UEMS PRM Section and Board held online General Assembly with workshops and plenary session from 30th September to 3rd October 2020, with participation of 56 delegates and experts. Many thanks go to our colleagues in Croatia with Prof. Tonko Vlak, president of Croatian PRM Society and co-workers to have tried to organize the meeting in Šibenik; but in the final analysis we had to give up to for the safety reasons. The work in the previous six months has been, as everywhere and everything else, disturbed by the pandemic of Covid-19. In a matter of days PRM practices changed, but our cooperation even enhanced and produced new ways of actions, and eventually we learned how to “dance” with the virus, reopen, rephrase and rethink our clinical practices, research, education and the place of the speciality of Physical and Rehabilitation Medicine. These have been reflected in some of our decisions of the General Assembly.
The work of the assembly proceeded online but in usual workshops of the three committees: the Board, Professional Practice Committee and Clinical Affairs Committee.
In the Board workshop, information about the next European Board Examination (BEX) was presented. The Board Examination 2020 will take place on 27th November 2020, 09:00 GMT and will be held on-line for all countries. Questions from the examinations 2009-2013 were disclosed to candidates by the platform identical with the exam platform, and candidates are encouraged to use the exam simulator. The results of the exam are expected to be available on 14th December 2020. Until the Board workshop,134 candidates registered to the exam, which is the highest number in the history of the European Board Examination in PRM. The exam will be computer-based and held in a number of countries simultaneously. Other certification (Fellows, Senior Fellows, Life fellows, Trainers, Training centres, Extraordinary certification of Training centres, Conditional endorsement of Training programmes, Accreditations of scientific events) were evaluated. President of the Board M G Ceravolo expressed her gratitude to all members of the Executive Committee and all National Managers for their effort in implementation of the Action Plan 2018-2022. Among activities performed to increase the participation in Board Certification by Examination she underlined: improving the educational material available on the EBPRM platform to help trainees to prepare to the exam, increasing the overall quality of Multiple Choice Questions and in particular switching the content of questions produced from theoretical knowledge to clinical problems and decision making in PRM, and achieving complete online delivery of the exam. Constant improvement of the quality of European Board exam in PRM allows for submission to the appraisal by CESMA, which is expected by 2021. With regard to pursuit to drive more countries to acknowledge European Exam as a mandatory part of the national examination for achieving the status of PRM physician, M G Ceravolo informed on the letter sent by Section and Board Presidents to Presidents of PRM National Societies subsequently distributed by National Managers, and discussed in details the responses achieved from 15 countries. To date, four countries (Belgium, Malta, Slovenia, and Switzerland) have already accepted Board Exam as mandatory part of their national examination. To enhance the achievement of required standards in PRM postgraduate and continuous education, promotion to diffuse the knowledge of the European Training Requirements in PRM was initiated and the relevant Letter to the Presidents of PRM National Societies was circulated by National Managers. The Action Plan 2018-2022 resulted in increasing the number of certified and recertified Trainers and Training Centres across Europe. Since the approval by the UEMS PRM Board, the criteria for the Conditional Endorsement of Training Programs in European Countries which are not part of the European Union, the European Free Trade Association, Serbia or Turkey, in which the medical speciality of Physical and Rehabilitation Medicine (PRM) is either officially recognized or not AND the medical speciality of PRM is still under construction, training programs in PRM have been developed in Russia and Ukraine with the educational support made available by official representatives of the UEMS PRM Section and Board. Until now 26 Russian PRM physicians and 2 Ukrainian PRM physicians have been certified by equivalence and became PRM Board Fellows. Board President informed that due to COVID-19 restrictions the European School Marseille in 2020 was cancelled, while 15-th edition of Euro-Mediterranean Rehabilitation School Syracuse is planned to be conducted as a single-day webinar held on November 11th, 2020 between 15:30 – 20:40. The title of the event remained unchanged: “Pharmacological Management in PRM: set-up, synergies, uncertainties and evidence based knowledge in various pathologies”. P Cantista updated the information on European Balneology Summer School. The event was postponed due to epidemiological situation since deemed not feasible as webinar due to the importance of practical training. The European School of Pain Management was also cancelled this year. A provisional program of Robotic Rehabilitation Summer School for 2021 is still in a draft form. M G Ceravolo expressed her gratitude to all persons involved in Board activities during her service at the post of the President of the European Board of PRM. N Christodoulou congratulated M G Ceravolo for her successful presidency. The participants of the workshop expressed their great thanks for the achievements of the Board.
