CFB MED11 Rehabilitation Medicine
Rehabilitation medicine is a medical specialty focused on restoring functional ability and quality of life in individuals with physical impairments or disabilities resulting from injury, illness, or chronic conditions.
Rehabilitation Medicine — Exam-Ready Comprehensive Notes
Lecture Map
Rehabilitation medicine is not simply "physiotherapy after an illness." It is a medical specialty centred on human functioning — the ability to perform the tasks of daily life — and how disease, injury, or ageing erode that functioning. While acute medicine aims to cure pathology, rehabilitation aims to maximise the patient's residual functional capacity after the pathology has been addressed (or when it cannot be fully reversed). The lecture introduces a framework (ICF), a process (5 phases), the team (multidisciplinary matrix), and the tools (types of exercise, neuroplasticity, adaptive devices, environmental modification) that underpin every rehabilitation programme. [1]
1. Define the principles and approaches in rehabilitation medicine 2. Distinguish the terms impairment, disability, handicap, functional and participation limitations and environmental and personal factors in rehabilitation 3. Identify the phases, intervention process and goals achievement for rehabilitation programme 4. Understand various types of exercise used in rehabilitation and neuroplasticity [1]
- Rehabilitation questions frequently appear as EMQs on assessment scales (Barthel Index, FIM), SAQs on spinal cord injury rehabilitation, and MCQs on exercise types.
- The ICF model is a favourite exam framework — examiners love asking you to classify a clinical scenario into impairment / activity limitation / participation restriction.
- Geriatric rehabilitation overlaps heavily: Comprehensive Geriatric Assessment (CGA) slides use the same ICF language, and past papers test your ability to select the correct assessment tool. [2][3]
After an acute illness, a patient may recover completely or be left with residual permanent impairment. Rehabilitation intervention targets the residual impairment to minimise functional loss. [1]
Why this matters from first principles: Acute medicine treats the disease itself (e.g., thrombolysis for stroke, antibiotics for meningitis). But the disease may leave behind a permanent deficit — hemiparesis, cognitive impairment, amputation. Without rehabilitation, that deficit translates into an inability to function in daily life, dependence on carers, loss of social roles, and poor quality of life. Rehabilitation bridges the gap between surviving an illness and actually living after it.
Core Concept 2 — The Old (WHO 1980) vs New (ICF 2001) Framework
| Term | Definition | Example |
|---|---|---|
| Impairment | Loss or abnormality at organ level | Hemiparesis after stroke |
| Disability | Restriction of ability to perform an activity | Cannot dress independently |
| Handicap | Disadvantage for the individual in society | Cannot return to work |
The simple (old) classification: Impairment → Disability → Handicap [1]
Why it was replaced: The old model was linear and unidirectional — implying that impairment inevitably leads to disability which inevitably leads to handicap. It didn't account for environmental or personal factors that could modify the outcome. A person with a below-knee amputation fitted with a prosthesis in a well-adapted environment may have minimal handicap; the same person in a rural village with no prosthetic services faces severe handicap. The old model couldn't capture this.
High Yield — ICF Model (WHO 2001)
The International Classification of Functioning, Disability and Health (ICF) replaces the old linear model with a biopsychosocial, interactive model. It has three components of functioning: Impairment, Activity, and Participation, all modified by Contextual Factors (Environmental and Personal). [1]
| ICF Component | Definition (from lecture) | Example |
|---|---|---|
| Impairment | A loss or abnormality of body structure or of a physiological or psychological function | Loss of a limb, loss of vision [1] |
| Activity (Limitation) | The nature and extent of functioning at the level of the person. Activities may be limited in nature, duration and quality | Taking care of oneself, maintaining a job [1] |
| Participation (Restriction) | The nature and extent of a person's involvement in life situations in relation to impairment, activities, health conditions and contextual factors. May be restricted in nature, duration and quality | Participation in community activities, obtaining a driving licence [1] |
| Contextual Factors | a. Environmental factors (physical, social, attitudinal environment) and b. Personal factors (age, gender, coping style, background) | Wheelchair ramp (environmental), motivation (personal) [1] |
The key difference: The ICF model is bidirectional and interactive. Contextual factors can modify any component. An impairment doesn't automatically cause an activity limitation if the right environment and personal factors are in place.
