Department of Physical and Rehabilitation Medicine, Faculty of Medicine, Slovak Medical University, Bratislava, Slovakia.
Department of Physical and Rehabilitation Medicine, Medical University of Lodz, Lodz, Poland.
Eur J Phys Rehabil Med. 2021 Dec;57(6):1020-1035. doi: 10.23736/S1973-9087.21.06983-5. Epub 2021 Apr 16.
Cerebral palsy (CP) is a group of the most common developmental disorders affecting movement and posture of the body, causing activity limitations and participation restrictions. The motor disorders of persons with CP are often accompanied by disturbances of sensation, cognition, communication and perception. The symptoms of CP are very diverse and persons with CP are usually presented with a mixed type of symptoms. The non-progressive disturbances can be attributed to disorders that were developed during pregnancy, birth and/or infant stage. The aim of this study was to improve physicians' professional practice of Physical and Rehabilitation Medicine for persons with cerebral palsy in order to improve their functionality, social and community integration, and to reduce activity limitations and/or participation restrictions. A systematic review of the literature including an 18-year period and consensus procedure by means of a Delphi process was performed and involved the delegates of all European countries represented in the Union of European Medical Specialists Physical and Rehabilitation Medicine (UEMS PRM) Section. As the result of a Consensus Delphi procedure, 74 recommendations are presented together with the systematic literature review. The PRM physician's role for persons with cerebral palsy is to lead and coordinate the multiprofessional team, working in an interdisciplinary way. They should propose and manage the complex but individual PRM program developed in conjunction with other health professionals, medical specialists and importantly in agreement with the patient, their family and care giver. This should be, according to the specific medical diagnosis to improve patients' health, functioning, social and education status, considering all impairments, comorbidities and complications, activity limitations and participation restrictions. This evidence-based position paper is representing the official position of The European Union through the UEMS PRM Section and designates the professional role of PRM physicians in persons with cerebral palsy.
脑性瘫痪（CP）是一组最常见的影响身体运动和姿势的发育障碍，导致活动受限和参与受限。CP 患者的运动障碍常伴有感觉、认知、沟通和感知障碍。CP 的症状非常多样化，CP 患者通常表现为混合症状类型。非进行性障碍可归因于妊娠、分娩和/或婴儿期发育的障碍。本研究的目的是提高物理医学和康复医学医生对脑瘫患者的专业实践，以提高他们的功能、社会和社区融合，并减少活动受限和/或参与受限。对包括 18 年在内的文献进行了系统评价，并通过德尔菲法进行了共识程序，涉及代表欧洲医学专家联合会物理医学和康复医学（UEMS PRM）分会的所有欧洲国家的代表。作为共识德尔菲程序的结果，提出了 74 项建议，并结合系统文献综述。CP 患者的 PRM 医生的角色是领导和协调多专业团队，以跨学科的方式工作。他们应提出并管理与其他健康专业人员、医学专家共同制定的复杂但个性化的 PRM 计划，重要的是要与患者、他们的家人和照顾者达成一致。这应根据特定的医疗诊断，改善患者的健康、功能、社会和教育状况，考虑到所有的损伤、合并症和并发症、活动受限和参与受限。本循证立场文件代表欧洲联盟通过 UEMS PRM 分会的正式立场，并指定了 PRM 医生在脑瘫患者中的专业角色。
