reduce falls and improve health-related quality of life among older adults discharged from hospital: a pilot randomized controlled trial
Haines, T. P, Russell, T., Brauer, S. G, Erwin, S., Lane, P., Urry, S., Jasiewicz, J., Condie, P.Objective: Falls, loss of health-related quality of life and physical capacity, reduced participation in activities of daily living, and increased fear of falling are all potential outcomes for older adults discharged from hospital. A low-cost video based exercise programme may address this.Design: This study was a randomized controlled trial with blinded outcomes assessment and a six-month follow-up.Subjects and setting: Participants were older adults (>65 years) using a mobility aid discharged from a tertiary hospital in Brisbane, Australia, without referral for community-based rehabilitation services.Intervention: A digital video disk-based programme encompassing six exercise types each with six levels of difficulty. A home visit from a project physiotherapist was conducted to ensure patient safety. Control group patients received usual care.Main measures: Falls, health-related quality of life, participation in activities of daily living, physical capacity and fear of falling.Results: Study participants (n = 53, 19 intervention, 34 control) experienced decreasing health-related quality of life, several falls (72), and lower levels of participation in activities of daily living over the six-month follow-up. The intervention group did not differ significantly from the control group in terms of the outcomes examined, though a non-significant reduction in the rate of falls was observed. Intervention group participants complied with the exercise programme well during the first two weeks following discharge from hospital but then reduced their compliance levels thereafter.Conclusions: The intervention may be beneficial for reducing the rate of falls in this patient population though further research with a larger sample size is indicated.
Long-term myocardial adaptations after cardiac rehabilitation in heart failure: a randomized six-year evaluation using magnetic resonance imaging
Muller, L., Myers, J., Kottman, W., Luchinger, R., Dubach, P.Objective: To assess exercise capacity and left ventricular function using magnetic resonance imaging (MRI) among patients with chronic heart failure randomized to a residential rehabilitation programme at baseline and six years after participation.Design: Randomized controlled study.Setting: Residential cardiac rehabilitation centre and community hospital. Intervention: One month of intensive exercise and risk reduction therapy including educational sessions, a low-fat diet, and 2 hours of individually prescribed exercise daily. Control subjects received usual care. Subjects were evaluated at baseline, after completing the one-month residential programme and six years later.Subjects: From an original study group of 50, 16 patients (8 exercise, 8 controls) with chronic heart failure were alive and available for evaluation after six years.Main measures: Cardiopulmonary exercise test responses and ventricular size and function using MRI.Results: Peak Vo2 was 20.0 and 12.4% higher after the rehabilitation programme and six years later, respectively, whereas minimal changes were observed among controls. Left ventricular mass and volumes tended to decrease among subjects in the exercise group, whereas left ventricular mass and volumes tended to increase among control subjects after six years. Ejection fraction increased approximately 20% in both groups.Conclusion: Six years after participation in a concentrated residential rehabilitation programme, exercise capacity was preserved and no significant changes were observed in ventricular size or function. These findings provide further support for exercise rehabilitation in chronic heart failure.

