Physical Medicine & Rehabilitation Assessment

Before a physical activity program is started, a PM&R Physician should perform a thorough pre-exercise assessment. As part of this process, a comprehensive History & Physical examination should be done. Key elements that should be detailed during this exam will include an in-depth look at the individual's prior medical history and uncovering the acute physical issues as well as the subacute chronic issues that are impacting the patient. Family medical history and assessment of the patient's substance use history (i.e. nicotine, alcohol, prescription/non-prescription drugs) are also important variables to consider. A thorough physical examination with focus on musculoskeletal and neurological testing must be completed. A baseline set of blood tests and an electrocardiogram may also be obtained to ensure that the patient does not have other underlying medical conditions that could limit activity. Such conditions like anemia, electrolyte disturbances, dehydration, or arrhythmias must be adequately addressed before an individual can safely embark on a program of regimented physical activity.

Another essential part of the assessment process will be the functional evaluation. The PM&R Physician should accurately determine what the patient's current functional status is. The individual's physical endurance and ability to perform basic activities of daily living should be looked at in detail. In tailoring a program for a patient, it is imperative to see how much function a patient has lost over a recent interim of time. This information will be useful in deciding how to set appropriate and useful goals for the patient.

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