1. Clinical and functional assessment in physical and
rehabilitation medicine
1.
Clinical and functional assessment of joints and muscles;
motor and sensory function;
2.
Assessment of cognition, speech and language, memory, behaviour, etc..;
3.
Laboratory tests and imaging techniques. Rational use of
modern medical imaging in physical and rehabilitation medicine;
4.
Quantitative evaluation by computerised recording of mechanical phenomena (force plates) as well as movement (different modern forms of recording displacement of body segments);
5.
Electrodiagnosis: electromyography, nerve conduction
studies and evoked potentials;
6.
Pulmonary function tests;
7.
Cardiovascular function tests, oxygen saturation, graded
exercise tests, physiological cost of energy;
8.
Biochemical and pathological tests in current use in
physical medicine and rehabilitation;
9.
Functional assessment: Use and application of the ICF.
Various scales, instruments, tests, and indices, utilised in conditions
relevant to physical and rehabilitation medicine;
10. Gait and
posture; gait analysis;
11. Clinical
and functional assessment of sphincter and continence.
2. Therapies in physical and rehabilitation medicine
1. Physiotherapy
o Knowledge
of the elementary techniques of passive and active physiotherapy. Different
techniques of manual and instrumental massage. Techniques of functional
rehabilitation of joint problems (manual and instrumental). Muscle
(re)training, stimulation of muscle activity, functional training. Techniques
of muscle strengthening, endurance training, retraining of abilities.
o
Methods specific to physiotherapy in different
pathologies.
Techniques
such as Cyriax, Mennell, etc...
Neuromuscular facilitation-inhibition techniques. Methodologies eg. Kabat,
Bobath, Bronström, Voljta etc…
Neurocognitive and learning techniques. Methodologies eg. Milani C.
,Salvini-Perfetti etc…
Management
of lymphoedema
o Indications,
prescriptions, controls on physiotherapy: a general knowledge of technique, and
the choice of techniques with regard to results of clinical and functional
assessment, type of pathology and the individual characteristics of each
patient.
2. Physical
Therapy modalities: Utilisation of physical therapy techniques, basic
knowledge, the effects of treatment, indications and contra indications.
o Electrotherapy:
galvanic currents; low, medium and high frequency treatment;
o Mechanical
vibration;
o ECSWT:
Extracorporeal shock wave therapy;
o Biofeedback;
o Thermotherapy:
cold and heat treatment;
o Balneotherapy.
3.
Occupational therapy
Fundamental
ergonomics;
Environmental evaluation (accessibility, mobility, usability);
Principles and methods of occupational therapy;
Materials, equipment, technology and assessment in occupational therapy.
The applications of occupational therapy: in joint/muscle training, endurance
training, in functional rehabilitation and in reintegration into the community (social, familial, domestic, professional and employment training). Vocational
assessment, guidance and training.
4. Equipment and
technical aids
o Materials
used;
o Bandages;
o Orthoses
(spine, limbs);
o Prostheses:
surgical indications for amputation. Equipment and rehabilitation of lower and
upper limb amputees;
o Stomatherapy;
o Technical
aids and appliance: facilities, tools, ADL equipment, means of transfers and of
communication, environmental control, household equipment; whether they are
simple or sophisticated but likely to aid disabled people in acquiring greater
independence and improving their quality of life.
o Wheelchair
advise and management, adaptations of custom made wheelchairs
5. Manual
therapy: Pathophysiology of manual medicine; Anatomical knowledge; Clinical
examination of the spine and limbs; Dysfunction of intervertebral segments;
Principles of manual techniques; Indications and contra indications; Potential
dangers of the manipulative acts; Clinical examination and assessment.
6. Reeducation
of speech and language disorders; Principles of and equipment and technology
used in speech and language therapy. Language development in childhood; Assessment
in speech therapy and its application to the rehabilitation of problems in
articulation, language (expression, comprehension, reading and writing);
Assessment and management of swallowing disorders.
7.
