White Book on Physical and Rehabilitation Medicine (PRM) in Europe. Chapter 1. Definitions and concepts of PRM

In the context of the White Book of Physical and Rehabilitation Medicine (PRM) in Europe, this paper deals with the definitions and concepts relevant for PRM. Physical and Rehabilitation Medicine is the primary medical specialty responsible for the prevention, medical diagnosis, treatment and rehabilitation management of persons of all ages with disabling health conditions and their co-morbidities, specifically addressing their impairments and activity limitations in order to facilitate their physical and cognitive functioning (including behavior), participation (including quality of life) and modifying personal and environmental factors. To arrive to this PRM definition we need to consider a conceptual description of it. Several fundamental aspects must be observed namely functioning, disability and rehabilitation. These definitions include and are presented in this chapter: - Functioning: all that human bodies do and the actions that people perform. In the International Classification of Functioning, Disability and Health (ICF), functioning is operationalized in terms of functioning domains, and these domains are partitioned into the dimensions of Body Functions and Structures, Activities and Participation; - Disability: the problem a person has performing the actions that he or she needs and wants to do, because of how an underlying health condition - a disease, injury or even ageing - affects his or her performance in his or her actual environment; - Rehabilitation: a set of measures that assist individuals, who experience or are likely to experience disability, to achieve and maintain optimum functioning in interaction with their environments. The ICF definition of disability clearly distinguishes between problems that result entirely from the underlying health condition (capacity) from problems arising from the interaction between capacity and the environment and personal factors (performance). This paper approaches all these concepts that are essential to the understanding of the PRM strategy to evaluate disability and implement interventions that may lead to the improvement of functioning and health

White Book on Physical and Rehabilitation Medicine (PRM) in Europe. Chapter 4. History of the specialty: where PRM comes from

In the context of the White Book of Physical and Rehabilitation Medicine (PRM) in Europe, this paper deals with the history of the PRM medical specialty. The specialty evolved in different European countries, and sometimes also into the single countries, from different medical streams that finally joined. These included among others: balneology, gymnastic, use of physical agents (water, heat, cold, massage, joint manipulations, physical exercise, etc.). Another important role has been played by the increasing number of people experiencing or likely to experience disability due to improvement of medicine and consequent survivals from wars, accidents and/or big infective epidemics (like polio); these evolutions happened in strict relationship with other specialties like cardiology, neurology, orthopaedics, pneumology, rheumatology, traumatology, creating a knowledge transversal to all of them. Consequently, the PRM specialty has been gradually introduced in the different European countries, however with no uniformity. Subsequently, European Organizations were created for its diffusion and coordination at the level of medical competences and patient care as well as medical teaching and research: The European Federation of Physical Medicine and Rehabilitation - later European Society (ESPRM), The Académie Médicale Européenne de Médecine de Réadaptation (EARME), The PRM Section of the European Union of Medical Specialists and the European College of PRM (served by the UEMS-PRM Board), were created and work today regarding these general aims. Nowadays a uniform definition of the specialty exists in Europe, which is concordant with the internationally accepted description of PRM (based on the ICF-model). Moreover, research in PRM has been mainly improved during recent decades in Europe due to some external as well as internal scientific influences, thus increasing its scientific importance, together with a parallel increase in rehabilitation journals, many of them indexed and some with impact factor (Cr, EJPRM, JRM, among others), as well as a parallel increase in scientific congresses and courses. Last but not least, the recent creation of the Cochrane Rehabilitation field will also give a great boost to this primary medical specialty, as well as the discovery on new physical agents and technologies that diminish activity limitation and participation restriction of disable persons