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Introduction of Physical Medicine and Rehabilitation

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

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