To identify the ‘physiatry’ in a single word is tough. This may be due that physiatry originated from two different fields, physical medicine and rehabilitation and emphases on assisting the general improvement of functional recovery in disabled patients. In addition, physiatry has new fields to develop; health and welfare. Therefore, the individuality of physiatry will change depending on how physiatrists act in these fields.
To endorse the progress of physiatry, physiatrists should apply their efforts in several directions. First, physiatrists must make efforts to treat the impairment itself in addition to use classical compensatory methods. Earlier, it was thought that the adult central nervous system was fixed and could not be repaired. Recently, growth of functional imaging techniques revealed that the adult central nervous system can get well from injury through neuroplasticity, and that this recovery can bring functional improvement. Because this recovery through neuroplasticity requires more period than compensatory techniques including one hand activity daily living, this method is difficult to adjust in clinical situations due to economic issues such as early discharge. Moreover, inadequate scientific evidence due to the difficulty in recruiting control groups is another reason for not regularly using this technique in the clinics. But, seeing the high prevalence of central nervous system injuries and developments in medical technologies, methods based on neuroplasticity will increase.
physiatrists must join in the development of future technologies. Recent trends toward the fusion of medicine and technology is related with many innovative therapies in rehabilitation fields. These include robotic therapies for hemiplegia, intelligent prosthesis for amputees, and stem cell therapies for treating cerebral palsies.
The individuality of physiatry is not easy to define. As mentioned in the introduction, physiatry originated from two different fields, physical medicine and rehabilitation and now these are musculoskeletal pain medicine and neurorehabilitation. Now, musculoskeletal pain medicine attracts physiatrists’ attention, but this area also opens to orthopedic surgeons, anesthesiologists, and family medicine physicians. So, physiatrists must strengthen their competitive power as having a deep knowledge of this area. In addition, physiatry has new markets to grow; health and welfare. These innovative areas will give physiatrists new chances in the future. Therefore, the individuality of physiatry will change depending on how physiatrists act in these fields.