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Advances in Physical and Rehabilitation Medicine
Edited by
Nachum Soroker and Haim Ring
Loewenstein Hospital Rehabilitation Center
Sackler Faculty of Medicine Tel Aviv University - Israel
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CONTRIBUTORS
Invited Keynote Lecturers
2nd World Congress of the ISPRM, Prague, Czech
Republic, May
18-22, 2003
Mindy Aisen, MD
Deputy Chief Research and Development Officer,
Department of Veterans Affairs, Washington, DC, USA
Gulseren Akyuz, MD
Professor of Rehabilitation Medicine, Department
of Physical Medicine and Rehabilitation, Marmara University, Istanbul,
Turkey
Gad Alon, PhD, PT
Associate Professor, Department of Physical
Therapy, University of Maryland, School of Medicine, Baltimore, MD, USA
Yitshal N Berner, MD, MPH
Head, Geriatric Medicine, Meir Hospital Kfar Saba,
Sackler Faculty of Medicine, Tel Aviv University, Israel
Niels Birbaumer, PhD
Head, Institute of Medical Psychology and
Behavioral Neurobiology, University of Tübingen, Germany
Amiram Catz, MD
Medical Director, Department of Spinal
Rehabilitation, Loewenstein Hospital Rehabilitation Center, Raanana,
Sackler Faculty of Medicine, Tel-Aviv University, Israel
M Anne Chamberlain, OBE
Charterhouse Professor of Rehabilitation
Medicine, Academic Unit of Musculoskeletal & Rehabilitation Medicine,
School of Medicine, University of Leeds, UK
Naoichi Chino, MD, MS, DMSc
Professor and Chairman, Department of
Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
Gerben DeJong, PhD
Associate Director, Brooks Center for
Rehabilitation Studies, Professor, Department of Health Services
Administration, University of Florida, USA
Peter B Disler, PhD, FRACP
Professor of Rehabilitation Medicine and
Director, Victorian Rehabilitation Research Institute, University of
Melbourne and Royal Melbourne Hospital, Australia
Catherine Dziri, MD
Professor, Department of Physical and
Rehabilitation Medicine, Institut National D’Orthopedie, M. Kassab,
University of Tunisia, Tunisian Public Health Ministry, Tunis, Tunisia
Wagih S El Masri(y), FRCS Ed
Consultant Surgeon Spinal Injuries, Director,
Midlands Centre for Spinal Injuries, Oswestry, UK
Reuben Eldar, MD, DPH
Professor, Head of Fleischman Unit for the Study
of Disability, Loewenstein Hospital Rehabilitation Center, Raanana, Israel
Alberto Esquenazi, MD
Chair, Department of PM&R and Chief Medical Officer, MossRehab & Albert
Einstein Medical Center; Director Gait & Motion Analysis Laboratory and
Regional Amputee Center, Philadelphia, PA, USA
Abdulla Eyadeh, MD
Head of Department, Physical Medicine and
Rehabilitation Hospital, Ministry of Health, Kuwait
Franco Franchignoni, MD
Head, Department of Occupational Rehabilitation &
Ergonomics, Rehabilitation Institute of Veruno, "Salvatore Maugeri"
Foundation, IRCCS, Italy
Salvatore Giaquinto, MD
Professor and Head, Department of
Neurorehabilitation, San Raffaele Pisana Tosinvest Hospital, Rome, Italy
