UEMS Physical And Rehabilitation Medicine Section Research Articles

Evidence-based position paper on physical and rehabilitation medicine professional practice for persons with COVID-19, including post COVID-19 condition: the European PRM position (UEMS PRM Section).

Although multiple factors still pose challenges to inpatient/outpatient rehabilitation for survivors of COVID-19, rehabilitation plays a key role for this patient population. This study aimed to improve Physical and Rehabilitation Medicine (PRM) physician's professional practice for persons with COVID-19-related functioning limitations, to promote functional recovery and reduce activity limitations and/or participation restrictions. A systematic review of the scientific literature was performed from December 2019 to August 2022, followed by production of recommendations through 5 Delphi rounds, by consensus among the delegates of all European countries represented in the Union of European Medical Specialists PRM Section. The systematic literature review is reported together with thirty-two recommendations resulting from the Delphi procedure. The PRM physician's role for persons with COVID-19-related limitations of functioning is to develop, foster, and monitor the implementation of an individual rehabilitation project tailored to the patient's age, previous medical and functional status, current comorbidities and complications, activity limitations and participation restrictions and personal and environmental factors. This is done by applying the concept of a multi-specialty integrated service model with multi-professional/interdisciplinary teams, providing care at all stages of COVID-19 illness. This evidence-based position paper represents the official position of the European Union through the UEMS PRM Section.

Evidence-based position paper of the UEMS PRM on the role of Physical and Rehabilitation Medicine (PRM) physician in the management of children and adults with spinal dysraphism.

Spinal dysraphism (SD) or spina bifida (SB) is a congenital deformity that results from embryonic neural tube closure failure during fetal development. This evidence-based position paper represents the official position of the European Union through the UEMS PRM Section. This paper aims to evaluate the role of the physical and rehabilitation medicine (PRM) physician and PRM practice for children and adults with spinal dysraphism. A systematic literature review and a consensus procedure involved all European countries delegates represented in the UEMS PRM section through a Delphi process. The systematic literature review is reported together with thirty-two recommendations resulting from the Delphi procedure. The professional role of the PRM physician requires specific expertise in the treatment of patients with SD to plan, lead and monitor the rehabilitation process in an interdisciplinary setting and to participate in the assessment of the needs of these patients in the transitional phase from childhood to adulthood, with particular attention to the activity limitation and participation restriction.

Evidence based position paper on Physical and Rehabilitation Medicine practice for people with muscular dystrophies.

Muscular dystrophies present a group of inherited degenerative disorder that are characterized by progressive muscular weakness. This evidence-based position paper represents the official position of the European Union through the UEMS PRM Section. The aim of the paper is to evaluate the role of the physical and rehabilitation medicine (PRM) physician and PRM practice for people with muscular dystrophies. 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. The systematic literature review is reported together with thirty-three recommendations resulting from the Delphi procedure. The role of the PRM physician is to assess the functional status of persons with muscular dystrophy and to plan, monitor and lead PRM program in an interdisciplinary setting within a multiprofessional team.

Evidence-based position paper on Physical and Rehabilitation Medicine practice for people with amyotrophic lateral sclerosis.

Amyotrophic lateral sclerosis (ALS) is a progressive motor neuron disease that affects both upper and lower motor neurons and is fatal in its course. This evidence-based position paper represents the official position of the UEMS PRM Section. The aim of the paper is to define the role of the physical and rehabilitation medicine (PRM) physician and PRM professional practice for people with ALS. 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. The systematic literature review is reported together with thirty-two recommendations resulting from the Delphi procedure. The responsibility of the PRM physician is functional assessment of persons with ALS and delivering the optimal and most effective PRM program of care. The rehabilitation program of patients with ALS should be delivered and monitored by the multiprofessional team, with the PRM physician as principal coordinator.

Evidence-based position paper on Physical and Rehabilitation Medicine professional practice for persons with acute and chronic pain. The European PRM position (UEMS PRM Section).

Pain is a frequent complaint from patients undergoing rehabilitation. It can be a major problem and can lead to several activity limitations and participation restrictions. For this reason, when the Professional Practice Committee (PPC) of the Physical and Rehabilitation Medicine (PRM) Section of the European Union of Medical Specialists (UEMS) decided to prepare evidence-based practice position papers (EBPPs) on the most relevant fields of PRM, a paper on the role of the PRM specialist on pain conditions was also included. The goals of this paper are to provide recommendations on the PRM physician's role in pain management; how to address this major problem and what is the best evidence-based approach for the PRM physician in acute and chronic pain conditions. This paper follows the methodology defined by the Professional Practice Committee of the UEMS-PRM Section. A systematic literature search in PubMed was carried out and the results obtained from filtered papers were subjected to four Delphi rounds. Fifteen recommendations were obtained from the Consensus Process and systematic review and were approved by all of the delegates of the UEMS-PRM Section. It is recommended that PRM physicians focus on pain as a primary aim of their interventions, in whatever field they are applying their competencies. It is also recommended that the approach to pain focuses either on reducing the symptoms and improving functioning/reducing disability or recurrences and improving the health condition in the long term avoiding chronicity. Every PRM specialist encounters the problem of pain and some specialize in this field and their role is greater than that of the regular PRM doctor. Based on the evidence available, it is reasonable to determine the role of the physiatrist in managing pain.