The ICF model shows that Health Condition (Disorder/Disease) interacts with Impairment, Activity, and Participation, all influenced by Contextual Factors (Environmental and Personal). [1]
Exam Trap — Disability vs Activity Limitation
In the old WHO model, "disability" refers to activity restriction. In the ICF model, the preferred term is "activity limitation." If an exam question uses ICF terminology, do NOT use the word "disability" as a synonym for activity limitation — "disability" in the ICF is an umbrella term for impairments, activity limitations, and participation restrictions collectively.
"The combined and coordinated use of medical, social, educational and vocational measures for training or retraining the individual to the highest possible level of functional ability" — WHO 1969 [1]
Why each word matters:
- Combined and coordinated — no single profession can deliver rehabilitation alone; it requires a team
- Medical, social, educational, vocational — rehabilitation extends beyond hospital medicine into the community
- Training or retraining — rehabilitation is active, not passive; the patient must participate
- Highest possible level — the goal is not perfection but the best achievable function
Rehabilitation Medicine as a Specialty
A Medical Specialty that deals with human functioning, including evaluation, diagnosis and intervention to minimise functional loss due to sequelae of diseases. [1]
Other names:
- Physical and Rehabilitation Medicine (PRM)
- Physical Medicine and Rehabilitation (PMR)
- Physiatry [1]
| Feature | Biomedical Model | Biopsychosocial Model |
|---|---|---|
| Focus | Cause of disease | Cause AND secondary effects of injury/illness |
| Interventions | Single (drug, surgery) | Multiple simultaneous interventions |
| Team structure | Hierarchical (doctor at top) | Matrix (all disciplines equal) |
| Outcome measure | Cure / pathology resolution | Function / quality of life |
Biomedical Model: Classical medical therapeutics direct treatment at the cause of disease. Biopsychosocial Model: Rehabilitation produces multiple simultaneous interventions addressing both the cause and secondary effects of injury and illness. [1]
The Rehabilitation Team — Matrix Organisation
Unlike the traditional medical model (hierarchical with senior doctor at the top), the rehabilitation team uses a matrix organisation where the rehabilitation physician coordinates with nurse, physiotherapist, occupational therapist, speech therapist, clinical psychologist, medical social worker, pharmacist, and other medical specialists — all at the same level. [1]
Why matrix? Because each discipline brings expertise that the physician alone cannot replicate. The physiotherapist understands gait retraining, the OT understands home modifications, the speech therapist manages dysphagia, and the social worker navigates community resources. Hierarchical structures slow communication; matrix structures allow parallel, coordinated care.
Rehabilitation: Adaptation of a new set of skills to survive. Change of habits and behaviours. E.g. after stroke, cardiac disease, amputation. Habilitation: Accustoming to an environment. E.g. spina bifida. [1]
Why the distinction matters:
- Re-habilitation implies the patient previously had function and needs to regain it (or adapt to its loss). The prefix "re-" means "again."
- Habilitation is for patients who never had the function in the first place (e.g., congenital conditions like spina bifida, cerebral palsy). The goal is to build skills from scratch, not re-learn them.
Core Concept 6 — The Five Phases of the Rehabilitation Process
This is the most exam-testable framework in the lecture. Each phase builds on the last.
Evaluation: Other than medical history, knowledge of patient's personal life tasks, roles and aspirations. To quantify individual effects of disablement. [1]
What makes rehab evaluation different from acute medicine evaluation? In acute medicine, you take a history of presenting complaint, past medical history, medications, etc. In rehabilitation, you additionally need to understand:
- What the patient did before the illness (premorbid function)
- What the patient wants to do after the illness (goals, aspirations)
- What roles the patient plays (worker, parent, community member)
- The home environment (stairs, bathroom access, carer availability)
ADL Assessment Tools
Basic ADL: Personal hygiene, Grooming, Feeding, Toileting, Transfer, Ambulation, Stair climbing. Tools: FIM, Barthel, WeeFIM. Advanced ADL (Instrumental ADL/IADL): Shopping, Driving, Gardening. Tools: FAM, PEDI. [1]
| Category | Activities | Scales | Who it applies to |
|---|---|---|---|
| Basic ADL (BADL) | Personal hygiene, grooming, feeding, toileting, transfer, ambulation, stair climbing | Barthel Index, FIM (Functional Independence Measure), WeeFIM (paediatric) | Everyone — the minimum for independent living |
| Instrumental ADL (IADL) | Shopping, driving, gardening, cooking, managing finances, telephone use | FAM (Functional Assessment Measure), PEDI (Pediatric Evaluation of Disability Inventory) | Higher-level function needed for community living |
Past paper connection: The 2018 Fourth Summative EMQ Q1 directly tests: "Assessment of the patient's level of independence" → Answer: Barthel Index. Q2: "Assessment of memory and cognitive performance" → Answer: Montreal Cognitive Assessment (MoCA). Q3: "Assessment of nutritional status of a frail bedbound patient" → Answer: Malnutrition Universal Screening Tool (MUST). [3]
Treatment to arrest the pathophysiologic process causing tissue injury. [1]
This phase is about stopping the disease from causing further damage to tissues. Examples from the lecture:
| Problem | Treatment |
|---|---|
| Spasticity | Botulinum toxin injection, Phenol motor point block |
| Contracture | Stretching exercise, Surgical release |
Why spasticity matters: After an upper motor neurone lesion (stroke, spinal cord injury), spasticity develops because of loss of descending inhibitory control. Spasticity → contracture → pain → further functional loss. Treating spasticity early with botulinum toxin (blocks ACh release at the neuromuscular junction, reducing muscle tone) or phenol (destroys motor nerve fibres chemically) prevents this cascade.
