Physical Medicine and Rehabilitation (PM&R)

Physical Medicine and Rehabilitation (PM&R), also known as physiatry, is a medical specialty that involves the process of restoring function for a person who has been disabled as a result of a disease, disorder, or injury.

The word physiatry comes from the two Greek words:

Physikos - meaning physical
Iatreia - meaning the art of healing

Physiatry provides integrated, multidisciplinary care aimed at recovery of the whole person - by addressing the individual's physical, emotional, medical, vocational, and social needs. A physician who specializes in physical medicine and rehabilitation is called a physiatrist.

What is rehabilitation?

Rehabilitation is the process of helping an individual achieve the highest level of function, independence, and quality of life possible. Rehabilitation does not reverse or undo the damage caused by disease or trauma, but rather helps restore the individual to optimal health, functioning, and well-being. Rehabilitate (from the Latin "habilitas") means to make able.

The goal of rehabilitation

The purpose of rehabilitation is to help the patient reach the highest level of function by preventing complications, reducing disability, and improving independence.

The rehabilitation program:

Rehabilitation medicine is designed to meet each person's specific needs; therefore, each program is different. Some general treatment components for rehabilitation programs include the following:

• Treating the basic disease and preventing complications
• Treating the disability and improving function
• Providing adaptive tools and altering the environment
• Teaching the patient and family and helping them adapt to lifestyle changes

The success of rehabilitation depends on many variables, including the following:

• The nature and severity of the disease, disorder, or injury
• The type and degree of any resulting impairments and disabilities
• The overall health of the patient
• Family support

Areas covered in rehabilitation programs may include the following:

Patient need:	Example:
Self-care skills, including activities of daily living (ADLs)	Feeding, grooming, bathing, dressing, toileting, and sexual function
Physical care	Nutritional needs, medication, and skin care
Mobility skills	Walking, transfers, and self-propelling a wheelchair
Respiratory care	Ventilator care, if needed; breathing treatments and exercises to promote lung function
Communication skills	Speech, writing, and alternative methods of communication
Cognitive skills	Memory, concentration, judgment, problem solving, and organizational skills
Socialization skills	Interacting with others at home and within the community
Vocational training	Work-related skills
Pain management	Medications and alternative methods of managing pain
Psychological counseling	Identifying problems and solutions with thinking, behavioral, and emotional issues
Family support	Assistance with adapting to lifestyle changes, financial concerns, and discharge planning
Education	Patient and family education and training about the condition, medical care, and adaptive techniques

Understanding rehabilitation terminology:

Rehabilitation is needed when a disease and injury causes an impairment. Consider the following:

• An impairment is a loss of normal function of part of the body, such as paralysis of a leg.
• Disability occurs when a person is not able to perform an activity in a normal way as a result of an impairment, such as not being able to walk. Most people with disabilities are not considered handicapped - they go to school, work, perform family duties, and interact with society fully and capably.
• A handicap occurs when there are limits that prevent a person with a disability from performing a role that is normal for that person, such as not being able to work. A handicap refers to a barrier that may be imposed by society, the environment, or by one's own attitude.