Physical Medicine and Rehabilitation: From the Birth of a Specialty to Its Recognition.

Physical Medicine and Rehabilitation (PMR) was subordinate to different specialties. Currently, it is recognized as essential to improving healthcare. How did it originate and which events impacted it? Different events have impacted the development of PMR including war, epidemic, sport, natural disasters, and the demographic and sociocultural characteristics of each country. At present, PMR is experiencing some difficulties throughout the world; we present proposals to improve its position to bring the specialty up to the specialty podium. Accidentology, sports events, and natural disasters enrich medicine in general and PRM in particular. Indeed, all these events create disability through a participatory and integrative strategy of the patients; PMR always takes up the challenge.

The Assessment of Student Doctors' attitude towards disabled people after teaching them a module.

OBJECTIVE: Assessing the attitude of medical students towards people with disabilities after teaching them a disability module. METHODS: Several themes were taught. To assess the attitude of disability before and after the course, we used the ATDP (Attitude towards disabled persons) scale after translating it from English into Classical Arabic using the translation-back translation method. RESULTS: 250 students benefited from this course. 78 of them were subjected to evaluation, including 20 male students (25.64%) and 58 female students (74.35%). There was no significant difference in the ATDP score between before and after among boys (before 72 (66.75-81.5) vs 72 (66, 81.5) after, p: 0.32). Among girls, there was a decrease in the ATDP score (74 (67.5-83.25) vs 70 (65-80.25), p: 0.03). No significant difference was found according to gender before and after. The ATDP construct validation in classical Arabic had a Cronbach's alpha of 0.60. The test-retest (ICC) 0.825. CONCLUSION: Although the perception towards disabled people has negatively changed among girls and while unchangeable within boys, this disability module in our faculty was a first experience in Morocco. It would be desirable to develop other educational methods in this subject matter.

Bibliometric Evaluation of Moroccan Physicians of physical medicine and Rehabilitation Publications in PubMed.

Backround: Moroccan Physicians in Physical Medicine and Rehabilitation (MP PMR) seek recognition at the international and national levels through publications. To our knowledge, no bibliometrics have been made to quantify these publications in indexed international journals. The aim is to quantify the publications MP PMR in indexed international journals. Methods and materiel: Is an observational study, we searched all the articles of the MP PMR published in the PubMed database until December 2019. The number of MP PMR articles was reported by academic academic centers, article type and indexed journal type. Results: We have found 26 articles since the creation of PMR in Morocco. The number of articles is correlated with the number of MP PMR remaining to 75 doctors and especially the ten professors. However, their contribution compared to their colleagues from other countries is promising. Scientific publications were limited to clinical cases in half of the cases. English was the dominant language of the works. Collaboration with foreign PMR was only with the French in 38.46% of cases. Only one French magazine took 34.61% of the works. Conclusion:  A lot of effort needs to be made by everyone, MP PMR and politicians to improve the quality and quantity of publications, research methodology and medical writing is one way, learning English in is another. Collaboration with other foreign collaborators is a necessity for a better visibility of publications.

Accessory spinal nerve damage during a cervical lymph node biopsy: case report.

The lesion of the accessory spinal nerve is often of iatrogenic origin. We report the case of an injury after a right jugulocarotid lymph node biopsy. A 30-year-old patient was referred for the treatment of right cervical lymphadenopathy suspected of tuberculosis. After the intervention and confirmation of tuberculosis diagnosis, the patient presented a functional impotence of the right shoulder and swarming of the right hand. The clinical examination found an active limitation of the shoulder, and a wasting of the upper bundle of the right trapezius muscle and the sternocleidomastoid. The EMG showed axonotmesis of the accessory spinal nerve and the MRI an amyotrophy of the trapezius with denervation edema. A simple rehabilitation has been scheduled. Damage of the accessory spinal nerve most often occurs after local surgery. EMG is essential for diagnosis. Rehabilitation is the first therapeutic option. Surgery can be considered if it fails. The surgeons must consider the protection of the accessory spinal nerve in case of cervical lymph node surgery.

Symmetry of postural tone in right homogeneous functional laterality evaluated by Fukuda test.

BACKGROUND: To study the symmetry of postural tone in subjects with right homogeneous functional laterality. METHODS: It was an observational study; we looked for the right homogeneous functional laterality by clinical tests on the eyes, feet and hands. Postural tone was evaluated by the Fikuda test. We measured the mean value of the Fikuda angle and in cm walking forward or backward compared to the A axis and the deviation to the left or right compared to the B walking axis. These two axes were perpendicular.Results: There were 80 homogeneous right-hand adult subjects. There were 52 males (63, 52%) and 28 females (36, 47%). The median age was 34, 85 years (23, 42- 47, 57). For the studied population the deviation angle according to Fukuda test was 0° (-15°; 15°), the subjects stepped 81 cm (52; 110) forward without deviation from the B walking axis 0cm (-14; 20). Male subjects remained on the walking axis 0° (-17°, 19°) while stepping 81 cm (51, 119) forward without right-left deviation 0 cm (-17, 19). Female subjects stepped (83 cm (52; 110) forward, and away from the walking axis (3 cm (-23; 21)), without deviation 0° (-17 °; 19 °).Conclusion: The functional homogeneous laterality did not influence postural tone. The lateralization is a complex phenomenon.

[Post-traumatic ossification of the medial collateral ligament of the knee: about a case]. / Ossification post-traumatique du ligament collatéral médial du genou: à propos d'un cas.

Heterotopic ossification is a pathological ossification of soft tissues. It is a benign, recurring disease with an unpredictable onset. We here report the case of a patient treated for a fracture of the left tibial tray with installation of a screwed plate. Two months after surgery the patient had a stiff left knee. Standard radiological examination showed ossification of the medial collateral ligament (MCL) confirmed by tomodensitometry. We do not currently know which factors determine the presence of tendon and ligamentous ossification. Although clinicians often prescribe prophylactic drugs, such as anti-inflammatory drugs and radiotherapy sessions to prevent heterotopic ossification in soft tissues, the physiopathology of heterotopic ossification is little known.