Mali Gil, MSc
Head, Speech & Language Department, Loewenstein
Hospital Rehabilitation Center, Raanana, Sackler Faculty of Medicine,
Tel-Aviv University, Israel
Gary Goldberg, BASc, MD
Director, Brain Injury Rehabilitation, University
of Pittsburgh Medical Center; Professor, Department of Physical Medicine
and Rehabilitation, University of Pittsburgh School of Medicine, USA
Martin Grabois, MD
Professor and Chairman, Physical Medicine and
Rehabilitation, Baylor College of Medicine, Houston, Texas, USA
Carl V Granger, MD
Professor, Rehabilitation Medicine; Director,
Center for Functional Assessment Research (CFAR), School of Medicine and
Biomedical Sciences, University at Buffalo,USA
Gunnar Grimby, MD, PhD, FRCP
Professor em Rehabilitation Medicine, Sahlgrenska
Academy at Göteborg University, Sweden
Zeev Groswasser, MD, MPH
Professor and Head, Department of Brain Injury
Rehabilitation, Loewenstein Hospital Rehabilitation Center, Raanana,
Sackler Faculty of Medicine, Tel Aviv University, Israel
Mark Hallett, MD
Chief, Medical Neurology Branch, Chief, Human
Motor Control Section, National Institute of Neurological Disorders and
Stroke, National Institutes of Health, Bethesda, MD, USA
Allen W Heinemann, PhD
Professor, Department of Physical Medicine and
Rehabilitation, Feinberg School of Medicine, Northwestern University and
Center for Rehabilitation Outcomes Research, Rehabilitation Institute of
Chicago, Chicago, Illinois, USA
Hermie J Hermens, PhD
Cluster Manager Non-invasive Neuromuscular
Assessment, Roessingh Research and Development, Enschede, Professor,
Department of Biomedical Engineering, University of Twente, The
Netherlands
Marta Imamura, MD, Ph.D
Division of Physical Medicine And Rehabilitation,
Department of Orthopaedics and Traumatology, University of Sao Paulo
School of Medicine, Sao Paulo, Brazil
Eli Isakov, PT, MD
Professor and Head, Orthopedic Rehabilitation
Department & Kinesiology Laboratory, Loewenstein Hospital Rehabilitation
Center, Raanana, Sackler Faculty of Medicine, Tel Aviv University, Israel
Shin-Ichi Izumi, MD, PhD
Professor and Chairman, Division of
Rehabilitation for the Physically Disabled, Tohoku University Graduate
School Of Medicine, Sendai, Japan
Garth R Johnson, FREng
Professor, Centre for Rehabilitation and
Engineering Studies, University of Newcastle upon Tyne, UK
Ofer Keren, MD
Vice Director, Department of Brain Injury
Rehabilitation, Director, Clinical Neurophysiological Unit, Loewenstein
Hospital Rehabilitation Center, Raanana, Sackler Faculty of Medicine, Tel
Aviv University, Israel
Jun Kimura, MD
Professor Emeritus, Kyoto University, Japan,
Professor, Department of Neurology,University of Iowa Health Care, USA
Crt Marincek, MD, PhD
Professor and Medical Director, Institute for
Rehabilitation, Ljubljana, Slovenia
Karl H Mauritz, MD
Professor and Chairman Klinik Berlin and
Department of Neurological Rehabilitation, Free University Berlin, Germany
John L Melvin, MD, MMSc