PPC (Professional Practice Committee) continued the work on the Field of competences part III with following projects in various phases of completion. An update was given on the advancement in the following papers: Oncology (Ayşe Küçükdeveci) – update of literature search, Cerebral palsy (Karol Hornáček) – ready for Delphi round 3, Neurodegenerative (Maria-Gabriella Ceravolo) – literature search, Amyotrophic lateral sclerosis (Milica Lazović) – ready for Delphi round 2, Myopathies/muscular dystrophies (Milica Lazović) – ready for Delphi round 2, Sarcopenia (Nikos Barotsis) – update of literature search, Multiple Sclerosis (Martina Kővári) – under preparation for Delphi round 1.The following papers are still at a starting phase: Pregnancy (Carlotte Kiekens), Limb loss (Helena Burger), New technologies designed to improve functioning: the role of the physical and rehabilitation medicine physician (Mauro Zampolini) – update of the previous EBPP according to the new methodology, Telerehabilitation and digital health (Mauro Zampolini) – new EBPP. The on-going Cochrane Rehabilitation projects were briefly presented by Stefano Negrini: Prioritization project, Be4rehab (part of WHO – Package of Interventions for Rehabilitation project), Rehabilitation Definition – a methodology meeting was held in Milan, trying to find a better definition of Rehabilitation, because the present is too inclusive, RCT in Rehabilitation Checklist project (RCTRACK) – a methodology meeting was held in Orlando, Cochrane Rehabilitation REH-COVER (REHabilitation – COVID19 Evidence-based Response) action – mapping, systematic reviews and rapid living systematic reviews devoted to COVID 19 are identified. There was a discussion about the Rehabilitation definition and on the inclusion of functioning as a more general or too narrow term, quality of life and satisfaction of quality of life. It was explained that functioning is considered as the positive aspect of disability. This definition is discussed to be changed mainly for research reasons. Fellow project of the European Academy of Rehabilitation Medicine: Under the supervision of Katharina Stibrant Sunnerhagen and Carlotte Kiekens, Rutger Osterthun, PRM physician from The Netherlands prepared a survey that was circulated among the delegates: how we see the role of PRM physician in the end of life decisions in the different European countries. Thirty surveys were compiled, more yet to arrive. In the Survey of Comparison of practice of PRM across Europe Summary of the results was finished by Rajiv Singh and planned to be published as a letter in EJPRM. The Cochrane Rehabilitation e-book political summaries are approved. Melissa Selb reported on behalf of Gerold Stucki of ISPRM ClinFIT taskforce that conducted a survey of ISPRM members of their contact with Covid-19 patients and on their opinion of ClinFIT Covid-19 set (247 answers from all world regions). Some items were added for post-acute and long-term phase to the 7 ICF categories for the acute phase and a new version is being prepared. Demonstration project on the application of ICSO-R to the European Framework for rehabilitation service types by applying ICSO-R 2.0 – the aim was to cover the 14 types with several example services: 19 countries participated. There is need of inclusion of more countries about general post-acute in high resource countries, vocational rehabilitation and rehabilitation in social assistance. Individual rehabilitation plan/projects initiative of ISPRM was presented by Mauro Zampolini. The results of the survey of Covid-19 initiative in the countries were presented by Elena Ilieva. Only 10 countries answered. Outpatient rehabilitation services were closed and inpatient were reduced and/or discontinued with conversion of some to COVID-19 acute treatment in the beginning, then gradually restarted with protectable measures and screening including PCR tests. Many countries reported “collateral damage” in non-COVID-19 patients with rehabilitation needs because of the lockdown, including delay in services and psychological problems. Only in Spain and Czech Republic PMR specialists were involved in acute rehabilitation of patients with COVID-19. Post-acute rehabilitation is performed in post-acute settings. Most of the countries use telemedicine/telerehabilitation in the situation of COVID-19 pandemic. PPC also presented various aspects of the access to PT/OT in terms of European regulations and concerns.
CAC (Clinical Affairs Committee) continued the work on the GLOBAL ROADMAP FOR IMPLEMENTATION OF ICF ACROSS EUROPE:Mauro Zampolini gave a comprehensive presentation on the Rehabilitation Plan/Project to the group which addressed a range of innovative assessment tools addressing rehabilitation potential. Delegates discussed terminology and agreed on ‘rehabilitation potential’. Prof Zampolini’s target is to have a new road map ready for implementation by 31/12/21. Dr. Anda Nulle gave a comprehensive presentation for the “PRM Programme for patients with Spinal Cord Injury in the post-acute phase” by Vaivari, Latvia, and the CAC recommends that the PRM Programme for patients with Spinal Cord Injury in the post-acute phase from Vaivari, Latvia receives its reaccreditation certificate at the General Assembly on 3/10/20. The CAC discussed the value of a strategy to highlight the benefits of accreditation and the strategy will be updated at the next CAC in March 2021. There was agreement that simplification of the application process would be advantageous to prospective applicants. CAC accreditation committee proposes development of the accreditation process by introducing virtual accreditation visits to applicant programmes. It was noted that virtual accreditation visits would be instructive and both time efficient and economical. Furthermore, Teleconferencing systems can be used to present the programmes to be accredited to make possible presentation to a larger number of centres. The approved accreditation procedure remains unchanged. Prof. Delargy thanked the delegates for their insightful contributions. He much appreciated the committee members kind words and vote of thanks for his 4-year tenure as CAC chair. He wished the incoming CAC chair Anda Nulle every success in developing the work of the Clinical affairs Committee.
At the end, several motions driven by the recent events have been approved: The UEMS PRM Section and Board considers Telerehabilitation and Digital Health as part of the PRM activity. The UEMS PRM Section and Board is committed to produce recommendations about Telerehabilitation and Digital Health and implementation guidelines in clinical practice. Considering the increasing demand from non-medical professionals to perform medical procedures, the General Assembly mandates the President of the UEMS PRM Section to take action against this trend by submitting a dossier to the next UEMS Council and concerns to the European Union authorities.
Next General Assembly is scheduled ONLINE in spring 2020: 18-20 March 2020.