scholarly journals The Human Movement System: Our Professional Identity

2014 ◽  
Vol 94 (7) ◽  
pp. 1034-1042 ◽  
Author(s):  
Shirley A. Sahrmann

The 2013 House of Delegates of the American Physical Therapy Association adopted a vision statement that addresses the role of physical therapy in transforming society through optimizing movement. The accompanying guidelines address the movement system as key to achieving this vision. The profession has incorporated movement in position statements and documents since the early 1980s, but movement as a physiological system has not been addressed. Clearly, those health care professions identified with a system of the body are more easily recognized for their expertise and role in preventing, diagnosing, and treating dysfunctions of the system than health professions identified with intervention but not a system. This perspective article provides a brief history of how leaders in the profession have advocated for clear identification of a body of knowledge. The reasons are discussed for why movement can be considered a physiological system, as are the advantages of promoting the system rather than just movement. In many ways, a focus on movement is more restrictive than incorporating the concept of the movement system. Promotion of the movement system also provides a logical context for the diagnoses made by physical therapists. In addition, there is growing evidence, particularly in relation to musculoskeletal conditions, that the focus is enlarging from pathoanatomy to pathokinesiology, further emphasizing the timeliness of promoting the role of movement as a system. Discussion also addresses musculoskeletal conditions as lifestyle issues in the same way that general health has been demonstrated to be clearly related to lifestyle. The suggestion is made that the profession should be addressing kinesiopathologic conditions and not just pathokinesiologic conditions, as would be in keeping with the physical therapist's role in prevention and as a life-span practitioner.

2006 ◽  
Vol 86 (12) ◽  
pp. 1619-1629 ◽  
Author(s):  
Diane U Jette ◽  
Kerry Ardleigh ◽  
Kellie Chandler ◽  
Lesley McShea

Abstract Background and PurposeOpponents of direct access to physical therapy argue that physical therapists may overlook serious medical conditions. More information is needed to determine the ability of physical therapists to practice safely in direct-access environments. The purpose of this study was to describe the ability of physical therapists to make decisions about the management of patients in a direct-access environment. Subjects. Of a random sample of 1,000 members of the Private Practice Section of the American Physical Therapy Association, 394 participated. Methods. A survey included 12 hypothetical case scenarios. For each case, participants determined whether they would provide intervention without referral, provide intervention and refer, or refer before intervention. The percentage of correct decisions for each group of scenarios was calculated for each participant, and participants were classified as having made correct decisions for 100% of cases or less for each group. Three sets of logistic regressions were completed to determine the characteristics of the participants in relation to the decision category. Results. The average percentages of correct decisions were 87%, 88%, and 79% for musculoskeletal, noncritical medical, and critical medical conditions, respectively. Of all participants, approximately 50% made correct decisions for all cases within each group. The odds of making 100% correct decisions if a physical therapist had an orthopedic specialization were 2.23 (95% confidence interval=1.35–3.71) for musculoskeletal conditions and 1.89 (95% confidence interval=1.14–3.15) for critical medical conditions. Discussion and Conclusion. Physical therapists with an orthopedic specialization were almost twice as likely to make correct decisions for critical medical and musculoskeletal conditions.


2002 ◽  
Vol 82 (7) ◽  
pp. 692-706 ◽  
Author(s):  
Laura Lee Swisher

Abstract Background and Purpose. Purtilo, Guccione, and others have noted that increased clinical autonomy for physical therapists presents more complex ethical dilemmas. The body of literature examining physical therapy ethics, however, is relatively small and has not been analyzed. The primary purposes of this research were: (1) to use multiple perspectives to describe and analyze literature examining ethics in physical therapy from 1970 to 2000, (2) to develop a model to describe the evolution of knowledge of ethics in physical therapy during this period, and (3) to compare the proposed model with the evolutionary models proposed by Purtilo in physical therapy and by Pellegrino in bioethics. Sample. The sample consisted of peer-reviewed journal articles cited in the MEDLINE or Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases between 1970 and 2000 or referenced in Ethics in Physical Therapy. Methods. A two-phase mixed quantitative and qualitative method was used to analyze publications. In the quantitative phase, the author sorted publications into a priori categories, including approach to ethics, author, decade, country of publication, role of the physical therapist, and component of morality. During the qualitative phase of the research, the author analyzed and sorted the publications to identify common themes, patterns, similarities, and evolutionary trends. These findings were compared with the evolutionary models of Pellegrino and Purtilo. Results. The 90 publications meeting inclusion criteria were predominantly philosophical, using the “principles” perspective; focused on the patient/client management role of the physical therapist; and addressed the moral judgment component of moral behavior. As predicted by Purtilo's model, the focus of identity evolved from self-identity to patient-focused identity, with increasing representation of societal identity. Recurrent themes included the need to further identify and clarify physical therapists' ethical dilemmas, the interrelationship between clinical and ethical decision making, and the changing relationship with patients. Discussion and Conclusion. Although knowledge of ethics grew steadily between 1970 and 2000, this retrospective analysis identified gaps in our current knowledge. Further research is needed to address the unique ethical problems commonly encountered in all 5 roles of the physical therapist; patient perspectives on ethical issues in physical therapy; variety in ethical approaches; factors affecting moral judgment, sensitivity, motivation, and courage; and cultural dimensions of ethical practice in physical therapy.


