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 ❖ 222 ❖ ASSOCIATE MEMBERS ❖ 70 ❖ AFFILIATE MEMBERS ❖ 13 ❖ RESIDENTS IN TRAINING ❖ 45

REGIONAL DISTRIBUTION OF PARM MEMBERS ❖ NCR ❖ 186 ❖ Region 1 – Ilocos Norte, Ilocosu Sur, La Union, Pangasinan) ❖ 12 ❖ Region 2 (Cagayan Isabela, Baguio, Mt. Province) ❖ 9 ❖ Region 3 (Bataan, Balanga, Bulacan, Nueva Ecija, Pampanga, Tarlac, Zambales) ❖ 28 ❖ Region 4-a (Batangas, Cavite, Laguna, Quezon, Rizal, Mindoro) ❖ 35 ❖ Region 5 (Legaspi, Camarines Norte and Sur) ❖ 3 ❖ Region 6 (Aklan, Capiz, Antique, Iloilo, Negros Occ.) ❖ 13 ❖ Region 7 (Bohol, Cebu, Negors Oriental) ❖ 11 ❖ Region 8 (Leyte, Samar) ❖ 4 ❖ Region 9 (Zamboanga,) ❖ 3 ❖ Region 10 (Bukidnon, Lanao Del Norte, Misamis Occidental and Oriental, CDO) ❖ 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