PMR Neurorehab Rotation
PM&R Residency Program Manual
PM&R Resident Rotation Descriptions
PM&R Inpatient Neurorehabilitation Service – Dr. Paul T. Diamond
In this rotation PM&R residents learn the special needs of neurorehabilitation, and study the application and benefits of various neurorehabilitation techniques. They will gain an understanding of basic central nervous system neuroanatomy and pathophysiology, and gain clinical experience managing patients during the acute phase of recovery following stroke and traumatic brain injury. They will learn how to functionally assess patients post-stroke and TBI and prescribe a therapeutic program. They will also become familiar with the post-acute phase of recovery from neurologic injury including community reentry, driving evaluations, vocational assessment and retraining. Residents will become familiar with neuroimaging techniques and the interpretation of the head CT and MRI, in addition to learning about the neuropsychological assessment of cognitive domains and the role of neuropsychological testing in rehabilitation practice. They will learn the principles of cognitive rehabilitation and behavioral management. They will also learn neuropharmacologic management. Residents will become proficient with the use of commonly used functional assessment measures and gain experience with the prescription of assistive and adaptive equipment. Outcome predictors will be studied, along with follow-up care services for the neurologic patient.
Goals and Objectives:
- Obtain a basic understanding of central neuroanatomy and the pathophysiology of stroke and acquired brain injury.
- Learn the demographics and epidemiology of stroke and ABI.
- Develop skills in therapeutic prescription writing and functional goal setting.
- Become familiar with the more commonly used functional assessment tools and predictors of functional outcome.
- Learn the principles behind spasticity management.
- Understand approaches toward the evaluation and management of the aphasias and dysphagias.
- Learn the principles behind the evaluation and management of the neurogenic bladder.
- Learn how to assess fall risk and implement appropriate fall precautions.
- Understand when to refer for neuropsychological testing and what the results of the testing mean.
- Learn applications for EMG biofeedback.
- Become familiar with the pharmacologic management of hypoarrousal and agitation.
- Learn approaches toward cognitive remediation.
- Gain exposure to orthotics and adaptive/assistive equipment applications in the neurorehabilitation population.
- Develop skills in the diagnosis and management of common complications post stroke and ABI such as heterotropic ossification, reflex sympathetic dystrophy, DVT, depression, delirium, seizure and contracture.
- Learn how to approach return to work and driving safety issues following stroke and ABI.