Michie Professor and Chairman, Department of
Rehabilitation Medicine, Jefferson Medical College of Thomas Jefferson
University, Philadelphia, PA, USA
Trilok N Monga, MD
Professor, Department of Physical Medicine and
Rehabilitation, Baylor College of Medicine, Executive, Rehabilitation Care
Line, Houston VA Medical Center, Houston, Texas, USA
Lewis M Nashner, ScD
NeuroCom International Incorporated, Clackamas,
USA
Hugo Nunez Bernadet, MD
President of the Uruguayan PMR Society and
Cono Sur Organization, Physical Medicine & Rehabilitation Department,
Republic University, Uruguay
Avi Ohry, MD
Director, Section of Rehabilitation Medicine,
Reuth Medical Center, Tel Aviv, Professor of Rehabilitation Medicine,
Sackler Faculty of Medicine, Tel Aviv University, Israel
Zaliha Omar, MD
Associate Professor, University of Malaya, Kuala
Lumpur, Malaysia
Bryan J O’Young, MD
Clinical Associate Professor, New York
University, The Rusk Institute, Department of Rehabilitation Medicine, USA
Chang Il Park, MD, PhD
Director, Rehabilitation Hospital, Yonsei
University College of Medicine, Seoul, South Korea
Haim Ring, MD, MSc PM&R
Professor and Chairman, Neurological
Rehabilitation Department C, Loewenstein Hospital Rehabilitation Center,
Raanana, Chairman, Rehabilitation Medicine Department, Sackler Faculty of
Medicine, Tel Aviv University, Israel
Itzhak Siev-Ner, MD
Head, Department of Orthopedic Rehabilitation,
Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv
University, Israel
Bengt H Sjölund, MD, PhD
Professor of Rehabilitation Medicine, Department
of Community Medicine and Rehabilitation, Umeå University, Sweden
Nachum Soroker, MD
Head, Department of Neurological Rehabilitation
B, Loewenstein Rehabilitation Hospital, Raanana, Sackler Faculty of
Medicine, Tel-Aviv University, Israel
Henk J Stam, MD, PhD
Professor and Head, Department of Rehabilitaton
Medicine, Chairman Institute of Rehabilitation Medicine, Erasmus
University Medical Centre, Rotterdam, The Netherlands
Dobrivoje S Stokic, MD
Director, Neurophysiology Laboratory, Director,
Center for Neuroscience and Neurological Recovery, Methodist
Rehabilitation Center, Jackson, MS, USA
Gerold Stucki, MD, MS
Professor and Chairman, Department of Physical
Medicine and Rehabilitation, Director, ICF Research Branch, WHO-FIC
Germany, University of Munich, Germany
Luigi Tesio, MD
Head, Department of Rehabilitation, Salvatore
Maugeri Foundation, IRCCS, Pavia, Italy
Jan Vacek, MD
Department of Rehabilitation Medicine,
Postgraduate Medical School, Prague, Czech Republic
Guy G Vanderstraeten, MD, PhD
Professor, Department of Physical Medicine and
Rehabilitation, University Hospital, Ghent, Belgium
Jean-Jacques Vatine, MD
Director, Outpatient and Research Division, Reuth
Medical Center, Tel Aviv, Israel
Nicolas E Walsh, MD
Professor and Distinguished Chairman, Department
of Rehabilitation Medicine, University of Texas Health Science Center, San
Antonio, Texas, USA
Anthony B Ward, MD
