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Introduction

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Part 1, Promoting Function, introduces the reader to foundational elements of patient care in terms of clinical decision-making and developing an appropriate, effective plan of care, then expands on those elements with chapters that specifically address key motor functions.

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Chapter 1, Framework for Clinical Decision-Making and Client Management, provides the foundational context for clinical decision-making. It addresses the International Classification of Functioning, Disability, and Health model as the basis for planning. Chapter 1 presents a brief overview of motor control and motor learning and considers strategies to examine motor function. The chapter is organized around the characteristics of three critical elements for planning: the task, the individual, and the environment. The major focus of Chapter 2, Interventions to Improve Motor Function, is to help the learner acquire a conceptual framework for developing a comprehensive plan of care to improve functional outcomes. It directs attention to the components of task analysis and progresses to a discussion of task-oriented, activity-based strategies as the foundation of intervention. Motor learning strategies are organized and discussed according to stages of motor learning.

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Chapters 3,4,5,6,7,8,9,10,11,12,13 present strategies and interventions to promote enhanced motor function and independence in key functional skills. The interventions presented in these chapters include descriptions of the general characteristics of each activity (e.g., base of support provided, location of center of mass, impact of gravity and body weight) and descriptions of required lead-up skills, appropriate interventions, and progressions. The chapters describe patient outcomes consistent with the Guide to Physical Therapist Practice,1 clinical applications, and patient examples. The student practice activities included here enhance student learning.

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The chapters are organized around a broad range of postures and activities required for normal human function (e.g., functional mobility skills, basic and instrumental activities of daily living). Postures and activities such as rolling and side-lying are presented first, with progression through upright standing and locomotion. Although the content is presented as a sequence from dependent to independent postures and activities, it should not be viewed as a "lock-step" progression. This means there are no absolute requirements for how the activities are sequenced or integrated into an individual plan of care. The sequencing presented has several implications for clinical practice:

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  • It will be the exception, rather than the norm, for an individual patient to require or benefit from the entire sequence of interventions presented.

  • Evaluation of examination data will guide selection and sequencing of interventions for an individual patient.

  • Interventions may be organized in a different sequence, used concurrently, expanded, or eliminated (i.e., deemed inappropriate) when developing a plan of care.

  • The content should be viewed and used as a source of treatment ideas based on the desired functional outcome and not as a prescribed sequence. For example, if a patient requires improved core (trunk) ...

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