The latest version of APTA's Guide to Physical Therapist Practice, which has been available as a book and CD and is now an online. the American Physical Therapy Association (APTA) and with APTA's permission. .. A Guide to Physical Therapist Practice (“the Guide”) is a reference not only. PDF | On Jan 1, , James Gordon and others published Guide to Physical Therapist Practice.

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The American Physical Therapy Association (APTA) has released the Guide to Physical Therapist Practice The latest version provides. Physical Therapist. Practice. [Guide to Physical Theraist Practice pbysTher ; ] American Physical Therapy Association. Named Works: A Guide to Physical Therapist Practice (Book) Source .. PDF versions of some of the revised Guide pages are available at APTA's Web site.

In addition. This information is not a tool for self-diagnosis or a substitute for professional care.. Enthesopathy of knee. Page 7F: Viral encephalitis is listed under Infectious and parasitic diseases.

The initial foundation for the document was laid by the Board-appointed Task Force on Practice Parameters. In June Volume I: The deliberations of these task forces and the materials that they produced resulted in the Board's development of A Guide to Physical Therapist Practice. How and Why Was the Guide Developed? Volume II was to be "composed of descriptions of preferred physical therapist practice for patient groupings defined by common physical therapist management: APTA's Board of Directors embarked on a process to determine whether practice parameters could be delineated for the profession of physical therapy.

Criteria for selection of panel members included the following: The members of the Project Advisory Group were chosen on the basis of the following criteria: That September.

During the early s. The Board initiated development of a document that would describe physical therapist practice-content and processes--both for members of the physical therapy profession and for health care policy makers and third-party payers. Volume I was published in the August issue of Physical Therapy.

Each Project Advisory Group member was assigned as a liaison to one of the panels. In February This part of the Guide. Revisions were made to Part One to reflect Part Two. Between October and September In March The first edition of the Guide was published in the November issue of Physical Therapy. In December These revisions were published in Physical Therapy. In early Another task force was charged to retrieve and review the available literature on tests and measures of health status.

Also throughout and The Guide does not provide specific protocols for treatments. The Guide serves the following purposes: To describe the roles of physical therapists in primary.

Clinical guidelines usually are based on a comprehensive search and systematic evaluation of peer-reviewed literature. The Institute of Medicine has defined clinical guidelines as "systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances [emphasis added]. The two task forces met throughout and to search the peer-reviewed literature and develop a comprehensive list of tests and measures that are used in physical therapist practice.

To delineate the tests and measures and the interventions that are used in physical therapist practice. To describe physical therapist practice in general. To describe the settings in which physical therapists practice. To standardize terminology used in and related to physical therapist practice.

To delineate preferred practice patterns that will help physical therapists a improve quality of care. Field reviews were conducted. To complete their charge to catalog the armamentarium of tests and measures that are used in physical therapist practice. Guccione AA. Institute of Medicine. Elliott SD. The Guide is not intended to set forth the standard of care for which a physical therapist may be legally responsible in any specific case.

Future Development of the Guide The Guide to Physical Therapist Practice is an evolving document that will be systematically revised as the physical therapy profession's knowledge base. Phys Ther. Lohr K. Clinical Practice Guidelines: Directions for a New Program. Plays Ther. They are the boundaries within which the physical therapist may select and implement any of a number of clinical alternatives based on consideration of a wide variety of factors. National Academy Press.

The Guide is the structure on which scientific evidence will be fastened. The preferred practice patterns identify the breadth of physical therapist practice.

Guidelines for Clinical Practice: From Development to Use. The development of an instrument to measure satisfaction with physical therapy. He put forth a. All of the disablement models attempt to better delineate the interrelationships among disease. A number of disablement models have emerged during the past 3 decades. Three key concepts serve as the building blocks of the Guide and as the foundation of physical therapist practice: Patients are recipients of physical therapist examination.