North Staffordshire Rehabilitation Centre,
Haywood Hospital, Stoke-on-Trent, UK
Harold P Weingarden, MD
Director, Rehabilitation Day Hospital, Department of
Neurological Rehabilitation, Sheba Medical Center, Sackler Faculty of
Medicine, Tel-Aviv University, Israel
Steven L Wolf, PhD, PT, FAPTA
Professor, Department of Rehabilitation Medicine,
Professor of Geriatrics, Department of Medicine, Associate Professor,
Department of Cell Biology, Emory University School of Medicine,
Professor, Adult and Elder Health, Nell Hodgson Woodruff School of Nursing
at Emory University, Atlanta, GA, USA
Mark Ylvisaker, PhD
Professor, Department of Communication
Disorders, College of Saint Rose, Albany, New York, USA
Mark A Young, MD, MBA, FACP
Chair, Physical Medicine & Rehabilitation, The
Maryland Rehabilitation Center & Workforce and Technology Center, State of
Maryland Division of Rehabilitation, Department of Education, USA
Nathan D Zasler, MD, FAAPM&R, FAADEP, CIME, DAAPM
CEO & Medical Director, Concussion Care Center of
Virginia, Ltd. & Tree of Life Services, Inc. Richmond, Virginia, USA;
Associate Clinical Professor, Department of Physical Medicine and
Rehabilitation, University of Virginia, Charlottesville, Virginia, USA
INDEX
Part I P&RM in Neurological Disorders
Diseases and Trauma of the Brain;
Motor Control, Cognition, Language and Behaviour
Human Brain Plasticity and Recovery from Stroke
M. Hallett
The Emerging Role of Transcranial Magnetic Stimulation
in the Assessment of Stroke Rehabilitation Intervention
A.J. Butler and S.L. Wolf
Assessment Measures for Stroke Rehabilitation
N. Chino and M. Liu
Therapy Services and Relationship to Functional
Improvement Patterns Following Stroke
A. Heinemann, R. Bode, P. Semik and C. O’Reilly
An Analysis of the Rate of Functional Gain That May Be
Expected During Inpatient Rehabilitation for Patients with Stroke
C. Granger and K. Ottenbacher
The Aftermath of Rehabilitation for Patients with
Severe Stroke
S. Giaquinto
Differential Diagnostic Issues in Acquired Brain Injury:The
Dilemma of Mild Traumatic Brain Injury
N. D. Zasler
Perceived Needs of Persons with Traumatic Brain Injury
and Relationship to Services
A. Heinemann, K. Sokol, L. Garvin and R. Bode
Factors Determining Return to Work After Severe
Traumatic Brain Injury
Z. Groswasser and O. Keren
The Breakdown and Re-Establishment of Functional
Behavioral Structures and Correlated Brain Pathophysiology
G. Goldberg
Theory Driven Cognitive Rehabilitation: The Case of
Spatial Neglect
N. Soroker
Event-related Potentials in Language Rehabilitation
S. Giaquinto
New Directions in the Assessment and Treatment of
Aphasia
M. Gil
The Thought Translation Device: A Brain-Computer
Interface for the Paralyzed
N. Birbaumer
Diseases and
Trauma of the Spinal Cord
Trends in the Assessment of Functional Outcomes after
Spinal Cord Lesions
A. Catz and M. Itzkovich
Where is the Evidence that Surgical Intervention is
Beneficial for Spinal Injuries?
