Member of Professional Practice Committee, UEMS Section of PRM, Department of Physical Medicine and Rehabilitation Faculty of Medicine, Ankara University, Ankara, Turkey -
Eur J Phys Rehabil Med. 2013 Aug;49(4):551-64.
One of the objectives of the Professional Practice Committee (PPC) of the Physical and Rehabilitation Medicine (PRM) Section of the Union of European Medical Specialists (UEMS) is the development of the field of competence of PRM physicians in Europe. To achieve this objective, UEMS PRM Section PPC has adopted a systematic action plan of preparing a series of papers describing the role of PRM physicians in a number of disabling health conditions, based on the evidence of effectiveness of the physical and rehabilitation medicine interventions. Inflammatory arthritis is a major cause of disability with an important economic burden in society. The goals in the management of inflammatory arthritis are to control pain and disease activity, prevent joint damage, protect and enhance function and improve quality of life. This paper aims to define the role of PRM physicians in people with inflammatory arthritis. PRM interventions imply non-pharmacological treatments which include patient education for joint protection, energy conservation and self-management techniques, exercise therapy, physical modalities, orthoses/assistive devices and balneotherapy. Therapeutic patient education and exercises are the cornerstones of therapy with strong evidence of their effectiveness to improve function. Physical modalities are primarily used to decrease pain and stiffness whereas orthoses/assistive devices are usually prescribed to enhance activities and participation. PRM physicians have distinct roles in the management of people with inflammatory arthritis such that they effectively organise and supervise the PRM program in the context of interdisciplinary team work. Their role starts with a comprehensive assessment of patient's functioning based on the International Classification of Functioning Disability and Health (ICF) as the framework. In the light of this assessment, appropriate PRM interventions individualised for the patient are administered. Future research and actions regarding the role of PRM in inflammatory arthritis should target access to care, updates on the use and effectiveness of physical modalities, orthoses/assistive devices, and standardization of therapeutic patient education programs.
欧洲医学专家联合会（UEMS）物理医学与康复医学（PRM）分会专业实践委员会（PPC）的目标之一是发展 PRM 医师在欧洲的能力领域。为了实现这一目标，UEMS PRM 分会 PPC 采用了系统的行动计划，根据物理和康复医学干预措施的有效性证据，编写了一系列描述 PRM 医师在多种致残性健康状况中作用的文件。炎症性关节炎是导致残疾的主要原因，也是社会面临的一个重要经济负担。炎症性关节炎管理的目标是控制疼痛和疾病活动，预防关节损伤，保护和增强功能，提高生活质量。本文旨在定义 PRM 医师在炎症性关节炎患者中的作用。PRM 干预措施包括非药物治疗，如关节保护、节能和自我管理技术、运动疗法、物理疗法、矫形器/辅助设备和水疗的患者教育。治疗性患者教育和运动是治疗的基石，有强有力的证据表明它们可以改善功能。物理疗法主要用于减轻疼痛和僵硬，而矫形器/辅助设备通常用于增强活动和参与度。PRM 医师在炎症性关节炎患者的管理中发挥着独特的作用，他们能够在跨学科团队工作的背景下有效地组织和监督 PRM 计划。他们的角色始于根据国际功能、残疾和健康分类（ICF）作为框架对患者的功能进行全面评估。根据这一评估，为患者提供个性化的适当 PRM 干预措施。关于 PRM 在炎症性关节炎中的作用的未来研究和行动应针对获得护理、物理疗法、矫形器/辅助设备的使用和有效性的更新以及治疗性患者教育计划的标准化。
