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Introduction of Physical Medicine and Rehabilitation. 台北榮總復健醫學部 R4 程遠揚. Physical medicine. Treat the physical problem detected by physical examination Musculoskeletal examination Neurological examination Functional examination . Musculoskeletal examination. Inspection Palpation

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Introduction of Physical Medicine and Rehabilitation


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  1. Introduction of Physical Medicine and Rehabilitation 台北榮總復健醫學部 R4 程遠揚

  2. Physical medicine • Treat the physical problem detected by physical examination • Musculoskeletal examination • Neurological examination • Functional examination

  3. Musculoskeletal examination • Inspection • Palpation • Active and passive ROM • Joint stability • Manual muscle testing • Specific tests

  4. Specific tests for shoulder

  5. Demonstration of shoulder impingement

  6. Specific tests for lower limbs

  7. Specific test for contracture

  8. Neurological examination • Consciousness-GCS • Cognitive status-JOMAC • Cranial nerves • Sensory system- temperature, pinprick, light touch, vibration • Motor coordination- HKS, FNF, RAM • Deep tendon reflex • Pathological reflex • Spasticity-Modified Ashworth scale

  9. Rancho Los Amigos scale • 1. No response • 2. Generalized response to stimuli • 3. Localized response to stimuli • 4. Confused agitated • 5. Confused inappropriate • 6. Confused appropriate • 7. Automatic appropriate • 8. Purposeful appropriate

  10. Functional examination • Bed mobility • Sitting ability • Standing ability • Activity of daily living evaluationFIM (functional independence measure) instrumentSelf-care: 6 items Sphincter control: 2 itemsTransfers: 3 itemsLocomotion: 2 itemsCommunication: 2 itemsSocial cognition function: 3 items1-7 score is given for each item

  11. Rehabilitation • Return patients suffered from diseases to previous function • PM&R represent a life-long care for patients of certain diseases • A practical science of medicine

  12. Patients of PMR department • The neonatal and child period: CP, MMC, autism, ADHD, unspecified developmental delay • Adolescent period: sports injury, TBI, SCI, AS • Elderly period: CVA, SCI, OA, Parkinsonism, LBP, Frozen shoulder • Post-operative patients

  13. Criteria for admission to a rehabilitation program • Stable clinical status • Significant persisting deficit • Sufficient cognitive function to learn

  14. Subdivision of PMR department • Physical therapy: Neuro-rehabilitationPhysical modalitiesPediatric rehabilitationHydrotherapyCardiopulmonary rehabilitation • Occupational therapyFunctional training of daily livingOrthosis formingSensory-integration training

  15. Subdivision of PMR department • Speech training and swallowing training • Psychosocial consulting • Vocational evaluation • Prosthesis designing