Preface

Our goal is to present an integrated model of therapeutic intervention applicable to a wide spectrum of adult patients engaged in physical rehabilitation. Part I, Promoting Function, first addresses the foundations of clinical decision-making and provides a conceptual framework for improving functional outcomes. The organization of content provides the student a logical learning progression of interventions used to improve motor function, with an emphasis on task-specific, motor learning, and neuromotor strategies (Chapters 1 and 2). Chapter 3 presents an overview of Proprioceptive Neuromuscular Facilitation. Chapters 4, 5, 6, 7, 8, 9, 10, 11, 12, 13 then present strategies and interventions within the context of functional skills critical to independent function and optimal rehabilitation outcomes. Each chapter includes descriptions of suggested interventions accompanied by a discussion of lead-up skills and progressions. Also provided are descriptions of patient outcomes consistent with the American Physical Therapy Association’s Guide to Physical Therapist Practice, together with clinical applications and patient examples. The interventions presented address many types of impairments and activity limitations that patients may exhibit across practice patterns. They should not be considered as practice pattern-specific but rather specific to the physical therapy diagnosis and plan of care. Our goal is to provide useful, practical examples of interventions that can be used to enhance functional performance.

Part II presents 15 case studies in narrative form. In addition, each case study includes an accompanying video addressing selected elements of the physical therapy plan of care available online at DavisPlus (www.fadavis.com). An outstanding group of clinicians from across the country have provided examples of patient management strategies based on effective clinical decision-making for patients with a variety of diagnoses, among them are traumatic brain injury, stroke, Parkinson’s disease, cerebellar glioblastoma, Guillain Barré syndrome, peripheral vestibular dysfunction, spinal cord injury, and transfemoral amputation. The guiding questions included with each case study are designed to enhance clinical decision-making and to challenge the student to address the unique needs of the individual patients presented. The video captures each patient at three critical points within the episode of care: (1) at the initial examination, (2) during a treatment session, and (3) at discharge from physical therapy intervention. Our hope is that the case studies will facilitate meaningful dialogue between and among physical therapy students and faculty.

The text utilizes several pedagogical applications. Important information is emphasized using boxes and tables for easy reference. Key terms appear in boldface italic font in blue ink and are defined in the text. The Red Flag feature alerts the student to precautions or preventative safety measures. The Clinical Note feature provides additional insights based on clinical observations. Chapters in Part I include group Student Practice Activities to enhance learning. These activities provide an opportunity to share knowledge and skills with student peers and to confirm or clarify the student’s understanding of the interventions. Each student in a group is encouraged to contribute his or her understanding of, or questions about, the technique or treatment activity being discussed and demonstrated. Dialogue should continue until a consensus of understanding is reached.

The case studies in Part II conclude with guiding questions designed to enhance students’ critical thinking skills. Answers to the guiding questions for Case Studies 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 are provided to students (and instructors) online at DavisPlus (www.fadavis.com). Answers to the guiding questions for Case Studies 11, 12, 13, 14, 15 are provided only to instructors online at DavisPlus (www.fadavis.com). The intention of selected answer availability for Case Studies 11 through 15 is to provide faculty greater options for incorporating case materials into course assignments, laboratory activities, and group discussions. Student feedback to the guiding questions based on the answers developed by the case study contributors can be obtained from the course instructor(s).

The text recognizes the continuing growth of the profession and the importance of basic and applied clinical research in guiding and informing evidence-based practice. It also integrates terminology and interventions presented in the Guide to Physical Therapist Practice.

Our greatest hope is that this text enhances students’ understanding of strategies to improve functional outcomes that lead to independence and ultimately an improved quality of life for our patients.