Preface

We are excited to share this third edition of Improving Functional Outcomes in Physical Rehabilitation with you. Major updates to the textbook and multimedia resources provide the reader with an engaging environment to improve clinical decision-making and clinical skill application. These resources are designed to present an integrated model of therapeutic intervention applicable to a wide spectrum of adult patients engaged in physical rehabilitation. Part I, Promoting Function, addresses the foundations of clinical decision-making and provides a conceptual framework for improving functional outcomes. The organization of content provides the student with 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 through 14 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 17 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 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. New to this edition are case studies related to multiple sclerosis and following a patient with a heart transplant through the continuum of care. 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 videos capture 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 uses several pedagogical applications. Important information is emphasized using boxes and tables for easy reference. Key terms are defined and appear in boldface italic blue ink. 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 designed to enhance learning through active engagement. These activities provide an opportunity to share knowledge and skills with student peers and to confirm or clarify 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 critical thinking skills. Answers to the guiding questions for selected cases are available to the reader online at www.fadavis.com. Answers to the guiding questions for the remaining cases have been reserved for instructors only online at www.fadavis.com. The instructor-reserved answers will provide faculty greater options for incorporating case materials into course assignments, laboratory activities, and group discussions. Student feedback to the guiding questions for these cases can be obtained from the course instructor(s).

New to this edition are instructor guides for both physical therapy and physical therapy assistant educators that are available online at www.fadavis.com. Included in these guides are chapter summaries, learning outcomes, Guide to Key Interventions, and curricular integration suggestions for the student practice activities and multimedia case studies. The guides also expand on the case studies with the addition of scenarios and guiding questions related to interprofessional healthcare collaboration.

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 the text enhances understanding of strategies to improve functional outcomes that lead to independence and ultimately an improved quality of life for our patients.