Oncology and physical medicine and rehabilitation

IntroductionCancer patients are living longer with deficiencies and functional impairments requiring often typically a care in physical medicine and rehabilitation (PMR).ObjectiveTo examine the care of cancer patients in PMR.MethodInvestigation made with a questionnaire diffused from the e-mail listing of the Société Française de Médecine Physique et de Réadaptation.ResultsSixty-seven answers received. Fifty-seven centers take care of cancer patients. On average, 4% of cancer patients are hospitalised in PMR. Spinal cord injuries and hemiplegias are the most common impairments. Forty-two percent of the PMR units take the patients in all the stages of cancer treatment. Working relationships between PMR and oncology units are formalized only eight times out of 52. In case of health degradation, relationships with a palliative care unit are frequent but not generalized. Eighty-five percent of the centers think that PMR is not enough developed in oncology.ConclusionsIn spite of its limited character, this investigation shows that the PMR units take these patients. Situations where PMR has an important role in the follow-up of cancer patients are multiple and publications have showed its interest, especially on the limitations of activities. It is important to make better known the interest of PMR in oncology units but also to develop specific care within PMR units.     

Musculoskeletal ultrasonography in physical and rehabilitation medicine

Musculoskeletal ultrasound has gained a significant place in the diagnosis and management of various musculoskeletal disorders due to its several advantages (being convenient, inexpensive, non-invasive, repeatable, providing dynamic imaging and not requiring any exposure to radiation). It has also become a valuable tool in the daily clinical practice of physical and rehabilitation medicine physicians; the musculoskeletal ultrasound probe having become synonymous with the physician's stethoscope. In this paper, aside from drawing attention to this growing issue in the agenda of PRM physicians, we will touch upon its basic technical features and certain aspects as regards muscle, tendon, ligament, nerve, joint lesions and ultrasound guided interventions.     

"Don't bump my bed, don't touch my feet!"

The case history of a 14-year-old male pediatric oncology patient is presented to illustrate a complex problem in pain management. The patient had multifocal osteosarcoma and was treated with chemotherapy. Because his disease was never under control and always advancing, his pain was constantly changing. The numerous pathologies that caused his pain, its various characteristics, and the attempts made to alleviate it varied. Methods to assess and strategies to relieve pain, as well as the evaluation of pain relief interventions, are described..     

Robotic technology and physical medicine and rehabilitation

In this opinion piece, I will revisit the basis for our belief that robotic manipulation is a valid approach to promote speedier and better recovery following a stroke and discuss some of the clinical evidence that led to the September 2010 guidelines for stroke care of the American Heart Association as well as the December 2010 guidelines of the Veterans Administration endorsing the use of robotic technology for the upper extremity (UE) but not for the lower extremity (LE) post-stroke rehabilitation effort.