Health care is a complex issue. It involves the patient’s needs and expectations as well as the practitioner’s. Complicating it further, now in the U.S. we have to negotiate the requirements and restrictions of Medicare and private health insurance plans, too. At MNF, we try to satisfy all parties while keeping the needs of the patient firmly in the center of the equation.
Each session is structured to optimize the outcome for the patient. An efficient plan of care is based on an in-depth initial evaluation. All aspects of the patient’s health are reviewed to help identify the mechanism of pain or dysfunction. The patient states the goals he or she wishes to achieve in physical therapy. The plan of care is outlined to reach those goals. The therapist and the patient are in constant conversation to adjust the plan of care as needed, according to the patient's response to the sessions and variables in the patient's life. For an optimal treatment outcome, the patient needs to be an active participant and to give constant input.
The therapist provides the patient with education regarding the mechanism of pain or dysfunction as well as the choice of techniques and exercises. It is extremely important that the patient understands the treatment plan. A full understanding allows for optimal patient follow-up through the home exercise program and self-care recommendations given by the therapist. It also allows the patient to take charge of his/her treatment. Empowerment is a key factor in recovery.
In functional re-education, it's important to explain how the exercises the therapist recommends relate to the patient's daily activities. Exercising for the sake of it has its rewards, but physical therapy aims at also improving the quality of life at a specific functional level. For example, core stability needs to translate into being able to reach up (as in reaching for a high shelf or serving the ball in tennis) without excessively arching and straining the back. The exercises/movements need to make sense on a functional level. This also becomes a good stimulus for the patient to perform the suggested home exercise program.
My current clinical reasoning is mostly based on the recommendations of the International Association for the Study of Pain as well as those of the Neuro-Orthopaedic Institute of Australia.
MNF PHYSICAL THERAPY
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