Member, Board Committee, UEMS Board of PRM, Department of Physical Medicine and Rehabilitation, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey -
Eur J Phys Rehabil Med. 2013 Aug;49(4):565-77.
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 PRM interventions. A wide range of health conditions treated by PRM specialists carries the risk of osteoporosis (OP). The consequences of OP may be associated with significant disability. The aim of this paper is: to define the role of PRM physicians in the prevention and management of OP, to describe the needs of people with OP in relation to rehabilitation strategy, and to highlight why and how PRM physicians should be involved in the diagnosis and management of OP. PRM physicians may intervene in the prevention of and risk factor assessment for OP, falls and fractures along with other assessments of functioning and of quality of life. In addition, they are involved in diagnosis and in both pharmacological and nonpharmacological treatment of OP. From a specific PRM perspective based on the International Classification of Functioning, Disability and Health (ICF), there is an important role in optimizing functioning and promoting "activities and participation", including interventions associated with environmental factors for people with OP or osteoporotic fractures. Evidence suggests that a large number of interventions within the scope of PRM that range from preventive strategies (including education and self management and most importantly exercise) to pain management strategies and spinal orthoses or hip protectors may be effective in the prevention and/or management of OP and its sequelae. Competencies and aptitudes of PRM specialists, focusing especially on functioning while providing care over the whole course of a health condition from the hospital to the community, may well place them in the management of OP. Evidence-based effective PRM interventions further warrant the role of PRM physicians in the management of OP.
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 采用了系统行动计划，根据 PRM 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。PRM 专家治疗的广泛健康状况都存在骨质疏松症（OP）的风险。OP 的后果可能与显著的残疾有关。本文的目的是：定义 PRM 医师在 OP 的预防和管理中的作用，描述与康复策略相关的 OP 患者的需求，并强调为什么以及如何让 PRM 医师参与 OP 的诊断和管理。PRM 医师可以参与 OP、跌倒和骨折的预防以及危险因素评估，以及功能和生活质量评估。此外，他们还参与 OP 的诊断以及药物和非药物治疗。基于国际功能、残疾和健康分类（ICF）的特定 PRM 视角，在优化功能和促进“活动和参与”方面存在重要作用，包括与环境因素相关的干预措施，适用于 OP 或骨质疏松性骨折患者。有证据表明，PRM 范围内的许多干预措施，从预防策略（包括教育和自我管理，最重要的是运动）到疼痛管理策略以及脊柱矫形器或髋保护器，可能对 OP 及其后果的预防和/或管理有效。PRM 专家的能力和技能，特别是在提供医疗服务时关注功能，涵盖从医院到社区的整个健康状况过程，可能非常适合 OP 的管理。基于证据的有效 PRM 干预措施进一步证明了 PRM 医师在 OP 管理中的作用。