Why contracture matters: If a joint is immobilised for too long, the soft tissues (muscles, tendons, joint capsule) shorten permanently. Stretching exercises maintain range of motion. If contracture is established, surgical release may be needed.
Phase III: Therapy to Enhance Organ Function
Therapy to enhance organ function, e.g. therapeutic exercise. [1]
This is the phase most people think of when they hear "rehabilitation" — the gym, the exercises, the therapist. But it's only one of five phases. The lecture covers two major types:
Three types of exercise for muscle strengthening: Isometric, Isotonic, Isokinetic. [1]
| Type | Definition | Joint Movement | Speed | Force | Example | Best For | Caution |
|---|---|---|---|---|---|---|---|
| Isometric | Generation of muscular force with no visible joint movement; external resistance is not overcome | None | N/A | Static | Hand press, static knee extension | Joint immobilised in a cast | Caution in hypertensive patients (raises BP due to sustained muscle contraction → Valsalva-like effect) |
| Isotonic | Generation of muscular force with visible joint movement at variable speed with constant external force | Yes | Variable | Constant | Push-up, sit-up, Thera-band | Home exercise programme (simple equipment) | — |
| Isokinetic | Generation of muscular force with visible joint movement at constant speed with variable external force; can generate maximal force throughout length-tension curve | Yes | Constant | Variable | Cybex machine | Controlled rehab settings | Requires expensive equipment |
Why isometric is cautioned in hypertension: During isometric contraction, the sustained muscle tension compresses blood vessels, increasing peripheral resistance. This raises both systolic and diastolic BP acutely. In a hypertensive patient, this could precipitate a hypertensive crisis or cardiac event.
Why isokinetic is special: Because the machine controls speed and adjusts resistance, the muscle generates maximal force at every point in the range of motion. This is the most efficient way to strengthen a muscle but requires specialised equipment, so it's typically done in hospital or clinic settings, not at home.
Exam Discriminator — Isometric vs Isotonic vs Isokinetic
The key discriminators are: (1) Is there joint movement? Isometric = NO. (2) Is the speed or force constant? Isotonic = constant force, variable speed. Isokinetic = constant speed, variable force. A common trap is confusing isotonic and isokinetic — remember: "tonic" = tone = force (constant), "kinetic" = movement = speed (constant).
All individuals who are > 40 or with risk factors (Hypertension, Smoking, Hypercholesterolaemia, or a history of coronary artery disease) should first undergo a graded exercise test. [1]
Why a graded exercise test first? To unmask occult ischaemic heart disease and determine the safe exercise intensity. If you prescribe vigorous exercise to someone with undiagnosed coronary stenosis, they could have an MI or sudden cardiac death during training.
Type of activity:
Aerobic exercise the participant can enjoy; Resistive exercise [1]
Why "can enjoy"? Adherence is the single biggest determinant of long-term benefit. If the patient hates the exercise, they won't do it. Prescribing an enjoyable activity (swimming, dancing, cycling) increases compliance.
Training Heart Rate Formula:
(220 – Age) × 50–85% for training effect [1]
This is the target heart rate range. Below 50% gives minimal cardiovascular benefit; above 85% increases cardiac risk without proportional benefit for most patients.