Evidence-based position paper on Physical and Rehabilitation Medicine professional practice for persons with stroke. The European PRM position (UEMS PRM Section).

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 has been performed involving the delegates of all European countries represented in the UEMS PRM Section. The systematic literature review is reported together with 78 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 organize 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.

Evidence-based position paper on Physical and Rehabilitation Medicine professional practice for Adults with Acquired Brain Injury. The European PRM position (UEMS PRM Section).

Acquired brain injury (ABI) is damage to the brain that occurs after birth caused either by a traumatic or by a nontraumatic injury. The rehabilitation process following ABI should be performed by a multi-professional team, working in an interdisciplinary way, with the aim of organizing a comprehensive and holistic approach to persons with every severity of ABI. This Evidence Based Position Paper 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 ABI. The aim was to formulate recommendations on the PRM physician's professional practice for persons with ABI in order to promote their functioning and enhance quality of life. This paper has been developed according to the methodology defined by the Professional Practice Committee of the UEMS-PRM Section: a systematic literature search has been performed in PubMed and Core Clinical Journals. On the basis of the selected papers, recommendations have been made as a result of five Delphi rounds. The literature review as well as thirty-one recommendations are presented. The expert consensus is that structured, comprehensive and holistic rehabilitation program delivered by the multi-professional team, working in an interdisciplinary way, with the leadership and coordination of the PRM physician, is likely to be effective, especially for those with severe disability after brain injury.

Evidence-based position paper on Physical and Rehabilitation Medicine (PRM) professional practice for persons with spinal cord injury. The European PRM position (UEMS PRM Section).

Spinal cord injury (SCI) is a devastating condition and a challenge for every health system and every society. This EBPP represents the official position of the European Union through the UEMS PRM Section and designates the professional role of PRM physicians for people with SCI. The aim of the paper was to improve Physical and Rehabilitation Medicine (PRM) physicians' professional practice for persons with SCI in order to improve their functionality, social and community reintegration, and to overcome activity limitations and/or participation restrictions. 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. The systematic literature review is reported together with thirty-eight recommendations resulting from the Delphi procedure. The professional role of PRM physicians who have expertise in the rehabilitation of SCI is to run rehabilitation programmes in multi-professional teams, working in an interdisciplinary way in a variety of settings to improve the functioning of people with SCI.

Evidence-based position paper on Physical and Rehabilitation Medicine (PRM) professional practice for people with cardiovascular conditions. The European PRM position (UEMS PRM Section).

Cardiovascular conditions are significant causes of mortality and morbidity leading to substantial disability. The aim of the paper is to improve Physical and Rehabilitation Medicine (PRM) physicians' professional practice for people with cardiovascular conditions in order to promote their functioning and to reduce activity limitations and/or participation restrictions. 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. The systematic literature review is reported together with thirty recommendations resulting from the Delphi procedure. The professional role of PRM physicians having expertise in the rehabilitation of cardiovascular conditions is to lead cardiac rehabilitation programs in multiprofessional teams, working in collaboration with other disciplines in a variety of settings to improve functioning of people with cardiovascular conditions. This evidence-based position paper represents the official position of the European Union through the UEMS PRM Section and designates the professional role of PRM physicians in persons with cardiovascular conditions.

Evidence-based position paper on Physical and Rehabilitation Medicine (PRM) professional practice for people with respiratory conditions. The European PRM position (UEMS PRM Section).

Chronic respiratory conditions are among the top causes of death and disability. The aim of the paper was to improve Physical and Rehabilitation Medicine (PRM) physicians' professional practice for people with chronic respiratory conditions in order to promote their functioning and to reduce activity limitations and/or participation restrictions. 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. The systematic literature review is reported together with twenty-three recommendations resulting from the Delphi procedure. The professional role of PRM physicians having expertise in the rehabilitation of chronic respiratory conditions is to lead pulmonary rehabilitation programs in multiprofessional teams, working in collaboration with other disciplines in a variety of settings to improve functioning of people with chronic respiratory conditions. This evidence-based position paper represents the official position of the European Union through the UEMS PRM Section and designates the professional role of PRM physicians for people with respiratory conditions.