W. El Masri (y)
Gait Rehabilitation in Spinal Cord Injury
K.H. Mauritz
Neurophysiological Monitoring for Intrathecal Baclofen
Pump Management and Troubleshooting
D.S. Stokic and S.A. Yablon
Neuropathies,
Myopathies and Peripheral Nerve Lesions
Management of Peripheral Neuropathic Pain: An Overview
J.J. Vatine, S. Faran and Y. Lerman
Part II P&RM in Orthopedic and Musculoskeletal Disorders
Limb Trauma, Surgery and Amputation
Prosthetic Restoration and Rehabilitation from Surgery
to Community Reintegration
A. Esquenazi
Rehabilitation for People Who Have Had Joint
Replacements
F. Khan, P. Disler and J. Pallant
Compartment Syndromes of the Lower Leg
A. Steyaert and G. Vanderstraeten
Rheumatoid
Arthritis; Osteoarthritis; Osteoporosis
Assessment of Rheumatoid Arthritis, Osteoarthritis and
Ankylosing Spondylitis
G. Stucki
Work and Rheumatic Diseases
M.A. Chamberlain
Clinical Practice Guidelines for Rehabilitation
Management of People with Osteoporosis
M. Grabois
The Bone and Joint Decade
N. Walsh
Back and Other
Musculoskeletal Pain
Evidence-Based Medicine in Treating Low Back Pain
T. Parlevliet and G. Vanderstraeten
An Analysis of the Rate Per Day of Pain Improvement
That May Be Expected and Factors Affecting Improvement in Outpatients with
Low Back Pain
C. Granger, J. Lackner, M. Kulas and C.
Russell
Evaluating Rehabilitation Programs for Fibromyalgia &
Other Chronic Musculoskeletal Pain
P. Disler, J. Pallant, J. Exton, F. Thomas,
L. Boyd, J. Stone, P. Lowthian and D. Lewis
Part III P&RM in Other Specific Conditions
Geriatric Population
Rehabilitation Goal Setting in the Aged
Y.N. Berner
Novel Interventions to Reduce Falls in Older Adults:
Tai Chi and Beyond
S.L. Wolf and M. O’Grady
Pediatric
Population
Traumatic Brain Injury in Childhood
A.B. Ward
Contextualized Hypothesis-Testing Assessment of
Children and Adolescents with Cognitive Impairment after Brain Injury
M. Ylvisaker
Neuropsychological Rehabilitation of Communication,
Cognitive, and Behavioral Disturbances Following TBI in Children and
Adolescents
M. Ylvisaker
Comprehensive Management of Cerebral Palsy
C. Il Park
Transitional Services
M.A. Chamberlain
Part IV Topics of General Interest in P&RM
Pain
Current and Future Treatment Strategies for Chronic
Pain
B.H. Sjölund
Multidisciplinary Pain Programs: Evolution and
Reinvention
M. Grabois
Pain Management and the Musculoskeletal System: Gender
Differences
M.A. Young
Spasticity
Management of Spasticity – A Scientific Basis for
Outcome Measures
G.R. Johnson
Sexual
Disability
Sexuality and Disability
T. Monga
Wound Care
Prevention and Treatment of Chronic Wounds
I. Siev-Ner
Premature Aging
Premature Aging: A Danger to Life Expectancy and
Quality of Life of the Disabled
A. Ohry
Electrodiagnosis
New Concept in Nerve Conduction Studies
J. Kimura
Surface Electromyography in Rehabilitation: A Mature
Tool to Assess Neuromuscular Function(ing)
H. Hermens
Biomechanics;
Kinesiology; Dynamic Posturography;
Motion and Gait Analysis
Biomechanical Factors in the Complexity of Stress
Fracture Formation
E. Isakov and J. Mizrahi
Impairment Based Approach to Managing Balance and
Mobility Disorders: Applications for Computerized Dynamic Posturography
L.M. Nashner
Recent Advances in Ambulatory Monitoring of Activities
of the Hand and Arm
H.J. Stam, F.C. Schasfoort and J.B.J.
Bussmann
Gait Analysis: When and Why It Should Be Used
E. Isakov
Orthoses
Orthoses for Different Kinds of Disabilities
È. Marinèek and H. Burger
Advanced
Technologies in Rehabilitation
Rehabilitation Engineering: Research Perspectives from
the US Veterans Health Administration
M. Aisen
Functional
Electrical Stimulation
Advances in Functional Electrical Stimulation, 2003,
and a Look to the Future
H. Weingarden
Training Dosage and Timing of Electrical Stimulation
May Be the Key for Maximizing the Effects of NMES in Neuro-Rehabilitation
G. Alon
Organization and
Management of Rehabilitation Services;
