Physical and Rehabilitation Medicine in Acute Rehabilitation
Medical rehabilitation is generally interpreted as a part of medicine that becomes relevant when prevention has failed or when the primary treatment of a disease or injury has resulted in incomplete recovery. In many cases rehabilitation interventions start when the primary physician has nothing more to offer to the patient and often the patient has to be transferred to another ward or hospital to make the first steps in a long process of rehabilitation.
This model of a sharp distinction between primary care and rehabilitation is outdated and carries many risks and disadvantages. Patients with acute injuries, such as spinal cord injury, traumatic brain injury, hand trauma, multiple bone fractures and myocardial infarcts nowadays receive rehabilitation interventions before surgery, during chemotherapy or radiotherapy and immediately after injury or acute diseases. So do patients with conditions such as stroke, amputation, organ transplantation, burn wounds and cancer treatment. All these activities can be included in acute medical rehabilitation which is aiming at prevention of further physical and psychological deterioration, at improving functioning, treatment of common complications such as joint contractures or pressure scores, at providing information on future perspectives and on managing discharge to home or to further in- and outpatient facilities.
This presentation will cover models of acute PRM services:
PRM beds in acute hospital
Mobile PRM team
PRM consultations to acute wards
Acute PRM center.
Advantages and limitations of these models will be discussed.
Furthermore the most common conditions in the acute phase of PRM will be presented, such as SCI, Stroke, Polytrauma, Head injury, Amputation, etc.
Finally complications with a large and long-term negative impact on rehabilitation will be discussed, as prevention of these complications is a cornerstone of acute PRM.
 Acute Medical Rehabilitation 2012, Volume I, Editors: Henk J. Stam (chief), H. Muzaffer Buyruk, John L. Melvin and Gerold Stucki, Chapter 1, p. 13 – 18