At the completion of this chapter, the reader will be able to:
Describe the various models of disablement and their similarities and differences
List the components of the examination process
Conduct a thorough history
Understand the importance of the systems review (review of systems)
Describe the various components of the tests and measures portion of the examination
Discuss the importance of the physical therapy evaluation
Describe the purposes of documentation and the different types of documentation
Have an understanding of the common medical abbreviations used in healthcare
Describe the difference between short-term and long-term goals
Describe the components and importance of patient/family/client-related instruction
Discuss various strategies to improve patient adherence and compliance
Understand the importance of the physical therapist’s role in the promotion of health, wellness, and physical fitness
A profession’s scope of practice is directly dependent on the education and skill of the provider, the established history of the practice scope within the profession, supporting evidence, and the regulatory environment.1 For the physical therapist, the profession has outlined the following six steps involved in the management of a typical patient/client2: (1) examination of the patient; (2) evaluation of the data and identification of problems; (3) determination of the diagnosis; (4) determination of the prognosis and plan of care (POC); (5) implementation of the POC (intervention); and (6) reexamination of the patient and evaluation of treatment outcomes (Figure 5-1). Through the accomplishment of this process, the physical therapist determines whether physical therapy services are needed and develops the POC in collaboration with the patient/client/caregiver.
Elements of patient management leading to optimal outcomes.
A disablement model is designed to detail the functional consequences and relationships of disease, impairment, and functional limitations. The Guide to Physical Therapist Practice, 3.0 (The Guide), promotes the practice of physical therapy based on a disablement model based on a number of theoretical frameworks that have been proposed to describe the path from disease to disability including Nagi’s (Table 5-1).3-9 Nagi’s model depicted the relationship between the following series of linked events6,10: pathology/pathophysiology (the presence of disease), which may lead to impairments (anatomic and structural abnormalities), which may in turn lead to functional limitations (restrictions on basic physical and mental actions), which may then lead to disability (difficulty doing activities of daily life) (Table 5-2). In addition, the model focused on persons with health, prevention, and wellness needs.
TABLE 5-1Disablement Model Comparisons |Favorite Table|Download (.pdf) TABLE 5-1 Disablement Model Comparisons
|NAGI Scheme ||WHO (ICFDH)-I ||WHO (ICFDH)-II (2001) |
Interruption or interference with normal processes and efforts of an organism to regain normal state