The Disablement Model The concept of disablement refers to the "various impact s of chronic and acute conditions on the functioning of specific body systems. The Guide uses an expanded disablement model[3. Impairment was defined as abnormal changes at the molecular. WHO is revising its original formulation of the disablement model and in December released a pre-final version. Handicap indicated the social disadvantages related to impairment or disability that limit or prevent fulfillment of a normal role.

In Based on Nagi's model. International Classification of Functioning. The diagnosis of multiple sclerosis. Any single disorder may disrupt the anatomical structures and physiological processes of one or more systems.

Disease may be the result of infection. A diagnosis of multiple sclerosis by itself. Signs and symptoms also may exist as long-term adaptations to the original disorder or injury. Using the disablement model as a theoretical framework to describe physical therapist practice does not negate the importance of the traditional medical diagnosis eg. In fact.

Guidelines to Physical Therapist Practice APTA [1]

Figure 2 shows the scope of physical therapist practice both within the context of the Nagi model and within the continuum of health care services.

For example. When the underlying cause is not identified. They may be defined as alterations in anatomical. Contrast two cases involving a diagnosis of multiple sclerosis. The physical therapist's knowledge that different clusters of signs and symptoms are consistent with underlying conditions--such as angina. It therefore is important for the physical therapist to understand the many possible underlying causes for the pain.

If the clinical findings on examination suggest a pathological or pathophysiological condition that is inconsistent with the referring practitioner's diagnosis. Alterations of structure and function. Impairments occur at the tissue. A year-old woman who needs only a posterior splint to walk efficiently and who is able to carry out all activities of daffy living ADL and instrumental activities of daily living IADL with total independence has very different needs from a year-old woman who is postpartum and wheelchair dependent and who is unable to take care of her family as a result of severe generalized weakness.

Physical therapists most often quantify and qualify the signs and symptoms of impairment that are associated with movement. Impairments Impairments typically are the consequence of disease. The Guide's diagnostic classification scheme uses the definition "abnormality of structure or function" for its impairment classification.

The complexity of interconnections among the four components of the disablement model is indicative of the knowledge of pathology and pathophysiology that each physical therapist must bring to bear in addressing impairments. The examination. The origin of some impairments is often' unclear. If a person has limited range of motion at the shoulder but bathes independently by using a shower mitt and applies the available range of motion at other joints to best mechanical advantage.

Although physical therapists are chiefly concerned with physical function. Disability The Guide defines disability broadly as the inability or restricted ability to perform actions. For instance. The more complex tasks associated with independent community living eg. Functional limitations are measured by testing the performance of physical and mental behaviors at the level of the person and should not be confused with diseases.

Successful performance of complex physical functional activities.

In other words. Functional limitations include sensorimotor performance in the execution of particular actions. Poor posture. The concept of functional limitations is based on a consensus about what is "normal. Functional Limitations Functional limitations occur when impairments result in a restriction of the ability to perform a physical action. In the physical therapist's examination. Disability refers to patterns of behavior that have emerged over periods of time during which functional limitations are severe enough that they cannot be overcome to maintain "normal" role performance.

These sensorimotor functional abilities underlie the daily. The physical therapist would diagnose them as impairments that may be remedied by physical therapy intervention. Labeling a person as "disabled" requires a judgment. The task or the environment also may be modified so that the task can be performed within the restrictions that the patient's condition imposes.

These two approaches focus on "enablement" rather than remediation of "disablement. Interrelationships Among Disease. If they cannot be remedied.

Changing the expectations of a patient. Disability is characterized by discordance between actual performance in a particular role and the expectations of the community regarding what are "normal" behaviors in that role. Functional Limitations. The model suggests a bidirectional interaction among the components. Disability depends on both the capacities of the individual and the expectations that are imposed on the individual by those in the immediate social environment.

Disability was not included in the model because disability "is not inherent in the individual but. Health-related quality of life HRQL can be said to represent the total effect of individual and environmental factors on function and health status.

Efforts to decrease duration of illness. These factors may include individual and environmental factors that predispose or interact to create a person's disability. Physical disablement concepts for physical therapy research and practice. Prevention of disease in a susceptible or potentially susceptible population through specific measures such as general health promotion efforts.

