Could you briefly introduce your background, Dr. Letellier?

I began studying medicine in Lille, then pursued a specialty internship at the Poitiers University Hospital, during which I completed a semester in Physical Medicine and Rehabilitation (PM&R) and earned a Master’s degree in research focused on neuromuscular diseases and clinical research. After an inter-CHU rotation in Paris, I oriented myself toward this holistic, technical, and innovative field of medicine. I further completed my training with a two-year fellowship in Montreal and finally a clinical attachment at the Garches University Hospital.
This field requires many other skills depending on the medical and technical areas one wants to explore, particularly through clinical research, to innovate and not just endure disability.

What does your job involve?
It involves restoring a certain level of patient autonomy, promoting participation in activities, and, in pediatrics, ensuring growth under optimal conditions. This is what we call rehabilitation and/or re-education, similar to helping an athlete recover from an injury to regain their highest level of performance. We don’t always cure, but we can improve complex situations and help patients live fully.

What types of patients do you see at ESEAN APF France Handicap?
We see patients from 0 to 18 years old, and sometimes slightly older, covering multiple temporary or complex disabilities affecting the musculoskeletal or cognitive systems. We care for patients with oncological, neurological, nutritional, respiratory, or orthopedic conditions […]

What is essential (must-have) in your profession?
A sense of teamwork and humility! And also the ability to follow through on ideas to adapt things that might not seem adaptable at first glance.

How does one consult a PM&R doctor?
By making an appointment with a medical secretary. No intermediary is required for minors, and it’s best to clearly explain the reason for the consultation. One can also be referred by a primary care physician, a therapist, or another specialist.

What does a typical PM&R consultation look like?
Like any medical consultation, it starts with introductions, a detailed interview to understand a problem or complaint, or to redefine the reason for the consultation. The physical exam focuses on the impairment, but with the mindset of “working with what we have” to promote autonomy and the enjoyment of participation, according to each individual’s capacity. Together with the patient and/or their parents, we define goals and areas of focus to achieve the objectives agreed upon.
How do you work with other healthcare professionals?
It’s a collective effort, like an orchestra or a team sport, where everyone has their role and helps provide an accurate assessment of the clinical situation. In consultations with the family or during multidisciplinary meetings, I propose a strategy aimed at objectives defined together.

Can you give an example of a rehabilitation program for a patient with upper limb limitations?
A fractured elbow, a paretic hand, a painful shoulder, or neonatal brachial plexus paralysis—these are all situations that the rehabilitation program addresses to help each child regain functional movements and gain autonomy. The approach includes physiotherapy work on joint range of motion, pain management techniques, occupational therapy for fine motor skills, positioning, and movement organization. Adapted physical activity educators (APA) may coordinate movements during physical, recreational, or sports activities. All of these approaches can be combined with robotic or non-robotic assistive devices to compensate for lost function, reduce pain, recruit muscle fibers, or retrain movement.

What are the recent advances in rehabilitation and mobility?
There have been significant advances in the use of robotics, applied to both lower and upper limbs. Robotics can assist with walking, compensate for lost function, and support muscle strength in the arms. There is also interest in muscle fiber recruitment through vibrotherapy of varying intensities and frequencies. Active and passive mobilization of the spine can be mechanized under a therapist’s guidance. Research projects are exploring augmented reality to motivate movement, as well as advanced research to “regenerate” certain cellular functions. Artificial intelligence contributes through sensor design to guide techniques or support fine motor or communication activities. Progress never stops, and curiosity is essential!

Do assistive devices—such as robotic arms, exoskeletons, or smart wheelchairs—change your practice?
Yes, these are areas to explore and use correctly to avoid disappointment and wasted money. Their effectiveness depends on clear goals and proper multidisciplinary support.

In your opinion, what are the biggest challenges for including people with disabilities in society?

• Changing society’s perception of those too often labeled as “weak” or “vulnerable.”
• Remembering that anyone can experience disability at some point in life.
• Understanding and supporting the lives of caregivers.
• Adapting employment opportunities to engage people according to their skills in specific areas.

How do you see your profession evolving in ten years?
Likely in a variable way, as it is currently difficult to inspire vocations due to the low number of doctors trained in pediatric PM&R. I envision doctors who remain highly empathetic, optimistic, and unafraid to use breakthrough technologies to achieve ambitious goals. This is possible when therapists are motivated and society supports the resilience of patients and their families.