Rate of Perceived Exertion (RPE) — Borg Scale:
Supervised by a therapist. Teach proper techniques, including monitoring heart rate and RPE. [1]
| RPE | Description |
|---|---|
| 6–7 | Very, very light |
| 8–9 | Very light |
| 10–11 | Fairly light |
| 12–13 | Somewhat hard |
| 14–15 | Hard |
| 16–17 | Very hard |
| 18–19 | Very, very hard |
| 20 | Maximal |
Why RPE matters: Heart rate alone can be unreliable (beta-blockers blunt HR response, arrhythmias distort HR). RPE is a subjective but validated measure. A target of 12–14 ("somewhat hard") correlates well with 50–70% VO₂max.
ACSM Guidelines for Cardiovascular Conditioning:
ACSM: - 3–4 times per week - Duration is 20–30 minutes - Intensity is 50–85% VO₂max (moderate intensity) / 50–85% HRR max - Warm-up 5–10 mins - Stretching - Cool down 5–10 mins [1]
Why warm-up and cool-down? Warm-up gradually increases heart rate and vasodilates the coronary arteries, reducing the risk of ischaemia. Cool-down prevents blood pooling in the legs (which can cause syncope) and allows gradual return to resting physiology.
Benefits of HIIT (high > 90%) vs MICT (Moderate): Direct: Significantly improve VO₂ at ventilatory threshold, left ventricular size and function, contractile function, LV diastolic diameter, diastolic volume, posterior wall thickening, fractional shortening, rate pressure product, cardiorespiratory fitness, ejection fraction, endothelial function Indirect: Mitochondrial biogenesis, insulin sensitivity and glucose regulation, HDL cholesterol, blood pressure, deep abdominal adiposity [1]
Why HIIT is gaining favour: HIIT produces superior cardiorespiratory improvements in less time. However, it carries higher risk (arrhythmia, MI) and requires more supervision. For rehabilitation patients, it is increasingly used in cardiac rehabilitation under strict monitoring.
Therapy to enhance organ function: e.g. therapeutic training for neurological patients — Neuroplasticity [1]
What is neuroplasticity? The brain's ability to reorganise itself by forming new neural connections throughout life. This is the biological basis of neurological rehabilitation — if the brain can rewire, then functional recovery is possible even after significant injury.
Neuroplasticity is interactive and involves: Behavioral Adaptations Physiological Responses: Facilitation, Potentiation, Long-term potentiation, Habituation, Conditioning, Denervation supersensitivity Biochemical Responses: Secondary messengers, Immediate early genes, Tropic factors, Metabolic changes Structural Responses: Regeneration, Axon sprouting, Dendritic pruning, Dendritic hypertrophy [1]
| Level | Mechanism | What It Means |
|---|---|---|
| Physiological | Facilitation | Lowering of synaptic threshold with repeated stimulation → easier to fire |
| Physiological | Long-term potentiation (LTP) | Persistent strengthening of synapses after high-frequency stimulation → the cellular basis of learning and memory |
| Physiological | Denervation supersensitivity | After loss of input, post-synaptic receptors upregulate → remaining inputs become more effective |
| Biochemical | Trophic factors (e.g., BDNF, NGF) | Support neuronal survival, growth, and differentiation; exercise increases BDNF |
| Structural | Axon sprouting | Surviving neurons grow new axon branches to reinnervate denervated targets |
| Structural | Dendritic hypertrophy | Increased dendritic branching to form new synapses |
Functional MRI can evaluate neuroplasticity — e.g. after stroke, movement of the paretic left hand activates bilateral cortices (not just contralateral), showing cortical reorganisation. [1]
Clinical implication: Rehabilitation must be started early and be intensive to capitalise on the window of maximum neuroplasticity (typically first 3–6 months post-stroke, though plasticity continues lifelong). "Bottom-up training" (peripheral repetitive practice) drives central neuroplastic change.