Three major dimensions of HRQL have been described in the literature: Each of these factors may be modified by prevention and the promotion of health.

The Individual. Such factors include economic status. Efforts to decrease the degree of disability and promote rehabilitation and restoration of function in patients with chronic and irreversible diseases.

References [1] Jette AM. In the diagnostic process. Other "non-health" factors that typically are not included in definitions of functional limitation or disability contribute to an individual's sense of well being--and to both overall quality of life and health-related quality of life. The physical therapist may prevent impairments.

World Health Organization. Soc Sci Med. Some conceptual issues in disability and rehabilitation. Disability and Rehabilitation. Disability in America: Toward a National Agenda for Prevention. Jette A. The disablement process. Draft V: Report and Plan for Medical Rehabilitation Research.

Enabling America: Assessing the Role of Rehabilitation Science and Engineering. Tarlov A. Sussman M. National Institutes of Health. Disability and Health. International Classification of Impairments. Arthritis and the process of disablement. Pope AM. American Sociological Association. Disability following hip fracture.

Ohio State University Press. Disability concepts revisited: Physical therapy diagnosis and the relationship between impairments and function.

Pope A. Stroke disability. Sociology and Rehabilitation. Are measures of function and disability important in low back care? Relationship among balance impairments. Physical impairments and functional limitations: Finch E. Woodhouse LJ. Krebs DE. Using health-related quality of life measures in physical therapy outcomes research. Thomas SG. Beninato M. What Does the Guide Contain?

Part One. Part Three. Each practice pattern describes the following: The Guide does not contain specific treatment protocols. Part Two. The Guide has five major components: The patterns are grouped under four categories of conditions: These lists are intended as general information and are not to be used for coding purposes.

Citations in the peer-reviewed literature regarding the reliability and validity of specific tests are included. Appendixes 2 through 4 contain the APTA core documents on which physical therapist practice is based: Appendixes Appendix I contains the Guide glossary. Appendix 5 contains Guidelines for Physical Therapy Documentation.

For the most recent versions of these documents. Appendix 7. APTA documents are revised on a regular basis. Education and Qualifications Physical therapists are professionally educated at the0 college or university level and are required to be licensed in the state or states in which they practice.

Who Are Physical Therapists. CAPTE accreditation is limited to only those professional education programs that award the postbaccalaureate degree. As of January Graduates from to the present have successfully completed professional physical therapist education programs accredited by the Commission on Accreditation in Physical Therapy Education CAPTE.

Practice Settings Physical therapists practice in a broad range of inpatient. Graduates from to completed physical therapy curricula approved by appropriate accreditation bodies. Physical therapists: Physical therapists identify risk factors and behaviors that may impede optimal functioning. Physical therapists acknowledge the need to educate and inform other professionals. Clients also are businesses. Physical therapist assistants--under the direction and supervision of the physical therapist--are the only paraprofessionals who assist in the provision of physical therapy interventions.

APTA therefore recommends that federal and state government agencies and other third-party payers require physical therapy to be provided only by a physical therapist or under the direction and supervision of a physical therapist. Through timely and appropriate screening. Physical therapists are the only professionals who provide physical therapy.

Clients are individuals who engage the services of a physical therapist and who can benefit from the physical therapist's consultation. In the context of the model of disablement[] on which this Guide is based. The collaboration may be with physicians. Physical therapists provide prevention services that forestall or prevent functional decline and the need for more intense care. Physical therapists also are involved in promoting health.

Scope of Practice Physical therapy is defined as the care and services provided by or under the direction and supervision of a physical therapist. Patients and Clients Physical therapists are committed to providing necessary and high-quality services to both patients and clients.

Patients are individuals who are the recipients of physical therapy examination. Physical therapists provide consultative services to health facilities. For acute musculoskeletal and neuromuscular conditions. As clinicians. Roles in Primary Care Physical therapists have a major role to play in the provision of primary care. The primary care team may function more efficiently when it includes physical therapists.