Quality of Care
Rehabilitation in General Hospitals and Rehabilitation
Centers
J. Melvin
Community-Based Rehabilitation: The Concept and Its
Implementation
R. Eldar
Quality of Care Improvement Mechanisms in
Rehabilitation Medicine
R. Eldar
Scope of
Speciality; Educational Needs; Ethical Considerations
International Rehabilitation Education: A Comparative
Analysis and Discussion
M. Young, P. Disler, G. Akyuz, H. Nunez
Bernadet, C. Dziri, A. Eyadeh, M. Imamura, S.I. Izumi, Z. Omar, B.J. O’Young,
H. Stam and J. Vacek
Publishing in Peer-Reviewed Journals: Time to Review
the Peer Review
H. Ring, M. Aisen, P. Di Benedetto, M.
Grabois, G. Grimby, D. Johnson, N. Walsh and N. Zasler
Ethical Considerations in Contemporary Rehabilitation
Medicine: Theoretical Background, Models and Practice
A. Ohry
Complementary Medicine in Rehabilitation
I. Siev-Ner and D. Gamus
Evidence-Based
Rehabilitation; Outcome Measurement; Assessment of Disability,
Participation and Quality of Life
Outcome Research in Rehabilitation: Variable
Construction, Trial Design and Statistical Inference
L. Tesio
Assessment of Handicap / Participation
G. Grimby
Health-related Quality of Life Assessment
F. Franchignoni and C. Bertolini
Value and Application of the WHO-ICF in Rehabilitation
Medicine
G. Stucki, A. Cieza and T. Ewert
The Case for Public Disclosure of Rehabilitation
Outcomes
G. DeJong
Appendix
G lobal
Physical & Rehabilitation Medicine Education: The Prague 2003 ISPRM
Educational Summit
M.A. Young, P.Disler
FOREWORD
Physical and Rehabilitation
Medicine 2003
Nachum Soroker and Haim Ring
Loewenstein Hospital Rehabilitation
Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
Introduction
By the turn of the century, physical and rehabilitation
medicine (P&RM) became one of the most rapidly developing disciplines
within the medical professions, deepening its roots in basic science,
strengthening its theoretical basis and employing sophisticated
methodologies for assessment and treatment.
In 2003, P&RM has gone far from its starting point
where preoccupation with motor, especially locomotor, dysfunction was the
hallmark of the specialty, and physical therapies were the main
remediation maneuvers. These are equally important today but the field of
interest has broaden to include various other domains of disease-related
dysability, including problems of perception, language, cognition, affect
and comportment. In accord, P&RM now is naturally linked to a large
variety of basic and applied sciences and disciplines like neuroscience,
cognitive science, biomechanics, linguistics, etc.
In addition, the value of P&RM practices is now
recognized more and more in clinical domains outside of P&RM traditional
mainstream, like oncology, organ transplantation, cardio-pulmonary
diseases, etc. This broadening, with the new opportunities it offers, also
poses serious questions concerning definition and delineation of the
specialty, as well as organization of services.
For example, in stroke - the most prevalent nosological
entity in P&RM practice today - the rehabilitation physician who wishes to
maintain a reasonable standard of knowledge in all the aspects relevant to
the rehabilitation of his patients, has to deal with huge amounts of
rapidly accumulating information on brain plasticity, motor control,
language, perception, attention, memory, executive functions, etc. In many
countries this physician should also take care of the necessary measures
to ensure optimal secondary prevention for his patient. For example, in
the Loewenstein Hospital (Raanana, Israel), where the editors of this
volume work, stroke patients are treated in specialized wards and it is
the rehabilitation physician who has to order and interpret brain-imaging,
doppler and hyper-coagulability examinations. Even with the use of
consultants invited to the rehabilitation center, it is the rehabilitation
physician who is finally responsible for taking measures to obtain optimal
control over known risk factors, discover unrecognized risk factors and
treat intercurrent infections prevalent in the early post-onset period. It
is unlikely to achieve a reasonable degree of mastery in all these fields
without employment of a kind of sub-specialization. P&RM confronts this
problem differently in different countries. The optimal system is a matter
of further discussion.
Evolving from a rather empirical approach, P&RM strives
now to work on a more solid, evidence-based, methodology. For this purpose,
several fields of action can be identified: a. Application of
quality-assurance standards to improve quality of care; b. Standard use of
outcome measurement for all interventions. This includes interventions
aimed at various levels (impairment, disability/activity, handicap/participation,
quality of life, secondary prevention), including cost-effectiveness
evaluation. c. Services organization aimed to ensure continuum of care for
the disabled. d. Introduction of new technologies and procedures, and
novel pharmacological treatments.