Task Reacquisition: Total person adaptive techniques for residual permanent impairment and functional limitation. [1]
When organ function cannot be fully restored (Phase III), the patient must learn to perform tasks in a new way.
| Strategy | Definition | Example |
|---|---|---|
| Compensation techniques | Using alternative methods to achieve the same task | One-handed dressing technique for hemiparesis |
| Adaptive devices | Equipment that modifies the task to make it easier | Built-up handles for cutlery, long-handled shoe horn |
| Orthosis | External device that supports or corrects a body part | Ankle-foot orthosis (AFO) for foot drop; KAF (knee-ankle-foot) orthosis; hand orthosis |
| Prosthesis | Replacement for a missing body part | Below-knee prosthesis after amputation |
AFO (ankle-foot orthosis) is used for foot drop. KAF orthosis supports the knee, ankle and foot. Prosthesis replaces amputated limbs. [1]
Environmental Modification: Environmental enhancement (physical, psychological, social and political) to reduce functional limitations. [1]
Examples:
- Physical: Ramp installation, grab rails in bathroom, widened doorways for wheelchair access
- Psychological: Family education, peer support groups
- Social: Community day centres, home help services
- Political: Disability discrimination legislation, accessible public transport
Why this phase is critical: Even a fully rehabilitated patient will fail if the environment doesn't support them. A wheelchair user cannot return home if there are stairs and no lift. The ICF model explicitly recognises that environmental factors determine whether an impairment becomes a participation restriction.
Practical Approach: 1. Evaluation (by team members) 2. Planning (goal setting) 3. Intervention (care and treatment) 4. Re-evaluation 5. Discharge planning Supported by: Team conference, Family conference [1]
Goal setting is a cornerstone of rehabilitation. Goals must be:
- Specific — "walk 10 metres with a walking frame" not "improve mobility"
- Measurable — can be objectively assessed
- Achievable — realistic given the patient's impairments
- Relevant — meaningful to the patient's life
- Time-bound — set a target date
Team conference brings all disciplines together to review progress. Family conference educates family/carers and adjusts expectations.
Personal: Mood, Depression, Maladapted behavior, Social Interaction, Opportunities to occupy themselves, Ability to adapt to change. Family and caregiver: Behavior and expectation of family and significant others. [1]
Why psychosocial factors matter: Depression is the most common psychiatric complication after stroke (prevalence ~30%). It independently reduces rehabilitation outcomes. If you don't screen for and treat depression, your physiotherapy and OT interventions will be less effective because the patient lacks motivation and engagement.
Clinical Pathway: ACUTE (Inpatient) → REHABILITATION (Inpatient) → COMMUNITY (Outpatient) Acute phase: Medical focus Rehab phase: Mobility, Cognitive, Self-care Community phase: Vocational, Sexual, Psychosocial [1]
| Phase | Setting | Focus |
|---|---|---|
| Acute | Hospital ward | Medical stabilisation |
| Rehabilitation | Rehab ward/unit | Mobility, cognition, self-care |
| Community | Outpatient, day hospital, home | Vocational rehabilitation, driving rehabilitation, sexual function, psychosocial reintegration |
Vocational rehabilitation training and driving rehabilitation for disabled are key community-phase interventions. [1]
Drivers of changes in healthy life expectancy between 1990 and 2010 (Salomon JA, et al. Lancet 2012; 380: 2144–62) [1]
Why this matters for rehabilitation: As populations age, the gap between life expectancy and healthy life expectancy widens. More years are lived with disability. This means the demand for rehabilitation services is increasing, and rehabilitation is becoming one of the most important healthcare interventions globally.
Integration with Related Material
The GC038 lecture on CGA uses the same ICF framework. CGA is essentially a structured evaluation (Phase I of rehabilitation) applied specifically to older adults. It includes:
- Medical assessment
- Functional assessment (Barthel Index, IADL)
- Cognitive assessment (MMSE, MoCA)
- Nutritional assessment
- Social assessment
- Environmental assessment [4]
The 2023 SAQ Q8 tests spinal cord injury rehabilitation concepts. Key points:
- Hemitransection (Brown-Séquard syndrome): ipsilateral motor loss + ipsilateral dorsal column loss + contralateral spinothalamic loss
- Neurogenic bladder complications: UTI, hydronephrosis/renal failure
- Medication for functional recovery: methylprednisolone (controversial) or newer agents [5]
The Covinsky 2011 JAMA paper highlights that hospitalisation itself causes functional decline (deconditioning, iatrogenic immobility). This reinforces why early mobilisation and rehabilitation during the acute phase are critical. [6]
The HKU OM lecture discusses return-to-work after occupational injury, including gradual return to work, work capacity evaluation, and managing expectations — all Phase IV and V concepts applied to the occupational setting. [7]
Likely Exam Questions
-
Which of the following is the BEST description of "Activity Limitation" in the ICF model?