Reintegration of disabled people into society: Principles
and methods of clinical psychology and of social assistance (social work);
Cognitive assessment (intellect, memory, concentration, behaviour) and learning
potential;
Its application to cognitive and psychological and social abilities: memory and concentration, the patient's understanding and acceptance of his problem, motivation for rehabilitation, mood, difficulties in interpersonal relationships; vocational training and
methods to ensure financial security;
Environmental implications.
8. Neuropsychological
rehabilitation: Assessment and management
9. Pharmacology:
Pharmacokinetics of drugs used in rehabilitation medicine;
Possible interactions with the rehabilitation programme and with therapeutic
exercise; Infiltration and injection techniques.
10. Acupuncture
and Electro-acupuncture
3. The immobile patient: Muscle and bone implications
1.
Physiopathology of immobilisation Consequences on the:
o
Cardiovascular system;
o
Respiratory system;
o
Nutritional system;
o
Metabolic system (osteoporosis);
o
Nephrological and urological system;
o
Cutaneous system (skin-pressure sores);
o
Muscular system;
o
Musculoskeletal system;
o
Neuropsychological system.
2.
Prevention and treatment of the above mentioned disorders
4. Adult locomotor system pathology in physical and
rehabilitation medicine
1.
Non traumatic conditions
Inflammatory joint disease, rheumatoid arthritis, spondylarthropathy ,polymyalgia rheumatica, connective
tissue disorders, crystal arthropathies, gout, chondrocalcinosis. osteomalacia,
osteoporosis, Paget's disease; Primary and secondary malignant tumours of bone;
Extra articular rheumatism; Neuromuscular diseases; Osteoarthritis; Spinal
pathology; Arthroplasty; Hand and foot disorders; An elementary knowledge of
joint surgery: arthroscopy, arthrotomy, arthrodesis; Chronic fatigue syndrome
and fibromyalgia, myofascial pain syndrome.
2.
Traumatic conditions in adults
o
Physiology and pathophysiology of tissue repair in the locomotor system;
o
Sprains and strains;
o
Dislocations: Traumatic and recurrent dislocations;
o
Fractures: Spinal (without neurological complications), limbs: principles of specific treatment, repair time including surgery eg. Osteotomy;
o
Specific disorders of the hand and foot;
o
Polytrauma;
o
Traumatic amputations.
3.
Burns Classification; treatment procedures; prevention
and rehabilitation of complications.
5. Physical and rehabilitation medicine and sport
1.
Physical and rehabilitation medicine related to sports activities;
2.
Sports for disabled people;
3.
Sports Therapy.
6. Physical and rehabilitation medicine in neurological
impairments
1.
Central nervous system
Vascular,
neoplastic, traumatic, inflammatory, infective, and degenerative conditions
cause of disability, and in particular:
o
stroke;
o
Parkinson's disease;
o
Cerebellar conditions;
o
Traumatic and non-traumatic brain injury;
o
Multiple sclerosis;
o
Motor neurone disease, including amyotrophic lateral
sclerosis;
o
Syringomyelia;
o
Spinal cord lesions: traumatic, neoplastic, others;
o
Spinocerebellar degenerative conditions: Friedreich's
disease, Strumpell Lorain, etc.
o
Neuropsychological dysfunction and Dementias.
2.
Peripheral nervous system
o
Poliomyelitis;
o
Traumatic compressive conditions and tumours of nerve
roots, plexus, nerve trunks: a good knowledge is required of the anatomical
relations of the peripheral nervous system;
o
Polyradiculopathies;
o
Other polyneuropathies: Charcot Marie Tooth disease,
Déjérine Sottas disease, etc;
o
Metabolic neuropathies.
3.
Sensory disorders
7. Physical and rehabilitation medicine and respiratory pathology
1.
A fundamental appreciation of acute and chronic
obstructive and restrictive syndromes; Circumstances leading to their
occurrence; Therapeutic principles
2.
Principles of rehabilitation: functional assessment
through pulmonary function tests
o
Active and passive techniques of bronchial and postural
drainage, manual clapping, instrumental techniques;
o
Patient education and training;
o
Artificial ventilation, assisted respiration, domiciliary
assisted respiration; Tracheostomy management;
o
Equipment for assisted respiration;
o
Surveillance and monitoring of treatment.
