Rehabilitation Medicine with Worldwide Reach

“Our global mission involves both investigating and integrating different health and medical practices for the benefit of our patients, as well as education, training, sharing and understanding of knowledge and experience in physical medicine and rehabilitation with others beyond the USA,” said Michael Y. Lee, MD, MHA.

Dr. Lee chairs the department – an interdisciplinary field in which physiatrists (rehabilitation specialists) work with a medical team of therapists and others to optimize health and function of people with disabilities.

Whether patients are born with a disability, or sustain an injury (for example, in a car accident), the department is making an effort to connect with universities and hospitals throughout N.C. and the world to serve this patient population.

Physiatrists are scarce in the US, especially in rural areas. To date, the field does not exist in many other countries – something Dr. Lee and his colleagues are trying to change by reaching out to medical professionals who work in related areas.

Statewide rehabilitation programs go worldwide

One of thLee_Vos_websitee department’s programs is TelAbility, a pediatric telemedicine program in which doctors use videoconferencing equipment to connect children and their caregivers with medical experts. The program reaches young patients who may not be able to travel to Chapel Hill for treatment.

Joshua Alexander, MD, the TelAbility director and an associate professor in the department, presented his program globally at an international conference in Sydney, Australia. Organizers of the Australian conference (who invited Dr. Alexander) noted the potential of telemedicine to go continent-wide.

In addition, Dr. Alexander is collaborating with Patricia Gregory, MD, an assistant professor in the department, to expand telemedicine to adults in her Stroke Telemedicine Access Recovery (STAR) project.

The program helps patients admitted to Southeastern Regional Medical Center in Lumberton, NC, with stroke recovery, secondary stroke prevention and access to caregiver resources. The hospital in Lumberton serves Robeson, Hoke, Scotland, Bladen and Cumberland counties – areas of a high stroke prevalence but with limited access to a physiatrist.

“WTelAbility_teleconferencee are exploring whether TelAbility can expand into the Robeson county area, since Dr. Alexander sees a number of patients from the area in his outpatient practice,” Dr. Gregory said.

Dr. Gregory is collaborating with Vera Moura, MD, a research instructor in the department’s Program on Integrative Medicine, to take her program to the international sphere.

Dr. Moura teaches mind-body medicine to both the public and to health care providers, working in small groups and using techniques such as meditation, guided imagery, biofeedback and expressive movements, among others.

“Self-care and self-awareness are very important if you’re dealing with other people,” Dr. Moura said, recognizing the particular benefit of the course to health care professionals, who, in turn, can provide a more interdisciplinary care plan for their patients.

Upcoming trip to Brazil to highlight stroke recovery

Both Dr. Moura and Dr. Gregory are traveling to Brazil this month to develop collaboration with doctors at the Federal University of Bahia in Salvador. They will consider the value of rehabilitation medicine on those affected by stroke.

According to Dr. Moura, stroke is the leading cause of death in Brazil, and a leading cause of disability in the United States.

Lee_bannerIt is especially prevalent in North Carolina, South Carolina and Georgia, she said, because of factors such as poverty and the lack of access to medical care in remote areas – obstacles similar to those in northeast Brazil.

“We are going to work with a focus group of patients to find patient perspectives of rehabilitation medicine,” Dr. Moura said. With the help of the focus group, researchers will consider how medical staff can help patients shift from immediate care to recovery care.

Dr. Moura said that another goal of the trip is to establish long-term personnel connections with the Federal University of Bahia, including the possible creation of a visiting professorship and a medical resident exchange between the universities, similar to the department’s efforts in Peru.

Global Partnership in Medical Rehabilitation

The Brazil trip is part of the department’s growing emphasis on making connections beyond borders for the benefit of all in its Global Partnership in Medical Rehabilitation.

In March 2009, Dr. Lee and two of the department’s residents traveled to Peru to educate doctors in other fields about rehabilitation medicine and its value for their patients.

By touring medical facilities and collaborating with healthcare practitioners, the residents brought back a renewed sense of commitment to provide resources, understanding more fully that some patients can not afford therapy, equipment and other medical services following a disability – in North Carolina and abroad.

The partnership will continue to encourage collaboration with global colleagues and rehabilitation medicine Lee_colleagueseducation for patients worldwide.

Bringing resources back home

The department is also working to expand its resources and bring recognition to the field by encouraging the world to look to UNC for quality rehabilitation care.

“We just hosted the Society of Acupuncture Research international conference,” Dr. Lee said, noting that 350 people from many countries shared research, knowledge and experience in acupuncture, a growing complementary treatment.

Dr. Lee also cited the department’s successful visiting scholars program, which has hosted clinicians and researchers from Slovenia, Colombia, Brazil, Japan and Korea.

By educating doctors and health professionals about rehabilitation techniques and outcomes – both in person and through technology – as well as implementing global strategies along the way, the department hopes to provide a bridge to more than a million patients with physical disabilities in North Carolina, and millions more worldwide.

- Story by Heather Mandelkehr ’10