TY - CHAP M1 - Book, Section TI - Framework for Clinical Decision-Making and Patient Management A1 - O'Sullivan, Susan B. A2 - O’Sullivan, Susan B. A2 - Schmitz, Thomas J. Y1 - 2016 N1 - T2 - Improving Functional Outcomes in Physical Rehabilitation, 2e AB - Optimal functional recovery is the primary goal of all rehabilitation. Although people have traditionally been identified or categorized by their disease or medical condition (e.g., spinal cord injury [SCI]), the World Health Organization's International Classification of Functioning, Disability, and Health (ICF) model1 provides an important framework for examining and treating the patient by clearly defining health condition, impairment, activity limitation, and participation restriction. The American Physical Therapy Association in its Guide to Physical Therapist Practice, Version 3.0, has adopted this framework.2 Thus the patient with SCI presents with paralysis; sensory loss; autonomic dysfunction (impairments); loss of independent function in bed mobility, dressing, bathing, and locomotion (activity limitations); and an inability to work or go to school (participation restrictions). Physical therapist practice intervenes primarily at the level of impairments, activity limitations, and participation restrictions. Effective clinical decision-making is based on an understanding of the ICF model and related contextual factors (environmental and personal factors) to arrive at effective choices for intervention. In addition, clinicians must understand factors that improve quality of life, prevention, wellness, and fitness. An effective plan of care (POC) clarifies risk factors and seeks to fully involve the patient in determining meaningful functional goals. This text focuses on improving motor function (motor control and motor learning) and muscle performance (strength, power, and endurance) through activities and exercises that optimize functional outcomes. Definitions of terminology of functioning, disability, and health are presented in Box 1.1. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/18 UR - fadavispt.mhmedical.com/content.aspx?aid=1134943287 ER -