"Physical therapy is not a subspecialty of the medical profession and physical therapists are not medical doctors; we are a separate profession that provides a unique service that physicians are unable and untrained to provide."

Letter to the AMA from the APTA, Dec 2009

Wednesday, June 4, 2008

Physical Therapy and the International Classification of Functioning and Disability

The Orthopedic Section of the APTA (and others, I assume) is attempting to link 'academic physical therapy' - typically viewed as too esoteric - with clinical physical therapy with a new model of describing common conditions seen in physical therapy patients.

The Orthopedic Section has a position statement on the following topic...

Use of the International Classification of Functioning and Disability (ICF) to Develop Evidence-Based Practice Guidelines for Treatment of Common Musculoskeletal Conditions

Joseph Godges, DPT, MA, OCS
Coordinator, ICF-Based Clinical Practice Guidelines

James J. Irrgang, PT, PhD, ATC
Orthopaedic Section President

The details are preliminary but the final goal is to guide physical therapy decision-making.

For example, how should a student physical therapist classify a patient with a physician's diagnosis of 'frozen shoulder? The ICF Shoulder Guidelines can instruct the new graduate how to perform the evaluation and diagnosis.

The ICF Lower Back Pain Guidelines are complicated and focus heavily on classification.

Physical Therapy Diagnosis can do much the same for lower back and lower quarter dysfunction using the SIMPLE system (details at www.SimpleScore.com).

If classification can guide daily treatment decisions then I encourage the new graduate and the 'old school' physical therapist to learn the ICF model.

The SIMPLE (Summary of Impairments of the Lumbar Spine and Extremities) system provides much the same in a more intuitive manner.

Link your measured impairments with the patients' self-reported functional limitations in order to improve your decision making.

More people will get 'more better' if you make it easy for them.

Physical therapy should be simple.

Free Tutorial

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Tim Richardson, PT owns a private practice at Medical Arts Rehabilitation, Inc in Palmetto, Florida. The clinic website is at MedicalArtsRehab.com.

Bulletproof Expert Systems: Clinical Decision Support for Physical Therapists in the Outpatient Setting is a manager's workbook with stories, checklists, charts, graphs, tables, and templates describing how you can use paper-based or computerized tools to improve your clinic's Medicare compliance, process adherence and patient outcomes.

Tim has implemented a computerized Clinical Decision Support (CDS) system in his clinic since 2006 that serves as a Reminder, Alerting, Prompting and Predicting CDS using evidence-based tests and measures.

Tim can be reached at
TimRichPT@BulletproofPT.com .

"Make Decisions like Doctors"

Copyright 2007-2010 by Tim Richardson, PT.
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American Physical Therapy Association

American Physical Therapy Association
Consistent with the American Physical Therapy Association Vision Statement for Physical Therapy 2020, the American Physical Therapy Association supports exclusive physical therapist ownership and operation of physical therapy services.