| 1. |
- Dincer, Fitnat, et al.
(författare)
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The approach of physiatrists to low back pain across Europe
- 2019
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Ingår i: Journal of Back and Musculoskeletal Rehabilitation. - : IOS PRESS. - 1053-8127 .- 1878-6324. ; 32:1, s. 131-139
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Low back pain (LBP) is the most common type of musculoskeletal pain, thus it is one of the most commonly encountered conditions in Physical and Rehabilitation Medicine. The physicians who are primarily responsible for the nonsurgical management of LBP are physiatrists. OBJECTIVE: The present study aimed to investigate the approaches of physiatrists to low back pain across Europe. Preferences, tendencies, and priorities in the diagnosis, management, and treatment of LBP, as well as the epidemiological data pertaining to LBP in PRM practice were evaluated in this Europe-wide study. METHODS: The study was conducted under the control of the European Society of Physical and Rehabilitation Medicine (ESPRM) Musculoskeletal Disorders Research Committee. A total of 576 physiatrists from most European countries participated in the survey. RESULTS: The results show that physiatrists frequently deal with patients with LBP in their daily practice. Most patients are not referred to other departments and are treated with various conservative methods. Less than one-fifth of patients are primarily referred for surgery. The physiatrists believe that a clear diagnosis to account for cases of low back pain is rarely established. The most common diagnosis is discopathy. History and physical examination remain the most valuable clinical evaluation tools for low back pain according to physiatrists. Less than half the patients require a magnetic resonance imaging. Non-steroidal anti-inflammatory drugs are the most commonly prescribed drugs for low back pain. Exercise, back care information, and physical therapy are the preferred conservative treatments. More than half of the physiatrists offer interventional treatments to patients with low back pain. CONCLUSION: The present study is a preliminary report that presents the attitudes of European physiatrists in the management of low back pain. Further researches are warranted to standardize the conservative management of LBP.
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| 2. |
- Ehrmann, Cristina, et al.
(författare)
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IMPACT OF SPASTICITY ON FUNCTIONING IN SPINAL CORD INJURY: AN APPLICATION OF GRAPHICAL MODELLING
- 2020
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Ingår i: Journal of Rehabilitation Medicine. - : FOUNDATION REHABILITATION INFORMATION. - 1650-1977 .- 1651-2081. ; 52:3
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To identify the impact of moderate-to-severe spasticity on functioning in people living with spinal cord injury. Design: Secondary analysis of cross-sectional survey data using graphical modelling. Subjects: Individuals (n= 1,436) with spinal cord injury aged over 16 years with reported spasticity problems. Methods: Spasticity and 13 other impairments in body functions were assessed using the spinal cord injury Secondary Conditions Scale. Impairments in mental functions were assessed using the Mental Health subscale of the 36-item Short Form (SF-36). Independence in activities was measured with the Spinal Cord Injury Independence Measure Self-Report. Restrictions in participation were measured with the Utrecht Scale for Evaluation Rehabilitation - Participation. Results: Fifty-one percent of participants reported moderate-to-severe spasticity. Graphical modelling showed that Chronic pain, Contractures, Tiredness, Doing housework, and Respiratory functions were associated with spasticity and were the top 5 potential targets for interventions to improve the experience of spasticity. The associations and intervention targets were dependent on the level and completeness of the lesion. Conclusion: This is the first application of graphical modelling in studying spasticity in people living with spinal cord injury. The results can be used as a basis for studies aiming to optimize rehabilitation interventions in people with moderate-to-severe spasticity.
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| 3. |
- Ertzgaard, Per, et al.
