The Medical Student's Guide to PM&R
Much of the practice of PM&R is built on the "team approach," a unique perspective on patient care. The patient's physical, functional, emotional, and psychosocial well being are all considered in treatment.
The physiatrist is trained to lead and coordinate care with the rehabilitation team, which might include representatives from:
- physical therapy
- recreational therapy
- social services
- internal medicine
- orthopedic surgery
- occupational therapy
- rehabilitation nursing
- speech therapy
The physiatrist is trained in writing prescriptions for specific exercise programs for maintaining and increasing range of motion, strengthening muscles, improving proprioception (awareness of joint position in space), muscle relaxation, and aerobic fitness, all in the context of improving function.
- Examples include strengthening and enhancing proprioception in a runner's sprained ankle, improving range of motion and preventing contracture in a spastic spinal-cord-injured patient, or providing optimal cardiopulmonary fitness in someone who has recently suffered a myocardial infarction.
A physiatrist can also prescribe a host of assistive and adaptive equipment including gait and mobility aids, environmental control devices, communication aids, and various other tools to allow greater independence, optimal safety, and decreased energy expenditure in activities of daily living (ADLs).
One area of expertise is the selection and fitting of wheelchairs and appropriate seating. The PM&R physician is also specially trained to prescribe proper orthoses (e.g., upper and lower limbs, and back bracing) and to prescribe prostheses to amputee patients.