They supervise the physical therapist assistant PTA when PTAs provide physical therapy interventions as selected by the physical therapist. Physical therapists also supervise any support personnel as they perform designated tasks related to the operation of the physical therapy service. Physical therapists also engage in research activities. Physical therapy intervention may result not only in more efficient and effective patient care but also in more appropriate utilization of other members of the primary care team.

For certain chronic conditions. With physical therapists functioning in a primary care role and delivering early intervention for work-related musculoskeletal injuries.

On a daily basis. Physical therapists oversee all aspects of the physical therapy service. They provide administrative services in many different types of practice. Through community-based agencies and school systems.

Physical therapists conduct screenings to determine the need for 1 primary. Roles in Prevention and in the Promotion of Health. Decreasing duration of illness.

There are three types of prevention in which physical therapists are involved: Preventing a target condition in a susceptible or potentially susceptible population through such specific measures as general health promotion efforts. Physical therapists are well prepared to coordinate care related to loss of physical function as a result of musculoskeletal. Examples of the prevention screening activities in which physical therapists engage include: These services focus both on the individual and on the environment to ensure comprehensive and appropriate intervention.

Tertiary care is provided by physical therapists in highly specialized. Roles in Secondary and Tertiary Care Physical therapists play major roles in secondary and tertiary care. Patients with musculoskeletal. Screening is based on a problem-focused. Physical therapists provide secondary care in a wide range of settings. Physical therapists also provide primary care in industrial or workplace settings. Limiting the degree of disability and promoting rehabilitation and restoration of function in patients with chronic and irreversible diseases.

The physical therapist especially notes how each of these last five components affects the ability to initiate. Data from the history Fig. Figure 2 lists the types of data that may be generated from the history. While taking the history. After organizing the available history information. The examination has three components: Epidemiologic research that is available about functional limitations of older women. The initial examination is a comprehensive screening and specific testing process leading to diagnostic classification or.

The systems review includes the following: The data that are obtained eg. Systems review. Tests and measures. The physical therapist may decide to use one. The physical therapist may decide that a full examination is. From the comprehensive identification and questioning processes of the history and systems review.

These tests and measures. As the examination progresses. These tests and measures are used to rule in or rule out causes of impairment and functional limitations. The examination therefore may be as brief or as lengthy as necessary. There are 24 tests and measures that are commonly performed by physical therapists. If the diagnostic process does not yield an identifiable cluster eg.

Factors that influence the complexity of the evaluation process include the clinical findings. Evaluation Physical therapists perform evaluations make clinical judgments based on the data gathered from the examination.

This process includes integrating and evaluating the data that are obtained during the examination history. Thus the diagnostic label indicates the primary dysfunctions toward which the physical therapist directs interventions.

Tests and measures vary in the precision of their measurements. They synthesize all of the findings from the history.

The evaluation reflects the chronicity or severity of the current problem. Although physicians typically use labels that identify disease. As in all other cases.

Physical therapists also consider the severity and complexity of the current impairments and the probability of prolonged impairment. Each pattern represents a diagnostic classification. The label used to categorize a condition should describe the problem in a way that directs the selection of interventions toward those interventions that are within the legal purview of the health care professional who is making the diagnosis.

In carrying out the diagnostic process.

Guide to Physical Therapist Practice. Second Edition. American Physical Therapy Association.

The prognosis is the determination of the predicted optimal level of improvement in function and the amount of time needed to reach that level.

It is. The pattern title therefore reflects the diagnosis--or impairment classification--made by the physical therapist. Classification schemes must be consistent with the boundaries placed on the profession by law which may regulate the application of certain types of diagnostic categories and by society which grants approval for managing specific types of problems and conditions. The physical therapist uses the classification scheme of the preferred practice patterns to complete a diagnostic process that begins with the collection of data examination.

If the diagnostic process reveals findings that are outside the scope of the physical therapist's knowledge. The preferred practice patterns in Part Two of the Guide describe the management of patients who are grouped by clusters of impairments that commonly occur together. The plan of care consists of statements that specify the anticipated goals and the expected outcomes. Prognosis Including the Plan of Care Once the diagnosis has been established.