(författare)
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A review and evaluation of patient-reported outcome measures for spasticity in persons with spinal cord damage: Recommendations from the Ability Network - an international initiative
- 2020
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Ingår i: Journal of Spinal Cord Medicine (JSCM). - : TAYLOR & FRANCIS LTD. - 1079-0268 .- 2045-7723. ; 43:6, s. 813-823
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Forskningsöversikt (refereegranskat)abstract
- Context: Patient-reported outcome measures (PROMs) are valuable for capturing the impact of spasticity on health-related quality of life (HRQoL) in persons with spinal cord damage (SCD) and evaluating the efficacy of interventions. Objective: To provide practical guidance for measuring HRQoL in persons with spasticity following SCD. Methods: Literature reviews identified measures of HRQoL and caregiver burden, utilized in studies addressing spasticity in SCD. Identified measures were evaluated for clinical relevance and practicality for use in clinical practice and research. The PRISM, SCI-SET, EQ-5D and SF-36 instruments were mapped to the International Classification of Functioning, Disability and Health (ICF). The PRISM and SCI-SET were evaluated using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. Results: Two spasticity-specific, five generic, and four preference-based measures were identified. ICF mapping and the COSMIN checklist supported the use of the PRISM and SCI-SET in SCD. The SF-36 is considered the most useful generic measure; disability-adapted versions may be more acceptable but further studies on psychometric properties are required. The SF-36 can be converted to a preference-based measure (SF-6D), or alternatively the EQ-5D can be used. While no measures specific to caregivers of people with SCD were identified, the Caregiver Burden Scale and the Zarit Burden Interview are considered suitable. Conclusion: Recommended measures include the PRISM and SCI-SET (condition-specific), SF-36 (generic), and Caregiver Burden Scale and Zarit Burden Interview (caregiver burden). Consideration should be given to using condition-specific and generic measures in combination; the PRISM or SCI-SET combined with SF-36 is recommended.
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| 4. |
- Küçükdeveci, Ayşe A, et al.
(författare)
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Evidence based position paper on Physical and Rehabilitation Medicine (PRM) professional practice for persons with stroke. The European PRM position (UEMS PRM Section).
- 2018
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Ingår i: European journal of physical and rehabilitation medicine. - 1973-9095. ; 54:6, s. 957-70
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Tidskriftsartikel (refereegranskat)abstract
- Stroke is a major cause of disability worldwide, with an expected rise of global burden in the next twenty years throughout Europe. This EBPP represents the official position of the European Union through the UEMS Physical and Rehabilitation Medicine (PRM) Section and designates the professional role of PRM physicians for people with stroke.The aim of this study is to improve PRM physicians' professional practice for persons with stroke in order to promote their functioning and enhance quality of life.A systematic review of the literature including a ten-year period and a consensus procedure by means of a Delphi process was been performed involving the delegates of all European countries represented in the UEMS PRM Section.The systematic literature review is reported together with seventy-eight recommendations resulting from the Delphi procedure.The professional role of PRM physicians for persons with stroke, is to improve specialized rehabilitation services worldwide in different settings and to organise and manage the comprehensive rehabilitation programme for stroke survivors considering all impairments, comorbidities and complications, activity limitations and participation restrictions as well as personal and environmental factors.
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| 5. |
- Osterthun, Rutger, et al.
(författare)
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End-of-life decisions and involvement of Physical and Rehabilitation Medicine Physicians in Europe.
- 2023
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Ingår i: Journal of rehabilitation medicine. - 1651-2081. ; 55
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Tidskriftsartikel (refereegranskat)abstract
- As Physical and Rehabilitation Medicine physicians are experts in functional prognoses of disabling health conditions, the aim of this study was to gain insight into their involvement in end-of-life decisions in patients with neurological or terminal diseases in European countries.Exploratory cross-sectional survey.Delegates of the Union of European Medical Specialists, Physical and Rehabilitation Medicine Section.In July 2020, a self-constructed survey was sent to 82 delegates from 38 European countries, who were asked to answer from the point of view of their country. Topics included the legal status of end-of-life decisions and the involvement of Physical and Rehabilitation Medicine physicians in these decisions.Between July 2020 and December 2020, 32 delegates from 28 countries completed the survey (response rate country level of 74%). If legal frameworks allow for these specific end-of-life decisions, involvement of Physical and Rehabilitation Medicine physicians was reported in 2 of 3 countries in euthanasia cases, 10 of 17 countries in non-treatment decision cases, and 13 of 16 countries in cases of intensified symptom management by the administration of drugs using potentially life-shortening doses.Estimated involvement of Physical and Rehabilitation Medicine physicians in end-of-life decisions varied between European countries, even when legal frameworks allow for these decisions.