GYMNASIUM ◽  
2017 ◽  
Vol XVII (1) ◽  
Author(s):  
Alina Mihaela Cristuță

Posture expresses the way in which the body receives external stimuli and gets ready to react, constantly adapting to the demands, according to the difficulty and to the individual's motor skills. The aim of this study is to educate the correct body posture through specific physical therapy means. The hypotheses presume that: by performing a specific assessment, one can spot the bad postures that are frequently adopted by school children; through specific intervention programs, one can educate, correct, and form a correct posture reflex. The objectives were to: assess the school children in order to spot physical deficiencies; to educate a correct posture and to form a correct posture reflex. The research methods were established according to the objectives. In the end, it can be concluded that this research  regarding the education of posture in school children has contributed to the prevention of instalment of physical deficiencies and to their correction, and the intervention measures were effective in educating the correct body posture.


2008 ◽  
Vol 13 (3) ◽  
pp. 236-242 ◽  
Author(s):  
Heather Adams ◽  
Pascal Thibault ◽  
Nicole Davidson ◽  
Maureen Simmonds ◽  
Ana Velly ◽  
...  

OBJECTIVES: The primary objective of the present study was to examine the role of sex as a moderator of the relation between depression and activity-related pain.METHODS: The study sample consisted of 83 participants (42 women, 41 men) with musculoskeletal conditions. Participants were asked to lift a series of 18 canisters that varied in weight (2.9 kg, 3.4 kg and 3.9 kg) and distance from the body. Participants were asked to rate their pain while they lifted each canister and estimate the weight of the canisters.RESULTS: Consistent with previous research, the relations among depression, pain intensity and disability were stronger for women than for men. ANOVA revealed that depression was associated with more intense activity-related pain in women only. For both women and men, the intensity of pain increased with each trial, although the weight of the objects lifted remained constant. Neither sex nor depression had an effect on participants’ weight estimates.CONCLUSIONS: The present discussion addresses the mechanisms through which depression may differentially affect pain in women and men. It also addresses the potential clinical implications of pain-augmenting effects of depression in women.


2021 ◽  
Vol 3 (1) ◽  
pp. 43-47
Author(s):  
Zahoor Ahmad ◽  
Zohra Shah

Introduction: Physical therapists works in a number of environments including hospitals, private practitioners, outpatient clinics, health care agencies, colleges, sports and recreation centres, workplaces and nursing homes. In Pakistan, the referral of patients to the physical therapy is mainly by physicians or doctors. It is it is important for the doctors to have awareness about the role of physical therapists. Material & Methods: This was a cross sectional survey conducted from Jan 2020 to August 2020. The research was based on a self-structured questionnaire which was provided to medical doctors at a hospital in Swabi, Khyber Pakhtunkhwa. The total number of participants in this survey was 145 doctors. The sampling techniques used for this survey was convenient sampling. Inclusion criteria of the study was medical doctors holding MBBS or equivalent degree. Data collected was analysed through SPSS version 22. Results: Out of 145 participants, 112 (77.2%) were males and 33 (22.8%) were females. Questionnaire was filled by 11.7% orthopaedic specialists, 11.0% neurologists, 13.1% paediatricians, 20.7% gynaecologists and 43.4% by doctor of other specialties. From the total participants, only 98 (67.4%) were aware about the eligibility criteria of entering in the field of physiotherapy, 77.9 % were aware about the specialization in physiotherapy and 90.3% were aware about the treatment of physiotherapy. Those who agreed that physiotherapy helps in reducing pain were 132 with percentage 91.0%.120(82.8%) doctors agreed that physical therapy is crucial in community-based recovery. According to 125 doctors, early intervention through physical therapy leads to an effective rehabilitation. A total of 61(42.1%) doctors agreed that physiotherapy was an excellent field. Conclusion: It was found out that nearly 60% of the medical doctors in District Swabi were familiar with physiotherapy care and with the field of physiotherapy. A big number of these doctors (80 percent of doctors) were aware that physiotherapy helps in reducing pain, provide appropriate care and plays an important role in the community.


BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e032329 ◽  
Author(s):  
Joshua Zadro ◽  
Mary O’Keeffe ◽  
Christopher Maher

ObjectivesPhysicians often refer patients with musculoskeletal conditions to physical therapy. However, it is unclear to what extent physical therapists’ treatment choices align with the evidence. The aim of this systematic review was to determine what percentage of physical therapy treatment choices for musculoskeletal conditions agree with management recommendations in evidence-based guidelines and systematic reviews.DesignSystematic review.SettingWe performed searches in Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, Allied and Complementary Medicine, Scopus and Web of Science combining terms synonymous with ‘practice patterns’ and ‘physical therapy’ from the earliest record to April 2018.ParticipantsStudies that quantified physical therapy treatment choices for musculoskeletal conditions through surveys of physical therapists, audits of clinical notes and other methods (eg, audits of billing codes, clinical observation) were eligible for inclusion.Primary and secondary outcomesUsing medians and IQRs, we summarised the percentage of physical therapists who chose treatments that were recommended, not recommended and had no recommendation, and summarised the percentage of physical therapy treatments provided for various musculoskeletal conditions within the categories of recommended, not recommended and no recommendation. Results were stratified by condition and how treatment choices were assessed (surveys of physical therapists vs audits of clinical notes).ResultsWe included 94 studies. For musculoskeletal conditions, the median percentage of physical therapists who chose recommended treatments was 54% (n=23 studies; surveys completed by physical therapists) and the median percentage of patients that received recommended physical therapy-delivered treatments was 63% (n=8 studies; audits of clinical notes). For treatments not recommended, these percentages were 43% (n=37; surveys) and 27% (n=20; audits). For treatments with no recommendation, these percentages were 81% (n=37; surveys) and 45% (n=31; audits).ConclusionsMany physical therapists seem not to follow evidence-based guidelines when managing musculoskeletal conditions. There is considerable scope to increase use of recommended treatments and reduce use of treatments that are not recommended.PROSPERO registration numberCRD42018094979.


Author(s):  
Sagrario Pérez-de la Cruz ◽  
Ivonne Ramírez

The purpose of this study was to explore how parents of children with neuromotor disorders in the department of Chuquisaca (Bolivia) perceive attendance to a physical therapy stimulation program and the expectations they place on the therapy and professional care provided to their children. Semi-structured interviews were conducted with the parents, related to their role in supporting the recommended exercise program for the child, generating topics such as benefits of the therapy for the child, impact on the family, and role of the project in terms of therapy and the physical therapists providing treatment, including both positive and negative aspects of the overall process. This study revealed the importance of understanding the feelings of families receiving intervention under a pioneering program in Bolivia for the detection and treatment of children with neuromotor disorders. Being able to access these types of services provides them with extensive personal, social, and economic support. Knowing their concerns, desires, and demands will allow us to continue to improve and offer the best care for children and families. The professionals involved should also be encouraged to develop effective teaching techniques to promote the inclusion of parents in the stimulation program.


2017 ◽  
Vol 27 (1) ◽  
pp. 69-79 ◽  
Author(s):  
Mary E. Wims ◽  
Shayla M. McIntyre ◽  
Ann York ◽  
Laura G. Covill

Abstract How physical therapists (PTs) in the United States currently use yoga in their clinical practices is unknown. The purpose of this study was to determine how PTs in the United States view yoga as a physical therapy (PT) tool and how PTs use yoga therapeutically. The authors conducted a 24-item survey via electronic communications of the Geriatric, Orthopedic, Pediatric, and Women's Health Sections of the American Physical Therapy Association. Participants (n = 333) from 47 states and the District of Columbia replied. Reported use of therapeutic yoga among participants was high (70.6%). Of those participants, nearly a third use asana and pranayama only. Most participants using therapeutic yoga also include additional mindfulness-related elements such as sensory awareness, concentration/focus, and/or meditation. Most participants learned about yoga through personal experiences, with many participants citing lack of familiarity in using yoga in PT practice. Safety is the primary concern of participants when recommending yoga to patients as an independent health and wellness activity. Interdisciplinary communication between PTs, yoga therapists, and yoga teachers is warranted to address the post-discharge needs of clients. Healthcare changes have required PTs to adapt to a biopsychosocial-spiritual model (BPSS) for improved patient outcomes. Therapeutic yoga may provide an opportunity for PTs to expand their role in health and wellness and chronic disease management. There is opportunity for continuing education in therapeutic yoga for PTs.


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