3.
Applications of the above in an intensive care unit: Comatose
or conscious patients
o
In an acute hospital: effects of thoracic and abdominal
surgery;
o
In non acute hospital wards: respiratory failure;
o
Home management program according to the restrictive or obstructive pathology;
o
With special attention to:
§
Major obstructive airways disease, severe asthma,
mucoviscidosis, Chronic Obstructive Pulmonary Disease
§
Major restrictive conditions: Lateral amyotrophic
sclerosis, extreme myopathy
8. Physical and rehabilitation medicine and cardiovascular
pathology
1.
Cardial disorders
o
Rehabilitation in valvulopathy;
o
Rehabilitation after myocardial infarction;
o
Rehabilitation in cardiomyopathies and in cardiac failure;
o
Rehabilitation in cardiosurgery and transplantation.
2.
Vascular disorders
o
Arterial system
·
Arterial occlusive disease of the legs: investigation,
the place of and technology of the rehabilitation at the various stages of the
condition;
·
The rehabilitation of amputees, care of the stump,
prosthetics.
o
Venous system
·
Prevention and treatment of deep venous thrombosis;
·
Venous problems ulcers, varicose ulcers.
o
Lymphatic system
·
Applications of the above in:
o
Intensive care unit ( acute hospital);
o
PRM Ward (acute hospital or rehabilitation hospital);
o
Post-acute and home management program;
o
Cardiovascular problems in disabled people during acute
and post-acute rehab. treatment;
o
Impact on treatment plan and on objectives.
9. Rehabilitation management of children
1.
Assessment of child development: Psychomotor development, movement, sensory and cognitive development; Testing and evaluation of the
stages of development;
2.
Pathophysiology in the developing locomotor system; Interaction between growth and anomalies in the musculoskeletal and joint
structures;
3.
Neuropaediatrics; cerebral palsy; spina bifida and
myelomeningocele; Infantile spinal amyotrophies; the neuro orthopaedic consequences of neurological disorders; prevention, treatment and monitoring;
4.
Congenital malformation of musculoskeletal system (spine,
limbs, skeletal agenesis, congenital aplasias and dysplasias; hip dysplasia,
club foot, other foot malformations);
5.
Growth disturbances;
6.
Lower limb discrepancy;
7.
Scolioses: idiopathic, congenital, secondary;
8.
Infantile trauma: A general appreciation of trauma and
rehabilitation in children, notably burns and amputations in children.
10. Physical and rehabilitation medicine in the management
of bowel, bladder and sexual problems
1.
Assessment of physiology of continence of
bladder/sphincter control and anal sphincter functioning;
2.
Bladder/sphincter pathological conditions: Neurological
and other; Urodynamics... Assessment and treatment;
3.
Ano-rectal sphincter pathology: Neurological and other; assessment
and treatment;
4.
Sexual consequences of neurological dysfunction including
pregnancy in spinal paralysis.
11. Physical and rehabilitation medicine in the elderly
person
1.
The process of aging in different systems:
o
Central and peripheral nervous system: Neuronal ageing,
influences on mood, cerebral functioning and feedback mechanisms;
o
Musculoskeletal system;
o
Cardiovascular and respiratory system.
2.
An appreciation of the fundamentals of geriatric
pathology: Epidemiology, pathology, evolution of ageing and therapy; The
“frailty” of old people; Indications for geriatric patients for staying at home or in an institutional placement.
12. Pain management in rehabilitation
Pain in Rehabilitation: evaluation and treatments;
Pain as a true disability and cause for loss of participation;
Many different and PRM specific tools for treatment.
13. Rehabilitation and prevention of disability in persons
with oncological problems
Treatment of local impairments (surgical etc.);
Treatment of global disability (pharmacological, radiological, psychological
damages);
Maintaining participation, also in long survivors;
Pathology of malignant tumours of different tissue origin;
Effects and side effects of therapy (surgery, chemotherapy, irradiation) –
assessment and management.