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| 6. |
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| 7. |
- Zampolini, Mauro, et al.
(författare)
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Evidence-based position paper on Physical and Rehabilitation Medicine (PRM) professional practice on telerehabilitation : the European PRM position (UEMS PRM Section)
- 2024
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Ingår i: European Journal of Physical and Rehabilitation Medicine. - : Edizioni Minerva Medica. - 1973-9087 .- 1973-9095. ; 60:2, s. 165-181
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: The evidence on the utility and effectiveness of rehabilitation interventions delivered via telerehabilitation is growing rapidly. Telerehabilitation is expected to have a key role in rehabilitation in the future.AIM: The aim of this evidence-based position paper (EBPP) is to improve PRM physicians' professional practice in telerehabilitation to be delivered to improve functioning and to reduce activity limitations and/or participation restrictions in individuals with a variety of disabling health conditions.METHODS: To produce recommendations for PRM physicians on telerehabilitation, a systematic review of the literature and a consensus procedure by means of a Delphi process have been performed involving the delegates of all European countries represented in the UEMS PRM Section. RESULTS: The systematic literature review is reported together with the 32 recommendations resulting from the Delphi procedure.CONCLUSIONS: It is recommended that PRM physicians deliver rehabilitation services remotely, via digital means or using communication technologies to eligible individuals, whenever required and feasible in a variety of health conditions in favor of the patient and his/her family, based on evidence of effectiveness and in compliance with relevant regulations. This EBPP represents the official position of the European Union through the UEMS PRM Section and designates the professional role of PRM physicians in telerehabilitation.
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| 8. |
- Zampolini, Mauro, et al.
(författare)
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The Individual Rehabilitation Project as the core of person-centred rehabilitation : the Physical and Rehabilitation Medicine Section and Board of the European Union of Medical Specialists framework for rehabilitation in Europe
- 2022
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Ingår i: European Journal of Physical and Rehabilitation Medicine. - : Edizioni Minerva Medica. - 1973-9087 .- 1973-9095. ; 58:4, s. 503-510
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Tidskriftsartikel (refereegranskat)abstract
- To facilitate the interaction between the health professional and the patient, a framework to guide the rehabilitation process is needed. This framework would encompass three interwoven aspects: the rehabilitation management plan, Individual Rehabilitation Project (IRP), and rehabilitation cycle(s). All three framework aspects focus on the patient and on the aim of rehabilitation, i.e. to optimize a person's functioning across the continuum of care. An IRP is a multi-element, person-centred rehabilitation management scheme, in which rehabilitation is generally provided by a multi-professional team under the leadership of a physical and rehabilitation medicine (PRM) physician, working in an interdisciplinary manner and together with the patient (or proxy). A reference system for operationalizing functioning and standardizing the process is the International Classification of Functioning, Disability and Health (ICF) - for assessing functioning needs, defining rehabilitation goals and outcomes. The objective of this paper is to present the IRP as a framework for rehabilitation in Europe (EUR-IRP). The specific aims are to 1) introduce the IRP and 2) describe the framework components, elements and variables of the IRP. Demonstration projects (case studies) using the EUR-IRP will be conducted. The present paper presents the efforts to date for developing the EUR-IRP, a key part of action plan of the PRM Section and Board of the European Union of Medical Specialists to implement the ICF systemwide across the care continuum. This paper serves as another step to bring together practice, science and governance in calling for contribution from rehabilitation clinicians and researchers and professional societies in PRM and beyond.
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