1st PUBLIC HEALTH CONVENTION ON THE HEALTH AND WELLNESS OF PERSONS WITH DISABILITIES CURRENT DEVELOPMENTS IN THE PHILIPPINE REHABILITATION SERVICES ROMIL M. MARTINEZ, M.D. PHYSIATRIST REHABILITATION PRACTICE The practice of physical medicine and rehabilitation (PM&R), when applied has the capacity to reduce human suffering and economic burdens imposed by both acute injury and chronic disability. REHABILITATION is the process of helping a person to reach the fullest physical, psychological, social, vocational, avocational, and educational potential consistent with his or her physiologic or anatomic impairment, environmental limitations, desires and life plans. REHABILITATION MEDICINE branch of medicine prevention, diagnosis, treatment and rehabilitation of neuromusculoskeletal, cardiovascular, pulmonary and other system disorders produce temporary or permanent disability performance of different diagnostic (EMG, bone densitometry, MSK ultrasound) and interventional (injections, prolotherapy) procedures rehab prescription/programs which uses physical agents, electricity, therapeutic exercise and mechanical agents pharmacologic prescriptions REHABILITATION TEAM Neurophysiology Exercise physiology Psychology of disability Medical and Surgical problem management Functional effects of these problems and associated physical impairments Familiarity with the knowledge and skills of the various members of the rehab team Managerial skills REHABILITATION TEAM Physician (Physiatrist) Physical Therapist Occupational Therapist Therapeutic Recreation Therapist Prosthetist-Orthotist Rehabilitation Nurse Speech-Language Pathologist Psychologist Social Worker Vocational Counselor Patient/Family PHYSICAL MEDICINE AND REHABILITATION UNIT/FACILITY/CENTER any facility that renders services for the rehabilitation of physical disabilities, this maybe hospital based or free standing. DOH CLASSIFICATION WHAT LEVEL REHAB MEDICINE IS CATEGORISED? RATIONALE Philippine Academy of Rehabilitation Medicine (PARM) an organization of medical specialists and trainees in Rehabilitation that seeks to achieve excellence in Physiatric practice, education and research. PARM MEMBERS FELLOW MEMBERS ASSOCIATE MEMBERS 70 AFFILIATE MEMBERS 222 13 RESIDENTS IN TRAINING 45 REGIONAL DISTRIBUTION OF PARM MEMBERS NCR 3 Region 6 (Aklan, Capiz, Antique, Iloilo, Negros Occ.) 13 3 Region 10 (Bukidnon, Lanao Del Norte, Misamis Occidental and Oriental, CDO) 4 Region 9 (Zamboanga,) 35 Region 5 (Legaspi, Camarines Norte and Sur) 11 Region 8 (Leyte, Samar) 28 Region 4-a (Batangas, Cavite, Laguna, Quezon, Rizal, Mindoro) 9 Region 3 (Bataan, Balanga, Bulacan, Nueva Ecija, Pampanga, Tarlac, Zambales) Region 7 (Bohol, Cebu, Negors Oriental) 12 Region 2 (Cagayan Isabela, Baguio, Mt. Province) 186 Region 1 – Ilocos Norte, Ilocosu Sur, La Union, Pangasinan) 8 Region 11 (Davao) 4 Region 12 (South Cotabato) 4 Region 13 (CARAGA) 1 Philippine Board of Rehabilitation Medicine (PBRM) a non-stock, non-profit corporation composed of Board Certified Rehabilitation Medicine specialists tasked with accrediting and evaluating training institutions with a specialty in Rehabilitation Medicine, and certifying graduates of these training programs. 4 training institutions UST PGH POC VMMC PHYSIATRIC EVALUATION History Signs and Symptoms Birth Work Physical Examination Inspection Palpation Neurological Musculoskeletal MMT DTRs Sensory Special Tests PHYSIATRIC REHABILITATION PROGRAM Physical Modalities Traction/Massage/Manipulation Electrotherapy Ultraviolet light therapy Hydrotherapy Therapeutic Exercise Orthotics/Prosthetics/Shoe Robotics Gait Analysis PHYSIATRIC MANAGEMENT PHARMACOLOGICAL NSAIDs, Muscle Relaxants, opiods other medications INTERVENTIONAL chemodenervation prolotherapy TPI, injections DIAGNOSTIC EMG NCV Bone Densitometry MSK Ultrasound others (x-rays, blood tests, CT scan, MRI) APPROPRIATE REFERRAL TO OTHER SPECIALTIES THANK YOU