Random Questions from and OMSI (I promise I searched)

[wkbrdpro]

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Hey,

I am an OMSI and have recently became interested in pm&r. A pm&r physician came to our school and gave a presentation about the past, present and future of pm&r which conjured up some questions in my head that I want to know the answer to:

He mentioned technological advances that will influence the field such as nanotechnology, improved imaging, and limb regeneration? -- The improved imaging seems obvious, but how will nanotechnology and limb regeneration influence the field?

He also mentioned PT's resolution stating their goal was to obtain full autonomy in the rehab field by 2020. Is this lofty or realistic?

Why is there no mention of the residency programs in Columbia MO, KU, or Wash U St. Louis? Are they not any good?

I realize this is my first post on SDN but I usually just lurk and use the search function when I have a question. BUT I couldn’t find any information on some of the questions I had about pm&r.

I probably have a million more questions but I will spare you for now. Thank you in advance for the responses.

 

[deleted185747]

Hey,

I am an OMSI and have recently became interested in pm&r. A pm&r physician came to our school and gave a presentation about the past, present and future of pm&r which conjured up some questions in my head that I want to know the answer to:

He mentioned technological advances that will influence the field such as nanotechnology, improved imaging, and limb regeneration? -- The improved imaging seems obvious, but how will nanotechnology and limb regeneration influence the field?

He also mentioned PT's resolution stating their goal was to obtain full autonomy in the rehab field by 2020. Is this lofty or realistic?

Why is there no mention of the residency programs in Columbia MO, KU, or Wash U St. Louis? Are they not any good?

I realize this is my first post on SDN but I usually just lurk and use the search function when I have a question. BUT I couldn’t find any information on some of the questions I had about pm&r.

I probably have a million more questions but I will spare you for now. Thank you in advance for the responses.

Limb regeneration is 10-20 years away and would have an obvious impact on the field of amputee rehabilitation, prosthetics and orthotics. Maybe someday our patients won't need a prosthesis. If it were possible to grow a new limb it would definitely need to be rehabilitated (strengthened, conditioned, desensitized, build muscle memory and proprioception, improved microvascular gas/nutrient exchange, etc.) Who knows exactly how well a regenerated limb would work? Only time will tell.

Your question about nanotechnology is kind of broad - this technology is being developed primarily for targeting specific cancer cells as far as I know. One application is making steerable particles which coalesce on the cancer and fight it with minimal side effects. The impact on PM&R as a specialty is that anytime you improve medical technology, many people will find a way to use it in their own specialty; Maybe you could use this to treat pain, maybe parkinsons, maybe even a severed spinal cord. Another type of nanotechnology is a small electrical device that you implant in the muscle and it can be used to stimulate a contraction, this is useful for treating a subluxed shoulder in person with hemiplegia (implant into deltoid and traps)

Physical therapists have been trying to gain autonomy for years, don't lose any sleep over it. If they were indeed successful it would be state by state and once someone died it would be reversed because face it, PT's don't want to be held ultimately responsible. Yes, there are groups actively fighting against PT autonomy to prevent people from dying. Many if not all specialties have to protect some of their turf from midlevels or other non-medical people. We will always have plenty to do even if PTs gain full autonomy. We do a lot more than just sign off on therapy orders (at least the doctors who work outside of Kaiser and the VA systems)

I cannot answer your question about the good PM&R programs in your area; one way is to look at the program reviews in SDN, find out their board pass rate, see what the program strengths and weaknesses are and what your goals are. Some would prepare you better for research, versus being a clinician, or strong inpatient neurorehabilitation vs outpatient EMG/Pain/MSK training.

Good luck

 

[PMR 4 MSK]

Limb regeneration - 10-20 years to regrow a limp appendage that will look like crap and be non-functional. 50 years at least to grow a functional appendage.

Nanotech - anyone's guess. Possibilities include revascularization of CNS infarcts, repeair of damaged tissues.

PTs are becoming DPTs and will have full autonomy in many states soon. This will not affect us much as the pts will still come to doctors for treatment. We do a lot more than just write "PT: Eval and Tx." It will require us to interact with the independent DPT, and that may sometimes put us at odds with them when diagnoses or treatment plans conflict.

Not sure about the residency programs. One of my former residency classmates is at Wash U. He's a good guy, so it be too bad.

 

[RUOkie]

The Chair at Missou is a great guy. Beyond him, I know nothing about the program.

 

[wkbrdpro]

Thank you for the responses so far. You guys are a great resource. I guess some of those questions were more obvious than I thought. I will do more research and look into those programs, too. A few other questions that have come to mind are:

Is the Fascial Distortion Model ever used in pm&r on a regular basis?

Are there research/centers/fields that focus on enhancing athletic performance in healthy individuals? Or is this a completely different field? I know there are sports medicine fellowships aimed to restore function in athletes but it seems like specializing and studying neuromuscular medicine would provide an advantage in this area.

 

[Jitter Bug]

Never heard of fascial distortion. So I'm gonna go with "no"

🙂

Truthfully, so many of us have our hands full helping the partially paralyzed and brain injured and missing limbed that we don't go much into working with healthy athletes-where's the challenge? Healthy motivated people don't really need my help.

But seriously yes some PM&R docs get really into sports medicine, like gait training for runners, cardio training routines to optimize Vo2max (or whatever the hell it is) in endurance athletes. It's more of a niche than a classic part of our field.

 

[deleted185747]

I've heard of fascial distortion; its the idea that fascial tissue are in planes throughout the body, essentially connecting the leg to the neck and everything to everything. It looks at stretching and manipulating the fascia. It is good to know what the various physical therapists are going to do to your patients so you can decide who is good and who isn't. I don't know how mainline the concept of fascial distortion is or what it is most useful for. Its not better than a vial of Botox tho 🙂

 

[PMR 4 MSK]

I don't know how mainline the concept of fascial distortion is or what it is most useful for.

I'm guessing its about 1 step above Chi flowing through the meridians.