Research Accelerator Program: A Strategic Initiative to Facilitate Interdisciplinary Collaboration That Advances Translational Research.

Developing a culture of innovative thinking and one that emphasizes clinician-researcher interaction is critical for the future of rehabilitation. We designed and implemented a strategy to build a culture of interdisciplinary communication and collaboration that facilitates translational research across several disciplines in our inpatient rehabilitation hospital. We colocated clinicians and researchers in workspaces within a new hospital and created the Research Accelerator Program-a collection of team-focused initiatives that promote communication and collaboration among researchers, clinicians, and other staff.

Improving Patient Safety and Quality in Physical Medicine and Rehabilitation Through Participation in the American Board of Physical Medicine and Rehabilitation Continuing Certification Program.

The American Board of Medical Specialties Continuing Certification Program's Improvement in Medical Practice Standard requires physicians to participate in practice improvement activities. Despite this universal requirement, there has been no assessment of this requirement or its potential impact on patient care. Because of its continuing certification oversight structure, the American Board of Physical Medicine and Rehabilitation is in a unique position to provide this assessment.

Anticoagulant-Related Intramuscular Hematomas in an Inpatient Acute Rehabilitation Population: A Case Series.

Anticoagulant-related intramuscular hematomas are uncommon. However, when they do occur, the clinical consequences can be significant. The authors describe nine patients on anticoagulation undergoing rehabilitation who experienced an intramuscular hematoma.

A Mobility Measure for Inpatient Rehabilitation Using Multigroup, Multidimensional Methods.

Background And Purpose: Inpatient rehabilitation facilities (IRFs) report patient functional status to Medicare and other payers using Quality Indicators (QI). While the QI is useful for payment purposes, its measurement properties are limited for monitoring patient progress. A mobility measure based on QI items and additional standardized assessments may enhance clinicians' ability to track patient improvement.

Allopathic (MD) and Osteopathic (DO) Performance on the American Board of Physical Medicine and Rehabilitation Initial Certifying Examinations.

Background: Osteopathic physicians (DOs) represent over 30% of residents in allopathic (MD) Accreditation Council for Graduate Medical Education (ACGME) accredited physical medicine and rehabilitation (PM&R) training programs. However, some have questioned the quality of osteopathic medical school training and the graduates of osteopathic medical schools. The performance of osteopathic physicians in allopathic PM&R training programs has not been assessed.

Association of Participation in the American Board of Physical Medicine and Rehabilitation Maintenance of Certification Program and Physician Disciplinary Actions.

Objective: The study analyzed the relationship between participation in the American Board of Physical Medicine and Rehabilitation maintenance of certification program and the incidence of disciplinary actions by state medical boards over a physician's career. The hypothesis is that physicians who do not maintain their board certification have a higher likelihood of state medical board disciplinary actions.

Design: This retrospective cohort study analyzed American Board of Physical Medicine and Rehabilitation maintenance of certification data from all board-certified physiatrists who were enrolled in the American Board of Physical Medicine and Rehabilitation maintenance of certification program from 1993 to 2007.

Does Performance on the American Board of Physical Medicine and Rehabilitation Initial Certification Examinations Predict Future Physician Disciplinary Actions?

Objective: The aim of the study was to determine the relationship between performance on the American Board of Physical Medicine and Rehabilitation primary certification examinations and the risk of subsequent disciplinary actions by state medical boards over a physician's career. The hypothesis is that physicians who do not pass either or both of the two initial specialty certification examinations are at higher risk of disciplinary action from a state medical licensing board.

Design: This is a retrospective cohort study that analyzed board certification examination data from all physicians who completed physical medicine and rehabilitation residency between 1968 and 2017.

Should There Be A Part II ABPMR Examination?: A Psychometric Inquiry.

Background: Certification by the American Board of Physical Medicine and Rehabilitation (ABPMR) requires passing both a written multiple choice examination (Part I) and an oral examination (Part II), but it has been unclear whether the two examinations measure the same or different dimensions of knowledge.

Objective: To evaluate the concordance between the Part I and Part II examinations for ABPMR initial certification with regard to candidate performance on the examinations and their subsets. Our question is whether the Part II examination provides additional assessment of a candidate beyond what Part I provides.

Burnout in Diplomates of the American Board of Physical Medicine and Rehabilitation-Prevalence and Potential Drivers: A Prospective Cross-Sectional Survey.

Background: Physician burnout is of growing concern. Burnout among physical medicine and rehabilitation (PM&R) physicians has shown a significant increase, positioning PM&R as one of the most "burned out" of specialties. Little has been written about potential factors contributing to physiatrist burnout or potential interventions.