- A. Loss of body structure
- B. Restriction in performing daily tasks ✓
- C. Disadvantage in social roles
- D. Loss of a physiological function
- Markscheme: Activity limitation = restriction at the person level in performing tasks (not organ level = impairment, not societal level = participation restriction)
-
Which type of exercise is MOST appropriate for a patient with a limb immobilised in a cast?
- A. Isotonic
- B. Isokinetic
- C. Isometric ✓
- D. Aerobic
- Markscheme: Isometric exercise generates force without joint movement, so it can strengthen muscles even when the joint is immobilised
-
Barthel Index measures:
- A. Cognitive function
- B. Basic ADL ✓
- C. Instrumental ADL
- D. Balance
- Markscheme: Barthel Index = Basic ADL (0–100). Cognitive = MoCA. IADL = Lawton's. Balance = Berg Balance Scale.
-
A 65-year-old man has right hemiparesis after left MCA stroke. Using the ICF model, classify the following: (a) right arm weakness, (b) inability to dress independently, (c) unable to return to work as a taxi driver. (3 marks)
- (a) Impairment — loss of physiological function (motor)
- (b) Activity limitation — restricted in self-care task
- (c) Participation restriction — unable to fulfil vocational role
-
List the 5 phases of the rehabilitation process. (5 marks)
- Phase I: Evaluation
- Phase II: Treatment to arrest pathophysiology
- Phase III: Therapy to enhance organ function
- Phase IV: Task reacquisition
- Phase V: Environmental modification
-
Name three types of exercise for muscle strengthening and state one advantage of each. (6 marks)
- Isometric: can be done with immobilised joint
- Isotonic: suitable for home exercise (simple equipment)
- Isokinetic: generates maximal force throughout range of motion
- Assessment of a patient's level of independence → Barthel Index
- Assessment of cognitive performance → Montreal Cognitive Assessment (MoCA)
- Assessment of nutritional status → MUST (Malnutrition Universal Screening Tool)
High Yield Summary
1. ICF Model (WHO 2001): Health Condition → Impairment / Activity / Participation, all modified by Contextual Factors (Environmental + Personal). Replaces old linear Impairment → Disability → Handicap model.
2. Rehabilitation = combined, coordinated use of medical/social/educational/vocational measures to achieve the highest possible functional ability (WHO 1969).
3. Biopsychosocial model → Matrix team organisation (not hierarchical). Team includes physician, PT, OT, ST, psychologist, MSW, pharmacist, nurse.
4. Rehabilitation vs Habilitation: Re-habilitation = re-learning lost skills (stroke, amputation). Habilitation = building new skills in congenital conditions (spina bifida).
5. Five Phases: I-Evaluation, II-Arrest pathophysiology (botulinum toxin for spasticity), III-Enhance organ function (exercise, neuroplasticity), IV-Task reacquisition (adaptive devices, orthoses, prostheses), V-Environmental modification.
6. Exercise Types: Isometric (no joint movement, cautioned in hypertension), Isotonic (constant force, good for home), Isokinetic (constant speed, maximal force, requires Cybex machine).
7. Cardiovascular Training: Graded exercise test first if > 40 or risk factors. Training HR = (220 − Age) × 50–85%. ACSM: 3–4×/week, 20–30 min, 50–85% VO₂max, with warm-up and cool-down.
8. Neuroplasticity: Facilitation, LTP, axon sprouting, denervation supersensitivity, dendritic hypertrophy. Basis for neurological rehabilitation. fMRI shows cortical reorganisation.
9. ADL Scales: Basic ADL → Barthel Index / FIM. Instrumental ADL → FAM / PEDI / Lawton's.
10. Clinical pathway: Acute (medical) → Rehabilitation (mobility, cognition, self-care) → Community (vocational, sexual, psychosocial).
Active Recall - Rehabilitation Medicine
[1] Lecture slides: CFB (MED11) Rehabilitation Medicine.pdf (all pages) [2] Lecture slides: GC 038. Comprehensive geriatric assessment and rehabilitation in older people.pdf [3] Past papers: 2018 Fourth Summative MCQ.pdf (Q1-3, Section B) [4] Lecture slides: HKGS Curriculum in Geriatric Medicine 2nd Ed.pdf (Chapter 2, Chapter 4) [5] Past papers: 2023 Fourth Summative SAQ.pdf (Q8) [6] Senior notes: Hospitalization-Associated Disability - Covinsky KE 2011 (JAMA).pdf [7] Lecture slides: HKU OM lecture 2023.09.09.pdf (p44)
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