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At the completion of this chapter, the reader will be able to:

  1. List the factors that, when dysfunctional, can have a negative impact on a movement

  2. Describe the various methods by which physical therapy can have a positive impact on movement dysfunction

  3. List three stages of learning according to Fitts and Posner

  4. Describe the differences between an open skill and a closed skill

  5. Describe the differences among the various types of practices

  6. Describe the types of feedback that can be provided by a patient and the advantages and disadvantages of each

  7. Discuss the importance of measuring functional outcomes

  8. Apply the various principles behind the provided patient example in a variety of situations


As with the previous chapter, the intent of this chapter is to demonstrate how comprehensive the knowledge base needs to be for a practicing clinician. To provide a comprehensive description of the tools at the disposal of a physical therapist requires the inclusion of many terms that may be unfamiliar to the student at this point such as “muscle energy,” and “proprioceptive neuromuscular facilitation.” However, the student will be introduced to these terms and will eventually learn about them in greater detail and be able to use them further down the line.

The correction of movement dysfunction requires a detailed analysis of the various components of a movement. As described in Chapter 4, the production of movement is a complex process involving a number of interrelated systems and normal development of those systems. Each of these systems controls a number of critical components that work together to allow normal movement to occur. As described in Chapter 6, these critical components are subject to breakdown, resulting in movement dysfunction. These components include, but are not limited to:

  • Pain

  • Structural malalignment

  • Cardiovascular fitness (anaerobic and aerobic—see Chapter 4)

  • Muscle performance (strength, endurance, and power)

  • Mobility (normal range of motion, flexibility, and accessory joint motion—see Chapter 11)

  • Neuromuscular control (stabilization, proprioception, balance, and coordination)

All of the listed components can be viewed as integrated entities, with each having the potential to have a negative impact on movement if dysfunctional. The focus of physical therapy is to determine the sum effect of the breakdown of these components on an individual’s function. Movement without purpose and control is both inefficient and ineffective. Skilled performance requires cooperation among strength, endurance, speed, and accuracy. In addition, skilled performance is dependent on practice or experience.


A physical therapist can be viewed as an expert in both the detection and correction of abnormal movement.

A trained physical therapist can observe a patient and determine a working hypothesis for a reason behind every abnormal movement observed. Once the diagnosis is correct, the intervention consists of methods to rehabilitate and retrain the dysfunctional structures.


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