what does a PT do?
- 1. diagnose/manage movement disorders and enhance physical/functional abilities
- 2. Restore, maintain, & promote not only optimal physical function but optimal wellness & fitness & optimal quality of life as it relates to movement & health
- 3.Prevent the onset, symptoms, & progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries
Patients are those who are recipients of a PT's direct intervention and care. Clients are those who benefit from a PT's advice, wisdom. (schools, businesses, etc.)
five phases of pt/client mgmt
evaluation > examination > diagnosis > prognosis > intervention > (outcomes)
Three main parts of the examination
History, systems review, tests and measures
What does the patient history entail?
Systematic gathering of data on the patient
What does the systems review entail?
identifies pt health status, problems that may require consultation
What is the most important aspect of the examination?
How do you use your resources during examination?
You use a team approach, utilizing EBP and an adaptable team approach of verbal/non-verbal communication
what is the evaluation?
It is a clinical assessment of the data and interpretation of tests and measures gathered during examination. Uses a problem list of functional limitations, disabilities, and impairments.
What is the definition of the PT diagnosis?
labels of movement dysfunction related to tissue pathology
What is the purpose of the diagnosis?
Find out what level of movement function the person is at and what their movement function goals are. To guide in intervention or referral
Why use classification schemes? Example?
used to generate preferred practice patterns. If a person has spina bifida, that comes with a host of movement disorders that require a specific practice pattern
What clues/tools do you have to develop the diagnosis?
your problem list, lists of medical diagnoses, diagnostic images
what if you can't identify a cluster of dysfunction?
Reexamine/reevaluate, treat the person by changes in symptoms
What is the prognosis?
predicted optimal level of function and the amount of time need to return to that function
Three aspects of a prognosis?
Goals, length of treatment, length of time until healing is complete
Short term goals of prognosis
measurable, specific, step by step process by which you will reach your long term goals. pt/family oriented. Measurable and specific. Linked to impairments, functional limitations, and disability. Must be time specific!
long term goals
same as short but sees through to the end of treatment/intervention
What is the intervention?
Purposeful and skilled interaction, involving effective communication, coordination, documentation, and instruction. must produce changes in patient condition.
components of intervention: Coordination, Communication, Documentation
coordination of care, D/C planning, referrals, documentation, record reviews
Components of the Intervention:Pt/Client-related Instruction
current condition, role of PT, future care, future transitions, maintenance/prevention
How do you execute Pt/Client-related Instruction?
- computer assisted instruction, demonstration, written, verbal, pictorial instruction, AV aids, review
- factors affecting how a patient can access these is educational level, needs, learning styles, barriers
- Therapeutic Exercise
- Functional training in self-care and home management
- Functional training in work and leisure integration
- Manual therapy techniques
- Prescription, application, and/or fabrication of assistive devices/equipment
- Airway Clearance techniques
- Integumentary repair and protection techniques
- Electrotherapeutic modalities
- Physical agents and mechanical modalities
Designing the Intervention
- Utilize PT practice patterns as a GUIDE
- Address each goal!
- Always a “work in progress”
- Incorporate the team & family
- Unique for each patient
- Is it working???
- Are we making progress toward the pt goals???
- Techniques including education
- Criteria for D/C & D/C plan
Planning for D/C
- Guided by achievement of goals & outcomes
- Patient and Family centered!!
- Add’l Criteria for D/C
- Pt wishes to d/c treatment
- Pt unable to progress
- Medical or psychosocial
- Pt unlikely to benefit from continued treatment