Member, Professional Practice Committee, UEMS Section of PRM, Board Committee, Department of Physical and Rehabilitation Medicine, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria -
Eur J Phys Rehabil Med. 2013 Aug;49(4):579-93.
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 PRM interventions. Osteoarthritis (OA) is the most common joint disorder and the major cause of musculoskeletal pain and limited mobility in the elderly in the world. Therefore, proper management of persons with OA is of substantial importance. The goal of OA management is to reduce the impact of OA on the individual by reducing pain and improving function, activities and participation. The aim of this paper is to descibe the explicit role of PRM physicians in providing management for persons with OA. The optimal management of OA requires the combination of both non-pharmacological and pharmacological approaches, an issue most of the main guidelines on the evidence-based management of OA share in common. There is good level of evidence about the effectiveness of PRM interventions in the management of OA: high level of evidence about the effect of education, weight reduction and exercise and growing evidence about the effectiveness of physical agent modalities. PRM specialists are involved not only in diagnosis and medical and physical treatments of OA, but, as a rehabilitation strategy, they also deal with the problems of the person focusing on the improvement of all components of human functioning as defined in the ICF including personal and environmental factors with a holistic approach. ICF core sets for OA serve as excellent models for directing proper assessments as well as targeting interventions. PRM specialists well meet the needs of people with OA from the early stages of the disease to the stage of disability that could cause activity limitations and participation restrictions. In conclusion, PRM specialists can make substantial contributions to providing management of OA in order to improve the functioning of individuals with OA from both personal and societal perspective.
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 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论文。骨关节炎(OA)是最常见的关节疾病,也是世界上老年人肌肉骨骼疼痛和活动受限的主要原因。因此,对 OA 患者进行适当的管理非常重要。OA 管理的目标是通过减轻疼痛和改善功能、活动和参与度来减轻 OA 对个体的影响。本文旨在描述 PRM 医师在 OA 患者管理中明确的作用。OA 的最佳管理需要结合非药物和药物方法,这是大多数关于 OA 循证管理的主要指南共同的问题。PRM 干预在 OA 管理中的有效性有很好的证据:教育、减肥和锻炼的效果有很高的证据水平,物理因子治疗的有效性证据也在增加。PRM 专家不仅参与 OA 的诊断和医疗及物理治疗,而且作为一种康复策略,他们还处理患者的问题,侧重于根据 ICF 定义的人类功能的所有组成部分(包括个人和环境因素)的改善,采用整体方法。OA 的 ICF 核心集是指导适当评估和确定干预目标的极好模型。PRM 专家能够满足 OA 患者从疾病早期到可能导致活动受限和参与受限的残疾阶段的需求。总之,PRM 专家可以为 OA 的管理做出实质性贡献,以从个人和社会角度改善 OA 患者的功能。