Rehabilitation Medicine Flashcards
What is rehabilitation?
▪️ ACTIVE process aimed at acquiring knowledge and skills to optimise physical, psychological and social function
▪️ In order to benefit the individual, reduce impact of conditions, and enable optimal participation
Who typically leads the rehabilitation team?
Consultant trained in rehabilitation medicine
Who might benefit most from rehabilitation?
▪️ Patients with complex disabilities - mixture of medical, physical, sensory, cognitive, social etc
▪️ ‘Profound disability’ - require help in all aspects of basic care plus specialist interventions
What events across history have influenced our understanding of and establishment of rehabilitation medicine?
▪️ Wars (e.g., WW2, Iraq war)
▪️ Epidemics (e.g., polio)
▪️ Sport
▪️ Natural disasters
What developments in scientific knowledge have aided the establishment of rehabilitation medicine?
▪️ Organ pathology
▪️ Physio pathophysiology
▪️ Pathology
▪️ Stages of development
▪️ Development of investigations
▪️ Development of manual techniques
What is the International Classification of Functioning, Disability and Health?
The current framework for describing and organising information regarding the impact of a health condition and the biopsychosocial factors related to it
Condition causes problems with:
▪️ Body functions and structures (impairment)
▪️ Activities (limitation)
▪️ Participation (restriction)
Problems are affected by:
▪️ Environmental factors
▪️ Personal factors
How can we used the IFC for rehabilitation medicine practice?
▪️ Address pathology
▪️ Alter impairments
▪️ Improve activity and functioning
▪️ Optimise appropriate participation
What are the main benefits of rehabilitation medicine?
▪️ Improve QoL
▪️ Reduction in care
▪️ Social benefit
▪️ Enhanced independence and community mobility
▪️ Driving through assistive tech
▪️ Occupational help
What are the main aims of rehabilitation medicine?
▪️ Increase independence in functional activities
▪️ Reduce impact of disability and associated distress
▪️ Long-term and holistic resolution of problems
Why was the Vietnam war influential in our understanding of TBI?
▪️ First conflict involving helicopter evacuation and early battlefield treatment
▪️ Changes in acute neurosurgical management
▪️ Valuable data on functional outcome
How have the Afghanistan and Iraq wars influenced our understanding of TBI?
▪️ Significant advances in acute trauma care informing advances in civilian trauma management
▪️ Magnetic e-Resonance Therapy
▪️ Resuscitation of major haemorrhage
▪️ Aggressive treatment of lethal triad
▪️ Damage control surgery
▪️ Increases in survival rate
What are the two main types of head injury?
▪️ Penetrating (more commonly injuries in war)
▪️ Closed
What is a penetrating TBI and what is it associated with?
Injuries due to projectile itself, secondary cavitation, and temporary pulsating cavitation
▪️ High mortality
▪️ Often contaminated - infection
▪️ High risk of post-traumatic epilepsy
What is a closed TBI and what are the main mechanisms of injury?
Predominantly due to blast injuries or acceleration/deceleration as a result of RTA/fall
▪️ Contusions
▪️ Subdural haemorrhage
▪️ Diffuse axonal injury
What percentage of people with moderate to severe TBI are able to maintain employment?
~34-46%
(only 41% in work 1-2 years post injury)