Evidence based position paper on Physical and Rehabilitation Medicine (PRM) professional practice for ageing people with disabilities. The European PRM position (UEMS PRM Section).

Ageing people with disabilities (APwDs) are faced with challenges of ageing which is straightforwardly related to disability that adds to the burden related to their early-onset disability. The aim of the paper is to improve Physical and Rehabilitation Medicine (PRM) physicians' professional practice for APwDs (as a distinct group from those who are disabled due to the ageing process) in order to promote their functioning properties and to reduce activity limitations and/or participation restrictions. 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. The systematic literature review is reported together with the 30 recommendations resulting from the Delphi procedure. The professional role of PRM physicians in relation to APwDs is extending, expanding and/or improving health-related rehabilitation services worldwide in various settings (getting beyond the rehabilitation facilities) emphasizing the concept of integrated care with collaboration across other sectors to meet the specific needs of APwDs. This evidence based position paper (EBPP) represents the official position of the European Union through the UEMS PRM Section and designates the professional role of PRM physicians in APwDs.

Evidence-based position paper on Physical and Rehabilitation Medicine (PRM) professional practice for people with obesity and related comorbidities. The European PRM position (UEMS PRM Section).

The WHO world health statistics report in 2015 shows that in Europe the overall obesity rate among adults is 21.5% in males and 24.5% in females. Obesity has important consequences for morbidity, disability and quality of life. The aim of the paper was to improve physical and rehabilitation medicine physicians' professional practice for the rehabilitation of patients with obesity and related comorbidities. A systematic review of the literature and a Consensus procedure by means of a Delphi method process has been performed involving the delegates of all European countries represented in the UEMS PRM Section. The systematic literature review is reported together with the 13 recommendations from the Delphi procedure. The professional role of PRM physicians in obesity is to propose a complete PRM treatment for the patients considering the comorbidities, impairments, activity limitations and participation restrictions, providing medical care and leadership to the multidisciplinary team, coordinating the individual PRM project developed in team in agreement with the patient and his family/care givers.

Practice, science and governance in interaction: European effort for the system-wide implementation of the International Classification of Functioning, Disability and Health (ICF) in Physical and Rehabilitation Medicine.

Since its launch in 2001, relevant international, regional and national PRM bodies have aimed to implement the International Classification of Functioning, Disability and Health (ICF) in Physical and Rehabilitation Medicine (PRM), whereby contributing to the development of suitable practical tools. These tools are available for implementing the ICF in day-to-day clinical practice, standardized reporting of functioning outcomes in quality management and research, and guiding evidence-informed policy. Educational efforts have reinforced PRM physicians' and other rehabilitation professionals' ICF knowledge, and numerous implementation projects have explored how the ICF is applied in clinical practice, research and policy. Largely lacking though is the system-wide implementation of ICF in day-to-day practice across all rehabilitation services of national health systems. In Europe, system-wide implementation of ICF requires the interaction between practice, science and governance. Considering its mandate, the UEMS PRM Section and Board have decided to lead a European effort towards system-wide ICF implementation in PRM, rehabilitation and health care at large, in interaction with governments, non-governmental actors and the private sector, and aligned with ISPRM's collaboration plan with WHO. In this paper we present the current PRM internal and external policy agenda towards system-wide ICF implementation and the corresponding implementation action plan, while highlighting priority action steps - promotion of ICF-based standardized reporting in national quality management and assurance programs, development of unambiguous rehabilitation service descriptions using the International Classification System for Service Organization in Health-related Rehabilitation, development of Clinical Assessment Schedules, qualitative linkage and quantitative mapping of data to the ICF, and the cultural adaptation of the ICF Clinical Data Collection Tool in European languages.

Evidence based position paper on physical and rehabilitation medicine (PRM) practice for people with spinal deformities during growth. The European PRM position (UEMS PRM Section).

Scoliosis and other spinal deformities involve 3-4% of the population during growth. Their so-called conservative treatment is in the field of competence of physical and rehabilitation medicine (PRM) physicians. This evidence based position paper represents the official position of the European Union through the European Union of Medical Specialists (UEMS) - PRM Section. The aim of the paper was to improve PRM specialists' professional practice for patients with spinal deformities during growth. A systematic review of the literature and a Consensus procedure with 26 recommendations by means of a Delphi method process has been performed involving the delegates of all European countries represented in the UEMS-PRM Section. the systematic literature review is reported together with 26 recommendations coming from the Consensus Delphi procedure. The professional role of PRM physicians in spinal deformities during growth is to propose a complete PRM treatment for the patients considering all the concurring diseases and pathologies, impairments, activity limitations and participation restrictions. The PRM physician's role is to coordinate the individual PRM project developed in team with other health professionals and medical specialists, in agreement with the patient and his family, according to the specific medical diagnoses.