Scoping Review of Interventions and Experiences Increasing Medical Student Interest in Physical Medicine and Rehabilitation.

ABSTRACT: Increasing medical student exposure to physical medicine and rehabilitation is an important factor for future growth of the field. Therefore, it is important to determine which types of interventions during medical school have the greatest impact on medical students' decision to pursue a career in physical medicine and rehabilitation. The purpose of this study is to perform a scoping review of the current literature that has analyzed how different interventions and experiences impact medical school students' decision to pursue a career in physical medicine and rehabilitation. A systematic and comprehensive search strategy was implemented across five different journal databases and yielded 18 articles meeting the inclusion criteria. Most studies analyzing specific interventions looked only at presurvey and postsurvey comparisons of the immediate impact of the intervention on interest in physical medicine and rehabilitation, and few looked at longitudinal outcomes, such as match characteristics. The most frequently cited factor that was shown to positively impact interest in physical medicine and rehabilitation was early exposure. Participating in clinical rotations also had a positive impact but was most effective when combined with early exposure. This review highlights the need for national recommendations for integrating physical medicine and rehabilitation into all 4 yrs of medical education.

Rehabilitation Utilization by Cancer Patients with Pathology-Confirmed Leptomeningeal Disease Receiving Intrathecal Chemotherapy.

ABSTRACT: The incidence of leptomeningeal disease (LMD) is believed to be increasing in part because of more effective chemotherapy treatments allowing cancer progression behind the blood-brain barrier. However, little has been published about the rehabilitation of this growing patient population. In this study, impairments and rehabilitation utilization by cytology-proven LMD patients receiving intrathecal chemotherapy at a cancer center are described. A total of 109 consecutive patients with pathology-confirmed LMD who received an intrathecal chemotherapy infusion from January 1, 2017, through October 31, 2017, were retrospectively reviewed. Of the 109 patients, 103 (95%) had impairments described in their medical record that could impact physical function, including 74 of 109 (68%) who had deconditioning or fatigue. Kaplan-Meier median survival from initial LMD diagnosis was 13.1 mos. The median number of hospital admissions and intrathecal chemotherapy administrations was both 8. Of the 109 patients, 43 (39%) had magnetic resonance imaging radiology interpreted LMD. Most LMD patients used rehabilitation services (95/109, 87%) and most were able to forego post-acute inpatient rehabilitation facilities (96/109, 88%). Additional research and education for rehabilitation professionals about this increasingly common syndrome are needed.