Making a diagnosis requires the clinician to collect and sort data into categories according to a classification scheme relevant to the clinician who is making the diagnosis. These classification schemes should meet the following criteria: The tests and measures necessary for confirming the diagnosis must be within the legal purview of the health care professional.

The plan of care is the culmination of the examination. The plan of care includes the anticipated discharge plans. In designing the plan of care. Physical therapist interventions consist of the following components: The plan of care identifies anticipated goals and expected outcomes. The primary criterion for discharge is the achievement of the anticipated goals and expected outcomes. When physical therapy services are terminated prior to achievement of anticipated goals and expected outcomes.

In consultation with appropriate individuals. Universal screening for domestic violence is increasingly becoming a statutory requirement. If required. The anticipated goals and expected outcomes also address risk reduction. The anticipated goals and expected outcomes in the plan should be measurable and time limited.

Instruction may be related to the current condition. Factors that influence the complexity. Physical therapists are responsible for coordination. The process of informing. The physical therapist selects. Administrative and support processes may include addressing required functions. Procedural interventions. Communication is the exchange of information. Forming the core of most physical therapy plans of care are: Chapter 3 details the types of procedural interventions commonly selected by the physical therapist.

The physical therapist then considers whether these goals and outcomes are realistic in the context of the examination data and the evaluation. In establishing a diagnosis and a prognosis and selecting interventions. Outcomes Throughout the entire episode of care. Reexamination may be indicated more than once during a single episode of care. Reexamination Reexamination is the process of performing selected tests and measures after the initial examination to evaluate progress and to modify or redirect interventions.

Indications for reexamination include new clinical findings or failure to respond to physical therapy interventions. Beginning with the history. It also may be performed over the course of a disease. A single episode of care should not be confused with multiple episodes of care that may be required by certain individuals who are classified in particular patterns. No defined number or range of number of visits is established for this type of episode. An episode of physical therapy prevention is a series of occasional clinical.

An episode of physical therapy maintenance is a series of occasional clinical. Prevention services. Discharge occurs based on the physical therapist's analysis of the achievement of anticipated goals and expected outcomes. Criteria for Termination of Physical Therapy Services Two processes are used for terminating physical therapy services: If reclassification involves a condition. There may be facility-specific or payerspecific requirements for documentation regarding the conclusion of physical therapy services as the patient moves between sites or across settings during the episode of care.

A visit consists of all physical therapy services provided in a hour period. Discharge Discharge is the process of ending physical therapy services that have been provided during a single episode of care. A defined number or identified range of number of visits will be established for an episode of care.

Episode of Care. Discharge does not occur with a transfer. Other Professional Roles of the Physical Therapist Consultation Consultation is the rendering of professional or expert opinion or advice by a physical therapist. Such consultation usually does not involve actual intervention. Examples of consultation activities in which physical therapists may engage include: When termination of physical therapy service occurs prior to achievement of anticipated goals and expected outcomes.

The consulting physical therapist applies highly specialized knowledge and skills to identify problems. Patient-related consultation is a service provided by a physical therapist at the request of a patient. Client-related consultation is a service provided by a physical therapist at the request of an individual. Administration includes the management. Examples of administration activities in which physical therapists engage include: Examples of critical inquiry activities in which physical therapists may engage include: When the physical therapist of record directs physical therapist assistants to perform specific components of physical therapy interventions.

In any case. The director of a physical therapy service is a physical therapist who has demonstrated qualifications based on education and experience in the field of physical therapy and who has accepted the inherent responsibilities of the role.

Regularly scheduled performance appraisals should be conducted by the supervisor based on applicable standards of practice and performance criteria. The degree of direction and supervision necessary for ensuring high-quality physical therapy depends on many factors.

Regardless of the setting in which the services are given. The director of a physical therapy service must: Responsibilities should be commensurate with the qualifications--including experience.