Robot-guided ankle sensorimotor rehabilitation of patients with multiple sclerosis.

Background: People with multiple sclerosis (MS) often develop symptoms including muscle weakness, spasticity, imbalance, and sensory loss in the lower limbs, especially at the ankle, which result in impaired balance and locomotion and increased risk of falls. Rehabilitation strategies that improve ankle function may improve mobility and safety of ambulation in patients with MS. This pilot study investigated effectiveness of a robot-guided ankle passive-active movement training in reducing motor and sensory impairments and improving balance and gait functions.

Cancer Rehabilitation: Do Functional Gains Relate to 60 Percent Rule Classification or to the Presence of Metastasis?

Background: Literature supporting the benefits of inpatient rehabilitation for cancer patients is increasing. Many cancer patients, however, do not qualify for inclusion in the Centers for Medicare and Medicaid 60% rule and consequently may not receive services. The benefit of inpatient rehabilitation in this specific cancer group has not been investigated and is the focus of this study.

Outcomes of acute inpatient rehabilitation of patients with left ventricular assist devices.

Objective: To investigate the benefits of comprehensive inpatient rehabilitation for patients after left ventricular assist device (LVAD) implantation.

Design: A retrospective cohort study.

Setting: An urban academic inpatient rehabilitation hospital.

Characterizations of reflex and nonreflex changes in spastic multiple sclerosis.

Background: Spasticity, an increased resistance of a limb to movement, is associated with functional limitations and a major source of disability in neurological disorders, including multiple sclerosis (MS) and stroke. Despite the clinical significance of spasticity in brain and spinal cord injuries, it is often not clear whether the spasticity is due to reflex or non-reflex changes.

New Method: Reflex and nonreflex properties of the human knee joint were studied in eight MS patients with spasticity and ten healthy subjects.

Inpatient rehabilitation of patients with cancer: efficacy and treatment considerations.

Although cancer can affect a great number of individuals and is the second leading cause of death in the United States, the number of individuals admitted to acute inpatient rehabilitation units with impairments primarily as the result of cancer diagnoses remains small. There is a lack of awareness among health care providers as to the functional loss that can be associated with cancer and the potential benefits of inpatient rehabilitation. Furthermore, financial pressures from third-party payors may dissuade the admission of patients with cancer for inpatient rehabilitation.

Reliability of the physical medicine and rehabilitation resident observation and competency assessment tool: a multi-institution study.

Objectives: To assess the psychometric qualities of a method of resident physician evaluation by faculty.

Design: Multicenter study by seven Physical Medicine and Rehabilitation training programs. Faculty physicians observed residents in brief patient encounters or teaching sessions, rated specific competencies, and provided residents with immediate feedback.

Charcot spine in a person with congenital insensitivity to pain with anhydrosis: a case report of re-diagnosis.

We report the case of a 43-year-old woman referred for evaluation of worsening gait. Her initial evaluation led to a diagnosis of a Charcot spine and 2 spinal stabilization surgeries. Because no clear cause for the Charcot spine could be determined from the patient's history or initial evaluation, an extensive diagnostic work-up was undertaken, which ultimately led to a diagnosis of congenital insensitivity to pain with anhydrosis (CIPA).

Inpatient rehabilitation following burn injury: patient demographics and functional outcomes.

Objective: To identify demographic characteristics of burn patients referred for inpatient rehabilitation, the benefits of rehabilitation in this population, and factors that influence functional outcome.

Design: Retrospective chart review.

Setting: Free-standing rehabilitation hospital.

Phantom breast pain as a source of functional loss.

Although physicians are aware of phantom limb pain, which can occur in up to 85% of patients who undergo amputation, and its potential effect on functional status, the presence of phantom pain after amputation of other body parts such as the breast and its effect on function may be less appreciated. We report the case of a 63-yr-old woman with multiple sclerosis who underwent a modified radical mastectomy for left intraductal breast carcinoma. After her mastectomy, she required a brief course of inpatient rehabilitation and was discharged from rehabilitation independent, with feeding, dressing, hygiene, and transfers.

Rehabilitation-specific communication skills training: improving the physician-patient relationship.

Objective: Evaluate the effectiveness of a rehabilitation-specific communication skills training program for physicians.

Design: Three groups of rehabilitation patients were interviewed 3 mo after discharge, one group before and two groups after implementation of a communication skills training program. The setting was a free-standing rehabilitation hospital with a residency training program.