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INTRODUCTION

Movement is central to life itself. This book is about teaching you to maximize the mobility skills of people who, for some reason, have lost their ability to move effectively. As health-care professionals working to improve patients' mobility, we have a tremendous opportunity to affect people's quality of life every day.

In some cases, you will be helping patients regain old skills, and in other cases, you will be teaching them new ways to get around. No matter what you are teaching them, there are certain principles and practices that will increase your effectiveness. What follows in this book is a working knowledge of these principles and practices. Applying them will serve you in common “textbook” conditions as well as in the unique and unexpected situations that make up clinical reality.

Although you will be learning some of these techniques and approaches for the first time, you may already employ many of them at an intuitive or unconscious level. Becoming more aware of them will allow you to use them with increasing levels of success and will contribute to more advanced clinical judgment. Because each person you work with is unique, every patient interaction will require that you make clinical decisions regarding the patient's mobility needs.

Understanding the contexts in which your patient interactions occur, decision-making abilities you must develop to be proficient in mobility tasks, and the various movement techniques utilized as your patients progress in mobility skills will allow you to customize your mobility approaches to the needs of each patient. These keys will also expand the usefulness of your skills to a wide range of situations so that you can navigate confidently in complex and challenging clinical situations (see Part 1, Fig. 1).

Increasing mobility has the potential to contribute significantly to an individual's overall quality of life.

Figure 1

The interactions of context, decision-making, and behaviors and techniques that help frame the ability to individualize each patient.

Just as there is a progression in the development of clinical skills, there is a natural progression in movement and rehabilitation. Because this progression is inherent in the facilitation of mobility, it is also interwoven throughout this book. Rather than repeat the explanation of each continuum in every section of the book, however, we describe them individually here and present a representative icon or catchword for each to help you bear it in mind while developing your skills. These “shortcuts” are not standard symbols or abbreviations but teaching and learning tools. After you have considered a principle and applied it in a few patient-care situations, you will be able to tap into that understanding in later, more complex decision-making situations by recalling the shortcut.

Contexts

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