A physical therapist determines the most appropriate utilization of the physical therapist assistant that will ensure the delivery of service that is safe.

Direction and Supervision of Personnel Direction and supervision are essential to the provision of high-quality physical therapy. An Interim Report. Geriatric Physical Therapy.

St Louis. Physical therapists use tests and measures to obtain measurements. Assessing the magnitude of a patient's report of pain. Depending on the data generated during the history and systems review.

The physical therapist collects data through many different methods. Physical therapists individualize the selection of tests and measures based on the history they take and systems review they perform. What Is Measurement? Obtaining measurements is an everyday part of physical therapist practice. Physical therapists may perform more than one test or obtain more than one measurement at a time.

Reliability and validity are properties of a measurement. Use of measurements without established reliability and validity may be appropriate. The data gathered through the use of tests and measures during initial examination provide information used for determining anticipated goals and expected outcomes. Because all measurements have some error. Whenever possible. Reliability of Measurements Assessing a measurement's reliability is an attempt to identify sources of error.

Reliable and valid measurements enable physical therapists to gauge the certainty of their examination data and the appropriate scope of inferences that may be drawn from those data. These data may indicate initial abilities in performing actions. Reliability and validity have not yet been reported for every measurement used by physical therapists.

Intrarater reliability indicates the degree to which measurements that are obtained by the same physical therapist at different times will be consistent.

Interrater reliability indicates the degree to which measurements obtained by multiple therapists will be consistent. Face validity exists when the measurement seems to reflect what is supposed to be measured-but it does not depend on evidence. There are two other forms of reliability: The comparative method of establishing concurrent validity is particularly relevant. Test-retest reliability is the consistency of repeated measurements that are separated in time when there is no change in what is being measured.

Content validity establishes the degree to which a measurement reflects the domain of interest. There are no direct tests of construct validity. Construct validity is a theoretical form of validity that is established on the basis of evidence that a measurement represents the underlying concept of what is to be measured.

Goniometric measurements. Theoretical evidence of construct validity is often provided by demonstrating convergence if tests or measures believed to represent the same construct are highly related. Guide Categories for Tests and Measures This chapter contains 24 categories of tests and measures Figure that the physical therapist may decide to use during an examination.

Tests and measures are listed in alphabetical order. Some measurements are only gross measurements. The sensitivity of a measurement indicates the proportion of individuals with a positive finding who already have or will have a particular characteristic or outcome.

Knowing the predictive validity of a measurement may facilitate the identification of achievable outcomes and increase the efficiency of discharge planning. Clinical Utility In addition to reliability and validity of the measurements obtained with a given test or measure. In Part Two. Physical therapists should consider the precision of the data yielded by a test or measure and whether it will meet the needs of the situation.

Predictive validity exists when "an inferred interpretation is justified by comparing a measurement with supporting evidence that is obtained at a later point in time" and "examines the justification of using a measurement to say something about future events or conditions. Predictive validity also may provide the physical therapist with several kinds of information about the value of selecting particular tests or measures for the examination.

The measurements used by the physical therapist should always be sensitive enough to detect the degree of change expected as a result of intervention. In contrast. Part Three of the Guide. Physical therapists may decide to use other tests and measures that are not described in the Guide. Tests and Measurements in Physical Therapy Practice. The physical therapist also should consider the time involved in administering a test or measure.

Selection of tests and measures depends on the findings of the history and systems review. A listing of tools used for collecting data is provided. A definition and purpose of the test and measure is provided. Examples of clinical indications that are identified during the history and systems review are provided to indicate the use of tests and measures. Cranial and Peripheral Nerve Integrity Environmental. The examination findings may indicate.

Examples of specific tests and measures are provided. Types of data that may be generated from the tests and measures are listed.

All tests and measures are appropriate in the presence of: Special requirements may prompt the physical therapist to perform tests and measures. In all cases. All tests and measures produce information used to identify the possible or actual causes of difficulties during performance of essential everyday activities. Echternach JL. What are the results and how will they help me in caring for my patients? The results of these tests and measures may indicate the need to use or recommend other tests and measures or the need to consult with.

