usl umbria2, foligno, perugia, italy; 10 president, European union of Medical specialists -physical and rehabilitation Medicine section and board, brussels, belgium; 11 president, European society of physical and rehabilitation Medicine (EsprM), rotterdam, the Netherlands;
The increasing complexity of healthcare provision and medical interventions requires collaboration between large numbers of health professionals. The nature of the interactions between team members determines whether the pattern of working is described as multi-, inter- or trans-disciplinary. Such team-working is an important part of the specialty of Physical and Rehabilitation Medicine. Grounded in group behaviour theory, team-working demonstrates that joint aims, trust and willingness to share knowledge, can improve patient outcomes, including mortality. The synthesis of individual skills and knowledge and working to common patient goals, has shown benefit in many conditions. This evidence base is perhaps best in stroke, but has been demonstrated in many other conditions, including acquired brain injury, back pain, mental health, cardiopulmonary conditions, chronic pain and hip fracture. There are also considerable benefits to staff and health organizations in terms of outcome and staff morale. This review paper examines the evidence for the benefit of such team-working and for the recommendations of team-working in rehabilitation services.
Endurance of knee extensor muscles in post-polio subjects is generally and significantly lower than that of knee extensors in healthy subjects, regardless of the implication of normal strength and subjective observations of post-polio subjects.
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