The objective of this work was to analyze the inter-observer reproducibility of an upright posture designed to bring out the thoracic humps by folding the upper limbs. The effect of this posture on back surface parameters was also compared with two standard radiological postures. A back surface topography was performed on 46 patients (40 girls and 6 boys) with a minimum of 15° Cobb angle on coronal spinal radiographs. Inter-observer reliability was evaluated using the typical error measurement (TEM) and Intraclass Correlation Coefficient (ICC). Variations between postures were assessed using a Student's t test. The inter-observer reproducibility is good enough for the three postures. The proposed posture leads to significant changes in the sagittal plane as well as in the identification of thoracic humps. This study shows the reproducibility of the proposed posture in order to explore the thoracic humps and highlights its relevance to explore scoliosis with back surface topography systems.
The Field of Competence (FOC) of specialists in Physical and Rehabilitation Medicine (PRM) in Europe follows uniform basic principles described in the White Book of PRM in Europe. An agreed basis of the field of competence is the European Board curriculum for the PRM-specialist certification. However, due to national traditions, different health systems and other factors, PRM practice varies between regions and countries in Europe. Even within a country the professional practice of the individual doctor may vary because of the specific setting he or she is working in. For that reason this paper aims at a comprehensive description of the FOC in PRM. PRM specialists deal with/intervene in a wide range of diseases and functional deficits. Their interventions include, prevention of diseases and their complications, diagnosis of diseases, functional assessment, information and education of patients, families and professionals, treatments (physical modalities, drugs and other interventions). PRM interventions are often organized within PRM programmes of care. PRM interventions benefit from the involvement of PRM specialists in research. PRM specialists have knowledge of the rehabilitation process, team working, medical and physical treatments, rehabilitation technology, prevention and management of complications and methodology of research in the field. PRM specialists are involved in reducing functional consequences of many health conditions and manage functioning and disability in the respective patients. Diagnostic skills include all dimensions of body functions and structures, activities and participation issues relevant for the rehabilitation process. Additionally relevant contextual factors are assessed. PRM interventions range from medication, physical treatments, psychosocial interventions and rehabilitation technology. As PRM is based on the principles of evidence-based medicine PRM specialist are involved in research too. Quality management programs for PRM interventions are established at national and European levels. PRM specialists are practising in various settings along a continuum of care, including acute settings, post acute and long term rehabilitation programs. The latter include community based activities and intermittent in- or out-patient programs. Within all PRM practice, Continuous Medical Education (CME) and Continuous Professional Development (CPD) are part of the comprehensive educational system.
If the present results are confirmed by other studies, analysis with back surface topography parameters may reduce the number of X-ray examinations required to detect increases in the Cobb angle.
This document is part of a series of documents designed by the French Physical and Rehabilitation Medicine Society (SOFMER) and the French Federation of PRM (FEDMER). These documents describe the needs for or a specific type of patients; PRM care objectives, human and material resources to be implemented, chronology as well as expected outcomes. "Care pathways in PRM" is a short document designed to enable the reader (physicians, decision-maker, administrator, lawyer or finance manager) to quickly apprehend the needs of these patients and the available therapeutic care structures for proper organization and pricing of these activities. Patients after total knee arthroplasty are classified into three care sequences and two clinical categories, each one being treated with the same six parameters according to the International Classification of Functioning, Disability and Health (WHO), while taking into account personal and environmental factors that could influence the needs of these patients.
This document is part of a series of documents designed by the French Physical and Rehabilitation Medicine Society (SOFMER) and the French Federation of PRM (FEDMER). These documents describe the needs for or a specific type of patients; PRM care objectives, human and material resources to be implemented, chronology as well as expected outcomes. "Care pathways in PRM" is a short document designed to enable the reader (physicians, decision-maker, administrator, lawyer or finance manager) to quickly apprehend the needs of these patients and the available therapeutic care structures for proper organization and pricing of these activities. Patients after total hip arthroplasty are classified into three care sequences and two clinical categories, each one being treated with the same six parameters according to the International Classification of Functioning, Disability and Health (WHO), while taking into account personal and environmental factors that could influence the needs of these patients.
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