RT Book, Section
A1 O'Sullivan, Susan B.
A2 O’Sullivan, Susan B.
A2 Schmitz, Thomas J.
SR Print(0)
ID 1186958153
T1 Framework for Clinical Decision-Making and Patient Management
T2 Improving Functional Outcomes in Physical Rehabilitation, 2e
YR 2016
FD 2016
PB McGraw-Hill Education
PP New York, NY
SN 9780803646124
LK fadavispt.mhmedical.com/content.aspx?aid=1186958153
RD 2023/11/29
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.