REHABILITATION MEDICINE

survival role having an associated scaling factor to

indicate impact on the individuals life.
Impairment

What is Rehabilitation Medicine?

Medical specialty that deals with the evaluation and
treatment of patients whose functional abilities have
been impaired.
Disabilities and impairments may result from injuries
or diseases, and the goal of rehabilitation is to
restore an ill or injured patient to self-sufficiency or
to gainful employment at his or her highest
attainable skill level in the shortest possible time.
Committed to achieving medical and technological
advances which give individuals with severely
disabling conditions the potential to lead healthy
and productive lives.

Disability vs Handicapped vs Impairment

Disability
is any restriction or lack (resulting from an
impairment) of ability to perform an activity in the
manner or within the range considered normal for a
human being. Disability is concerned with functional
performance or activity, and limitations therein,
affecting the whole person. The disability codes
attempt to encompass those activities considered
important in daily life. Like impairment, the
classification of disability is hierarchical but allows
for an additional parameter to record the severity of
disability.
Handicapped
is a disadvantage for a given individual, resulting
from an impairment or a disability, that limits or
prevents the fulfilment of a role that is normal
(depending on age, sex, and social and cultural
factors) for that individual. (WHO 1980). Handicap
focuses on the person as a social being and reflects
the interaction with and adaptation to the persons
surroundings. The handicap codes attempt to classify
those consequences which place that individual at a
disadvantage in relation to their peers. The
classification system for handicap is not hierarchical,
but comprises a group of survival roles, with each

is any loss or abnormality of psychological,

physiological or anatomical structure or function.
Impairment is considered to occur at the level of
organ or system function. Assessment of impairment
requires judgement of mental and physical
functioning of the body and its component parts
according to accepted standards. The classification
of impairment is hierarchical, allowing considerable
specificity for those needing to record such detail.

Members of the Rehabilitation Team:

Physical medicine and rehabilitation (PM&R)
physicians or are specialists in diagnosing and
treating problems of the musculoskeletal and
neurological system. Through non-surgical
intervention the physiatrist evaluates, prescribes,
monitors and coordinates the rehabilitation needs of
the patient. The goal of the PM&R physician is to
treat the whole person not just the patient's
symptoms.
Case manager/social worker - This professional
helps patients and their families adjust to and cope
with new disabilities, whether short term or
permanent. The case manager/social worker also
coordinates financial assistance, including insurance,
disability payments, and state and federal funding;
family education; and discharge planning, including
the information and counselling needed to make
informed decisions about further care.
Chaplain - help patients and their families use their
spiritual resources when adjusting to life-changing
disabilities. A chaplain is available to answer
questions and, if desired, help establish advance
directives such as a living will and durable power of
attorney.
Dietician - Clinical dieticians oversee patients'
nutrition. They teach patients and families about
specialized diets, and work with other team
members to ensure that meals are nutritious and
appropriate for patients' levels of ability to prepare
and eat.

 Family - The family is the patient's major support

system. The rehabilitation team will ask family
members to participate in care and therapies to help
patients achieve maximum results
Medical director - is the captain of the team. The
medical director oversees patients' recovery and
prescribes therapies. The medical director may ask
physicians in other specialty areas to become part of
the rehabilitation team. The Physiatrist/
Rehabilitation Doctor is usually the Medical Director.
Nursing staff - Nurses in the Rehabilitation Unit help
patients achieve as much independence and
endurance as possible. Besides providing medical
care, they spend time teaching patients self-care
skills such as eating, dressing and toileting.
Occupational therapist - Occupational therapists
evaluate patients' perceptions, sensations, motor
function and cognition. Then they develop treatment
programs in self-care, dressing, eating, homemaking,
and muscle strengthening and coordination. They
also evaluate the need for special devices to help
patients adapt to living at home.
Patient - The patient must provide more initiative,
hard work and determination than anyone else on
the team. Patients have three hours of therapy daily.
They are encouraged to do as much for themselves
as possible during and after rehabilitation.
Physical Therapist - A specialist in how the body
moves, a physical therapist helps patients improve
coordination, muscle tone and endurance to
increase mobility from sitting and reaching to
walking. A physical therapist may decide whether
braces or prostheses are necessary.
Psychologist/Psychiatrist - Psychologists are
professionals who specialize in cognitive and
psychological evaluations. They counsel patients and
family members, and help them adjust to changes
that occur when a person has a disability.
Psychologists also advise other team members on
treating patients who have difficulty with emotional
or cognitive behaviour.
Speech/language pathologist - help patients regain
speaking, understanding, reading and writing skills
that may have been lost because of stroke, surgery
or injury. Speech/language pathologists also

evaluate swallowing disorders and design treatment

programs to promote the return to a normal diet.
Orthotists and Prosthetists - design, construct, and
fit artificial limbs and orthopedic devices for patients
with body deformities and disorders. Prosthetists
specialize in designing and making artificial limbs,
while Orthotists specialize in designing and fitting
orthopedic braces such as surgical supports and
corrective shoes.

SECTION 3C (2ND Sem, SY 2011-2012)