Physical Medicine and Rehabilitation: Interdisciplinary, Interventional, and International

Abstract

In this issue of PM&R, a new featured column is being introduced: The International Perspective. In this column, the journal will facilitate a broad look at our specialty from a global perspective. Indeed, physical medicine and rehabilitation (PMR) is not only interdisciplinary and interventional, it is also international. This new section will focus on areas of scientific and clinical relevance, and on issues of importance for the advancement of PMR in an international context. We are confident that much can be learned from each other through narrative descriptions, perspective viewpoints, and summary reviews on contemporary topics of international importance to the field of PMR. Disability is truly an international issue. In the recent World Heath Organization (WHO) “World Report on Disability,” it is stated that more than 1 billion people in the world live with some form of disability, of whom nearly 200 million experience considerable difficulties in functioning [1]. The report further states that disability will be an even greater concern in the years ahead because its prevalence is on the rise. This is due to a growing number of people over 65 years old and the higher risk of disability in older people, as well as the global increase in chronic health conditions such as diabetes, cardiovascular disease, neurologic disorders, cancer, and mental health disorders. The WHO report also presents innovative policies and programs that can improve the lives of persons with disabilities and facilitate implementation of the United Nations Convention on the Rights of Persons with Disabilities, which came into force in May 2008. The WHO report emphasizes the necessity to create or amend national plans on rehabilitation and to establish infrastructure and capacitytoimplementtheplans,soastoimproveaccesstorehabilitationservices.Weknow that there are numerous efforts being made around the world to do this. We hope that this new column will serve as a medium to present, describe, and discuss these efforts. Our specialty is young and has evolved over the past century. As an example of a highly specialized rehabilitation service, it has been less than 60 years since spinal cord injury rehabilitation was developed at Stoke Mandeville Hospital in England. In many parts of the world, the first PMR specialists were certified within the past 2 decades. The evolutionary history of PMR societies varies in different regions and countries around the world. For example, simply consider the various names of the specialty: “physical medicine and rehabilitation (PMR),” “rehabilitation medicine (RM),” or “physical and rehabilitation medicine (PRM)”[2]. These differences may reflect subtle variations in viewpoints. Understanding our varied histories, evolution, and type of worldwide training programs should help us to appreciate the role of PMR, PRM, or RM in the international medical community. Universally, PMR interacts with many other medical disciplines, usually in the spirit of cooperation but occasionally in a conflicting manner. These positive and negative interactionsusuallyoccuronissuesofdiagnosingandtreatingdiseaseandmanagingdisability.The strengthandvalueofPMRcanbedemonstratedbythedevelopmentofmedicalcareservices that have not been historically provided by other disciplines [3]. This development will be facilitated if we recognize evolutionary histories of individual PMR societies that describe how they have coped with various kinds of challenges. There is a strong need to focus on our medical education system and our training of young physicians and allied health professionals in rehabilitation [2]. Around the world, there are many examples of how core curricula in PMR and rehabilitation medicine have developed as part of our university medical systems. By describing such endeavors, we can continue to learn, agree on commonalities, and in the long term, progress toward a more unifiedknowledgeofrehabilitationinterventions.Manycountrieshavealsotakeninitiatives