Physiotherapy Research International

Pain and hip lateral rotator muscle strength contribute to functional status in females with patellofemoral pain
Frances Long-Rossi, Gretchen B. Salsich Tue, 29 Sep 2009 04:12:00 -0000
Background and Purpose. Patellofemoral pain (PFP) is a common musculoskeletal pain condition, especially in females. Decreased hip muscle strength has been implicated as a contributing factor, yet the relationships between pain, hip muscle strength and function are not known. The purpose of this study was to test the hypothesis that pain and hip muscle strength explain unique portions of variance in the functional status of females with PFP. Methods. An observational, cohort study was conducted. The subjects for this study were twenty-one females with PFP (age: 26 ± 7 years; height: 163 ± 4 cm; and body mass: 62 ± 10 kg). Subjects had a minimum pain duration of two months (mean pain duration: 4.9 ± 3.6 years). The main measures were pain during a unilateral squat, measured with a visual analogue scale; isometric muscle force of gluteus medius, gluteus maximus and hip lateral rotators; and Kujala score (self-report measure of function). Hierarchical multiple regression analysis was performed with Kujala score as the dependent variable. Pain and hip lateral rotator muscle strength were independent variables, entered in that order. Other strength measures were not correlated with the Kujala score, and as such, were not used in the analysis. Results. Pain explained 22% of the variance in the Kujala score (p = 0.03). Hip lateral rotator strength explained an additional 14% of the variance, after accounting for pain level (p = 0.06). Conclusions. Pain and hip lateral rotator strength contributed to the functional status of females with PFP. Improving pain and hip lateral rotator muscle strength may improve function in females with this common pain condition. Copyright © 2009 John Wiley & Sons, Ltd.
Reproducibility and validity of digital inclinometry for measuring cervical range of motion in normal subjects
Tamara Prushansky, Orly Deryi, Bahaa Jabarreen Wed, 24 Jun 2009 08:44:00 -0000
Background and Purpose. Measurements of cervical range of motion (CROM) have been extensively reported in the past decade employing simple (goniometers) as well as sophisticated (electro-, magneto- and ultrasonography-based) systems. The recent introduction of the simple, user-friendly and relatively cheap digital inclinometer (DI) has opened a potentially new venue for measurement of this segment's motion. The purpose of the present study was to assess intra-tester reproducibility of DI-based findings as well as its validity in comparison to the ultrasonography-based Zebris CMS 70P (Zebris Medizintechnik GmbhTM, Isny, Germany) for measuring CROM in normal subjects. Methods. Active CROM of healthy women (n = 15) and men (n = 15) aged 24.2(2.4) years was measured on two sessions, Test 1 and Test 2, spread over 7.2(±0.7) days apart. On Test 1, the six primary movements of the neck (flexion, F; extension, E; right and left lateral flexion, RLF and LLF; and right and left rotations, RR and LR) were measured using the DI and the Zebris. On Test 2, the same measurements were performed using the DI only. All measurements were conducted by the same tester, with the subject in the seated position. The only exception was DI measurement of cervical rotation that was performed in the supine position due to the DI gravity-dependence, rendering DI measurements in the transverse plane irrelevant. Results. No significant differences were revealed between the two instruments with respect to the sagittal and frontal planes, whereas the DI-based CROM in rotation was significantly greater then its Zebris-based counterpart. The inter-device interclass correlation coefficients (ICCs) for the frontal were 0.72 (RLF) and 0.62 (LLF), and 0.77 (F) and 0.83 (E). Poor correlations were indicated for the rotations. The intra-tester reproducibility derived from the test-retest DI measurement indicated good to excellent reproducibility in all planes with ICCs ranging from 0.82 (LLF) to 0.94 (E). The Standard Error of Measurement ranged from 1.6° (RR) to 2.6° (F). Conclusion. DI-based CROM measurements are reproducible and valid for recording sagittal and frontal plane motions in healthy subjects. The higher range in rotations, relative to the Zebris-based findings, is most probably attributable to the test position. Being relatively cheap, portable and convenient for tester and subject alike, the DI seems to be an effective instrument for assessing CROM. Copyright © 2009 John Wiley & Sons, Ltd.
Prevalence, risk factors and preventive strategies in work-related musculoskeletal disorders among Israeli physical therapists
Vitaly Rozenfeld, Joseph Ribak, Josepha Danziger, Judith Tsamir, Eli Carmeli Wed, 22 Apr 2009 07:10:00 -0000
Background and Purpose. Although physical therapists (PTs) have extensive knowledge of body mechanisms and injury prevention, work-related musculoskeletal disorders (WRMD) are quite common in this population. The purposes of this study were: to determine the prevalence and impact of WRMD among Israeli PTs; to investigate WRMD risk factors and to identify preventive strategies used by PTs; and to compare the risk of injuries in two professional settings: rehabilitation centres (RCs) and outpatient clinics (OPCs). Method. A validated, modified Cromie questionnaire, translated into Hebrew, was distributed to the PTs at their workplaces. The relationship between WRMD symptoms and professional settings was analysed by Pearson chi-square. The risk models were developed by logistic regression. One hundred and twelve PTs working in OPCs and RCs who defined themselves as healthy individuals were the subjects of this study. Results. Lifetime prevalence of WRMD was 83%. The highest prevalence of WRMD was in the lower back area (80%). Rehabilitation treatment was associated with an increased risk of lower back (odds ratio [OR] = 1.05) and shoulder symptoms (OR = 1.04); manual treatment was associated with an increased risk of wrist/thumb symptoms (OR = 1.11). Discussion. Work in RCs was associated with an increased prevalence of lower back/shoulder symptoms, whereas work in OPCs was associated with an increased prevalence of thumb/wrist symptoms. PT's used different strategies to reduce risk of WRMD, including altering practice technique. The respondents recommended administrative and ergonomic changes in the workplace. Conclusion. Workplace-specific interventions to reduce WRMD in PTs should be developed and tested in future studies. Copyright © 2009 John Wiley & Sons, Ltd.

Developmental Neurorehabilitation: Articles recently published in

What symptoms predict the diagnosis of autism or PDD-NOS in infants and toddlers with developmental delays using the Baby and Infant Screen for aUtIsm Traits
Dempsey, TimothyFodstad, Jill C.Matson, Johnny L.
Screening for mathematical disabilities in kindergarten
Roeyers, HerbertDesoete, AnnemieStock, Pieter
Changes in gait following continuous intrathecal baclofen infusion in ambulant children and young adults with cerebral palsy
Lempereur, MathieuRémy-Néris, OlivierFilipetti, PaulBrochard, Sylvain

Physiotherapy Theory and Practice: Articles recently published in

Transversus abdominis: Changes in thickness during the unsupported upper limb exercise test in older adults
Petkov, JohnThoirs, KerryWilliams, MariePieterse, JohnMcEvoy, MaureenFulton, Ian
Exploration of patients' perspectives of quality within an extended scope physiotherapists' spinal screening service
Reeve, SarahMay, Stephen
Bridging the gap between theory and practice: Dynamic systems theory as a framework for understanding and promoting recovery of function in children and youth with acquired brain injuries
Levac, DanielleDeMatteo, Carol

 
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American Journal of Physical Medicine & Rehabilitation - Current Table Of Contents - American Journal of Physical Medicine & Rehabilitation,July 2007, Volume 86, Issue 7

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