General assessment of gross coordinated movement (e.g., balance, gait, locomotion, transfers, transitions) and motor function (motor control, motor learning)

tries to avoid mistakes but errors are common

most patients are discharged before reaching this stage of learning.

a process characterized by the interpretation of collected data.

involves repetitive, uninterrupted movements that have no distinct beginning and ending.

the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.

a prediction of a patient’s optimal level of function expected as the result of a plan for treatment during an episode of care and the anticipated length of time needed to reach specified functional outcomes

the patient needs to think about each component or the sequencing of the skilled movement

refers to the impact and functional consequence of acute or chronic conditions

ACTIVE or PASSIVE

lifting and lowering a weight or performing a self-stretching maneuver

Therapeutic exercise are individualized to each patient’s unique needs.

makes infrequent errors and concentrates on fine-tuning

requires infrequent feedback from the therapist and begins to make corrections even before errors occur

What to do

Executing tasks in the current environment

ICIDH model

need constant feedback

to move or be moved in order to allow range of motion (ROM) for functional activities (functional ROM)

composed of a series of discrete movements that are combined in a particular sequence.

Bowel or bladder function, burning with urination, sexual function, unusual menstrual cycles, pregnancy

Physical therapists use this systematic process to identify an appropriate diagnostic category amenable to physical therapy intervention.

Kicking a ball

History of surgery or use of adaptive equipment

The capacity of muscle to produce tension and do physical work.

The ability of the neuromuscular system through synergistic muscle actions to hold a proximal or distal body to control a stable base during superimposed movement

Problems with the anatomical features of the body.

Examination

NCMRR model

Refinement

History of CNS or peripheral nerve symptoms, muscular cramping, spasms, atrophy, weakness

Skin temperature, color, texture, integrity, scar formation, wound or incision healing

easily adapts to variations in task demands and environmental conditions

Wheelchair transfers

does not have to pay attention to the movements in the task, thus making it possible to do other tasks simultaneously

needs a CLOSED environment

To make effective decisions, merging clarification and understanding with critical and creative thinking is unnecessary

Nagi model

The ability to move freely, without restriction; used interchangeably with mobility

must learn the goal or purpose and the requirements of the exercise or functional task.

Used interchangeably with static or dynamic balance

Prevention: Activities such as health promotion designed to prevent disease in an at-risk population.

The ability to perform moderate-intensity, repetitive, total body movements (walking, jogging, cycling, swimming, etc.) over an extended period of time.

Locking a wheelchair

type of intervention that physical therapists use with every individual they see.

One of the many areas of clinical decision-making in which a therapist is involved is the (3) of therapeutic exercise interventions based on the unique needs of each patient or client.

Difficulties an individual may have in executing actions, tasks, and activities.

Results of recent bloodwork or treatment, bleeding or lymphedema

the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of an individual patient.

focuses on producing the most consistent and efficient movements

History of skin cancer, dermatological conditions (eczema, psoriasis, etc.), lumps or growths

also involves combining knowledge of evidence from well-designed research studies with the expertise of the clinician and the values, goals, and circumstances of the patient.

Walking

Little to no instruction unless the patient encounters a recurrence of symptoms

Isolating and contracting a specific muscle group

Executing tasks in a standard environment

ability to align body segments against gravity to maintain or move the body (COM) w/in the available BOS without falling

Doing a push up

Includes both referring to another provider and receiving referrals from another provider

Grasping an object

History of thyroid or other hormonal conditions, medications

Delegation of some portion of treatment while remaining responsible for the care provided.

Problems associated with the physiology of the body systems (including psychological functions).

Providing or seeking professional expertise/judgement

Movements are automatic

problem-solving to self-correct errors

This process involves analysis and integration of information to establish the diagnosis, prognosis, and plan of care using a series of sound clinical decisions.

Prevention: Early diagnosis and reduction of the severity or duration of existing disease and sequelae.

means by which a therapist helps a patient learn how to reduce his or her impairments and how to participate fully in the plan of care to achieve goals.

refers to a dynamic, complex process of reasoning and analytical (critical) thinking that involves making judgments and determinations in the context of patient care.

FOCUSED

Problems an individual may experience with involvement in life situations

ABILITY OF MUSCLES to anticipate or respond to proprioceptive and kinesthetic information and, subsequently, to work in correct sequence to create coordinated movement.

an integral component of the prognosis, is established in coordination with the patient and, if indicated, others involved in the care of the patient.

Sharing responsibilities

Heartburn, reflux, diarrhea, constipation, vomiting, severe abdominal pain, swallowing problems

are required of the physical therapist throughout the entire episode of patient management.

Therapeutic exercise requires passive participation by the patient/client.

Open environment w less Feedback

The entire background of an individual's life and living situation

is more than a consequence of a medical condition; rather, it is part of the human condition that is experienced by everyone either temporarily or permanently.

ICF framework

explores slight variations and modifications under different environmental conditions (intertrial variability)

learn how to do the motor task safely and correctly.

The correct timing and sequencing of muscle firing combined with the appropriate intensity leading to the effective initiation, guiding, and grading of movement

Heart rate and rhythm, respiratory rate, blood pressure, and edema

Symmetry, gross ROM and strength, height and weight

in equilibrium w/ gravity via sensory & motor systems

Cycling

is the systematic, planned performance of physical movements, postures, or activities

involves an action or movement with a recognizable beginning and end.

Shortness of breath, pressure or pain in the chest, pulsating pain, history of heart or lung disease

can be used in two ways—it refers to either a process or a category (label) within a classification system.

encompasses strength, power, and muscular endurance

essential and required element of patient management whose primary purpose is to guide the physical therapy prognosis, plan of care, and interventions

Ability to make needs known, consciousness, orientation (person, place, time), expected emotional/behavioral responses, learning preferences (e.g., learning barriers, educational needs)

Persistent fatigue, malaise, fever, chills, sweats, unexplained weight change, depression, mood swings, suicidal thoughts

Prevention: Use of rehabilitation to reduce the degree or limit the progression of existing disability and improve multiple aspects of function in persons with chronic, irreversible health conditions

ascending and descending stairs