Essentials of Rehabilitation Practice and Science

Basic Practice Concepts

• Rehabilitation philosophy
  • The Philosophical Foundations of Physical Medicine and Rehabilitation
• History of Physical Medicine and Rehabilitation
  • The Early History of the Specialty of Physical Medicine and Rehabilitation
• Rehabilitation teams
• Functional assessment
• Environmental assessment
  • Physical environment
  • Environmental Assessment
  • Interpersonal environment
• Racial Disparities in Access to and Outcomes from Rehabilitation Services
• Conceptual models of disability
• Measurement of Outcomes

Specialized Physiatric Assessment and Management Strategies

• Specialized Physiatric Assessment and Management Strategies
• Osteopathic Medicine
• Adapting Your Practice During a Pandemic: COVID-19
• Procedures
  • Diagnostic
    • Physiatric approaches to physical examination
      1. Neurological examination and classification of SCI
      2. Cognitive/behavioral/neuropsychological testing
      3. Specialized musculoskeletal examination
         1. Spine and neck
         2. Extremities
      4. Assessment/determination of spinal stability after spinal compression fractures and spinal cord injury
         1. Assessment/Determination of Spinal Column Stability
      5. Physiological principles underlying electrodiagnosis and neurophysiologic testing
    • Imaging
      1. MRI and CT scanning
      2. Plain radiography
      3. Ultrasound Imaging of Musculoskeletal Disorders
  • Principles of pharmalogic treatments
    • Injectable agents
      1. Peripheral agents, soft tissue injections
         1. Anesthetic agents
         2. Steroids and Corticosteroids
      2. Central agents
         1. Intrathecal Agents
         2. Other central pumps
      3. Steroids
      4. Analgesics
         1. Non-opioids
            • Nonsteroidal Anti-Inflammatory Medications
            • Anticonvulsants
            • Other adjuvant agents
         2. Opioids
            • Opioid Management for Chronic Pain
      5. Immune stimulators
    • Therapeutic Injection of Dextrose: Prolotherapy, Perineural Injection Therapy and Hydrodissection
    • Joint injections/aspiration
    • Spinal procedures
    • Chemodenervation and Neurolysis
    • Anticoagulant Pharmacology
• Physiatric therapeutics
  • Exercise
    • Exercise prescription and basic principles of therapeutic exercise
      1. Strengthening
      2. Flexibility
      3. Endurance
         1. Cardiovascular
            • Cardiac issues in sports medicine
         2. Muscular
            • Hydration Issues in the Athlete and Exercise Associated Hyponatremia
      4. Skill aquisition
         • Downed runner
    • Integrative Approaches to Therapeutic Exercise
    • Core stabilization
      1. To support specific athletic skills including injury prevention
         1. Throwing athletes
      2. For injured workers including prevention
         1. Core Strengthening
    • Alternative and complementary approaches
      1. Acupuncture
         • Alternative and Complementary Approaches – Acupuncture
      2. Biomechanical
         • Pilates
      3. Energy flow
         • Tai chi
    • Role of exercise in neuromuscular conditions
  • Therapeutic modalities
    • Heat
    • Cold
    • Electricity
    • Manual treatments
  • Orthotics
    • Upper Limb Orthotics
    • Lower Limb Orthotics/Therapeutic Footwear
    • Cervical, Thoracic and Lumbosacral Orthoses
  • Durable medical equipment that supports activities of daily living, transfers and ambulation
    • Wheelchair and Power Mobility for Adults
  • Environmental evaluation
    • Therapeutic massage
    • Home/workplace modification
    • Universal design
    • Ergonomics
  • Virtual Reality and Robotic Applications in Rehabilitation
  • Caregiving training
• Administrative rehabilitation medicine
  • Systems based practice
    • Administrative Rehabilitation Medicine: Systems-based Practice
    • Palliative care
  • Rehabilitation team functioning
  • Outcome measurement in rehabilitation
    • Disability evaluation
    • Quality improvement / patient safety issues relevant to rehabilitation
  • Compliance issues relevant to rehabilitation
  • Regulatory and accreditation requirements in rehabilitation
    • Professionalism in rehabilitation including peer, student, resident and fellow recommendations/assessment
    • Ethical issues commonly managed during rehabilitation
  • Resource allocation in rehabilitation
  • Quality Payment Program/Pay for Performance
  • Rehabilitation levels of care
  • Medico-legal considerations / risk management in rehabilitation
  • Patient advocacy in rehabilitation
    • Clinical informatics in rehabilitation practice
  • Communication issues relevant in rehabilitation
    • Communication Issues in Physical Medicine and Rehabilitation
    • Electronic medical record/electronic health record
    • Privacy
    • Meaningful use
    • Medical Reconciliation/Hand-offs Care
  • Development of a Comprehensive Cancer Rehabilitation Program

Basic Science Concepts

• Basic skills for assessment of medical literature
  • Essentials of understanding medical literature: Classes of evidence, FDA guidelines, basic statistics, and study design for understanding medical literature
• Neurological recovery and regeneration
  • Central
    • Natural Recovery and Regeneration of the Central Nervous System
  • Peripheral
    • Peripheral neurological recovery and regeneration
• Neuromuscular Junction Physiology
• Movement of physiology, biomechanics/kinesiology, and analysis
  • Biomechanic of gait and treatment of abnormal gait patterns
  • Assessment and treatment of balance impairments
  • Energy expenditure during basic mobility and approaches to energy conservation
    • Pain and placebo physiology
    • Energy expenditure during basic mobility and approaches to energy conservation
• Pain and placebo physiology
• Normal aging
  • Cell death/apoptosis
• Illness behavior
  • Influence of psychosocial factors on illness behaviors
  • Female athlete triad
• Normal development
  • Normal childhood and adolescent development
  • Psychological and psychosocial development during adulthood
  • Developmental transitions
    • Child to adult
      1. Transition to Adulthood for Persons with Childhood Onset Disabilities
    • Middle age to old age
• Models of learning and behavioral modification in rehabilitation
  • Incorporation of prevention and risk factor modification in rehabilitation

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