References [1] American Physical Therapy Association. Responses that are monitored both at rest and during and after activity may indicate the degree of severity of the impairment. Clinical Indications. New York. American Physical Therapy Association. Sackett DL. The terms "physical therapy" and "physiotherapy.

APTA recommends that federal and state government agencies and other third-party payers require physical therapy to be provided only by a physical therapist or under the direction and supervision of a physical therapist.

Users' guides to the medical literature. Evidence-Based Medicine: Guyatt GH. Primer on Measurement: An Introductory Guide to Measurement Issues.

Physical therapist assistants--under the direction and supervision of the physical therapist-are the only paraprofessionals who assist in the provision of physical therapy interventions. How to use an article about a diagnostic test. All of these data are then synthesized during the evaluation process to establish the diagnosis. During activity. Other information that may be required for the examination includes findings of other professionals.

Richardson WS. Churchill Livingstone Inc. Straus SE. Clinical indications for these tests and measures may include: Parkinson disease. Clinical indications for the use of tests and measures are predicated on the history and systems review findings eg.

The physical therapist uses tests and measures to quantify these traits. Anthropometric Characteristics Anthropometric characteristics are those traits that describe body dimensions. Clinical Indications Clinical indications for tests and measures are predicated on the history and systems review findings egg.

Results of tests and measures of anthropometric characteristics are integrated with the history and systems review findings and the results of other tests and measures. Attention is the selective awareness of the environment or selective responsiveness to stimuli.

Additional information

Cognition is the act or process of knowing. Results of tests and measures of arousal. Clinical Indications Clinical indications for the use of tests and measures are predicated on the history and systems review findings eg. Down syndrome. The findings may. Results of tests and measures of assistive and adaptive devices are integrated with the history and systems review findings and the results of other tests and measures. Assistive devices include crutches. Adaptive devices include raised toilet seats.

ADL scales. IADL scales. Results of tests and measures of circulation arterial. Lymphatic Circulation is the movement of blood through organs and tissues to deliver oxygen and to remove carbon dioxide and the passive movement drainage of lymph through channels.

The physical therapist uses tests and measures to assess the cranial and peripheral nerves. Guillain-Barre syndrome. Results of tests and measures of cranial and peripheral nerve integrity are integrated with the history and systems review findings and the results of other tests and measures.

Peripheral nerve integrity is the intactness of the spinal nerves. Erb palsy. Meniere disease. The physical therapist uses the results of tests and measures to identify any of a variety of possible impediments. Results of tests and measures of environmental.

The physical therapist also uses the results to suggest modifications to the environment eg. The physical therapist may conduct tests and measures as part of work hardening or work conditioning programs and may use the results of tests and measures to develop such programs. Results of tests and measures of ergonomics and body mechanics are integrated with the history.

Professionalism in Physical Therapy: History, Practice, and Development

Tools Used for Gathering Data Tools for gathering data include: Ergonomics uses scientific and engineering principles to improve safety. These tests and measures may be conducted after a work injury or as a preventive step. Body mechanics are the interrelationships of the muscles and joints as they maintain or adjust posture in response to forces placed on or generated by the body.

Locomotion is the ability to move from one place to another. Balance is the ability to maintain the body in equilibrium with gravity both statically ie.

The physical therapist uses these tests and measures to assess disturbances in gait. Results of tests and measures of gait. Descriptions of: Results of tests and measures of integumentary integrity are integrated with the history and systems review findings and the results of other tests and measures.

The physical therapist uses these tests and measures to assess the effects of a wide variety of disorders that result in skin and subcutaneous changes. Results of tests and measures of joint integrity and mobility are integrated with the history and systems review findings and the results of other tests and measures.

The tests and measures of joint integrity assess the anatomic and biomechanical components of the joint. The physical therapist uses these tests and measures to assess whether there is excessive motion hypermobility or limited motion hypomobility of the joint. Joint mobility is the capacity of the joint to be moved passively. The tests and measures of joint mobility assess the performance of accessory joint movements. The physical therapist uses these tests and measures in the assessment of weakness.

