Gaines R F, Tobis J S
Arch Phys Med Rehabil. 1981 Apr;62(4):180-2.
Consultation reports on 142 profoundly retarded and severely motor-disabled patients in a state residential care facility who were seen by physiatrists from an academic department of physical medicine and rehabilitation (PM&R) were reviewed. In all, 168 reasons for consultation were listed: 117 for specific identification or management of disabilities related to gross-motor or fine-motor function, 37 for surgical problems, and 10 for medical problems. The consultants made 314 recommendations altogether: 100 suggested the evaluation or treatment of gross-motor disabilities by a physical therapist, 43 suggested occupational therapy evaluation or treatment, and an additional 73 suggested adaptive equipment involving an orthotist. The recommendations also involved the following problems: medical-33; surgical-37; behavioral-27; further rehabilitation-1. The skills of a consultant knowledgeable in the management of multiply handicapped people include the coordination of medical, surgical, physical and behavioral care. Such knowledge is also a useful adjunct to overall patient care in complex cases with motor involvement. The preliminary association during which these consultations were done served as the basis of a growing affiliation between the state institution and the department of PM&R.
对一所州立寄宿护理机构中142名重度智障且严重运动功能障碍患者的会诊报告进行了回顾，这些患者由一所物理医学与康复（PM&R）学术部门的理疗医师进行诊治。总共列出了168条会诊原因：117条是关于与粗大运动或精细运动功能相关的残疾的具体识别或处理，37条是关于手术问题，10条是关于医疗问题。会诊医师共提出了314条建议：100条建议由物理治疗师对粗大运动残疾进行评估或治疗，43条建议进行职业治疗评估或治疗，另外73条建议使用涉及矫形师的适应性设备。这些建议还涉及以下问题：医疗方面33条；手术方面37条；行为方面27条；进一步康复方面1条。一位精通多重残障人士管理的会诊医师的技能包括协调医疗、手术、物理和行为护理。在有运动障碍的复杂病例中，这些知识也是整体患者护理的有益辅助。进行这些会诊时的初步合作成为了州立机构与PM&R部门之间日益紧密联系的基础。