Outcome measurement (including cost-effectiveness
evaluation) have become probably the most salient contribution of P&RM to
the realm of medicine in general. Standard application of valid and
reliable tools help organize the clinical work, assess the degree to which
preset goals are achieved, enable comparison of different remediation
strategies, assess the added value of novel treatments, evaluate
cost-effectiveness of used policies, etc. With new theoretical frameworks
like the WHO-ICF, this remains a very important field of research and
further development. The linkage between impairment and disability (using
the older WHO-ICIDH terminology) and the active preoccupation in P&RM with
efforts to restore impaired mechanisms underlying disability, calls for
development of new outcome measures looking at the mechanistic level. For
example, tools designed for longitudinal assessment of aphasic language
impairments of different kinds, in addition to available global measures
of communication behaviour.
One of the major and significant interrogates from the
service-delivery point of view is the location for conducting the
rehabilitation treatment (specialized P&RM ward within a general hospital
vs. separate rehabilitation center; disease-specific ward vs. ward with a
large case mix; day hospital vs. problem-specific community-based
rehabilitation [CBR] services). A second issue concerns the optimal timing
for rehabilitation (early after onset, when the rehabilitation process
might be interrupted by frequent medical problems and clinical instability,
or later, when the medical condition is more stabilized but unwanted
outcomes of delayed treatment probably occurred). It is becoming clear
that the continuum of care, namely the establishment of a paradigm
of venue-wise treatment dictating as clear as possible the way the
different modalities (in-patient, day hospital, CBR, etc.) integrate, is
the right answer for the benefit of all parties involved. Most importantly,
for patients’ benefit.
Advanced technologies aimed to solve locomotion,
communication and perceptual problems of disabled persons are rapidly
developing and even proliferating, bringing on one hand potential benefits
and on the other hand potential dangers and high costs. Hence, the need
for a balanced approach taking into consideration issues pertinent to "patient-device"
interface as well as cost-effectiveness considerations both on the side of
the patient and the side of the medical system. In 2003 this is becoming
another responsibility of the P&RM specialist.
With the development new pharmacological products,
notoriously botulin toxin for the treatment of spasticity, or medications
aimed to enhance cognitive functioning in victims of degenerative diseases
of the brain, the therapeutic arsenal in the hands of the P&RM specialist
increases. Here again, outcome measurement and careful cost-effectiveness
evaluation are domains where the rehabilitation physician has an important
and responsible role.
This Volume
All the above issues are contemplated from different
personal angles in this publication, aimed to present current knowledge
and theoryzing in major domains of P&RM. The book contains 65 chapters
written by the keynote lecturers of the 2 nd World
Congress of the International Society of Physical and Rehabilitation
Medicine (ISPRM), held in Prague, Czech Republic, May 18-22, 2003.
Each keynote lecturer was asked to organize the
contents of her/his chapter in accord with the mission of the congress,
set as follows: a. Presentation of recent advances and future challenges
in rehabilitation science; b. Linking clinical practice in P&RM to basic
science through presentation of theory-driven procedures of assessment and
intervention; c. Emphasis on outcome measurement and evidence-based P&RM.
The chapters are divided in four parts coresponding to
the construction of the scientific program of the Prague congress: a. P&RM
in Neurological Disorders (19 chapters); b. P&RM in Orthopedic and
Musculoskeletal Disorders (10 chapters); c. P&RM in Other Specific
Conditions (7 chapters); d. Topics of General Interest in P&RM (29
chapters).
Being a "reflection on advances in rehabilitation and
future challenges" (the congress motto), the authors, each one a leader in
her/his field, had the assignment to review the addressed issues with a
futuristic approach. Readers will find stimulating novel ideas in various
chapters of the book that will be of help in introducing new approaches
for assessment and treatment into their own P&RM practice.
The editors of this book served as congress chairperson and chairman of
the the organizing committee (Haim Ring) and chairperson of the scientific
committee (Nachum Soroker). Preparation of this publication took place in
parallel to the preparations for the congress, with the aim of having this
volume ready by the congress time. An appology is due for all possible
errors that might have occurred during this rapid intensive process. The
publisher of this book is ‘Monduzzi Editore’, who publishes also the
general proceedings in a separate volume containing 160 manuscripts
submitted by participants to the congress.
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