Motor function is the ability to learn or demonstrate the skillful and efficient assumption.

Results of tests and measures of motor function motor control and motor learning are integrated with the history and systems review findings and the results of other tests and measures. Results of tests and measures of muscle performance including strength. The physical therapist uses these tests and measures to determine the ability to produce. Power is the work produced per unit of time or the product of strength and speed.

Endurance is the ability of muscle to sustain forces repeatedly or to generate forces over a period of time. Strength is the muscle force exerted by a muscle or a group of muscles to overcome a resistance under a specific set of circumstances.

Recruitment of motor units. The muscle force that can be measured depends on the interrelationships among such factors as the length of the muscle. Tests and Measures Tests and measures may include those that characterize or quantify: The physical therapist also uses tests and measures to assess mobility. The physical therapist uses tests and measures to characterize movement skills in infants. Results of tests and measures of neuromotor development and sensory integration are integrated with the history and systems review findings and the results of other tests and measures.

Sensory integration is the ability to integrate information that is derived from the environment and that relates to movement. Orthotic devices include braces. Supportive devices include compression garments. Geriatric physical therapists specialize in providing therapy for such conditions in older adults. Integumentary[ edit ] Integumentary physical therapy includes the treatment of conditions involving the skin and all its related organs.

Common conditions managed include wounds and burns. Physical therapists may utilize surgical instruments, wound irrigations, dressings and topical agents to remove the damaged or contaminated tissue and promote tissue healing. The work done by physical therapists in the integumentary specialty do work similar to what would be done by medical doctors or nurses in the emergency room or triage.

Neurological[ edit ] Neurological physical therapy is a field focused on working with individuals who have a neurological disorder or disease. These can include stroke , chronic back pain, Alzheimer's disease, Charcot-Marie-Tooth disease CMT , ALS , brain injury, cerebral palsy , multiple sclerosis , Parkinson's disease , facial palsy and spinal cord injury. Common impairments associated with neurologic conditions include impairments of vision, balance, ambulation, activities of daily living , movement, muscle strength and loss of functional independence.

Orthopedic[ edit ] Treatment by orthopedic physical therapists Orthopedic physical therapists diagnose, manage, and treat disorders and injuries of the musculoskeletal system including rehabilitation after orthopedic surgery.

This speciality of physical therapy is most often found in the out-patient clinical setting. Orthopedic therapists are trained in the treatment of post-operative orthopedic procedures, fractures, acute sports injuries, arthritis, sprains, strains, back and neck pain, spinal conditions, and amputations.

Pediatric[ edit ] Pediatric physical therapy assists in early detection of health problems and uses a variety of modalities to provide physical therapy for disorders in the pediatric population.

Sports[ edit ] Physical therapists are closely involved in the care and wellbeing of athletes including recreational, semi-professional paid and professional full-time employment participants.

This area of practice encompasses athletic injury management under 5 main categories: acute care — assessment and diagnosis of an initial injury; treatment — application of specialist advice and techniques to encourage healing; rehabilitation — progressive management for full return to sport ; prevention — identification and address of deficiencies known to directly result in, or act as precursors to injury, such as movement assessment education — sharing of specialist knowledge to individual athletes, teams or clubs to assist in prevention or management of injury Physical therapists who work for professional sport teams often have a specialized sports certification issued through their national registering organisation.

Most Physical therapists who practice in a sporting environment are also active in collaborative sports medicine programs too See also: athletic trainers.

Community Physiotherapy promotes concept of community responsibility of health and healthy living. Community physiotherapy is practiced by specially trained and specialized physiotherapists.

Women's health[ edit ] Women's health physical therapy mostly addresses women's issues related to the female reproductive system, child birth, and post-partum.These agents may include athermal. Such consultation usually does not involve actual treatment. This document has been in development for almost a decade. Phys Ther. Complications of soft tissue and circulatory disorders are decreased.

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