The new ICF Browser is an exciting tool. I'm not kidding.
The new International Classification of Functioning (ICF) Browser has the capability to specify exactly what physical therapists do and how we work on patients.
Example:
Today I evaluated a 50-year old female office worker before lunch. She had tried to lift a heavy piece of furniture five days ago and developed sudden-onset right lower back pain.
She presented today with a lateral shift in standing, positive right sciatic tension test, good (>35 degrees) hip external rotation, negative Gower's sign and a stiff back (P/A).
She was in no apparent distress (low fear-avoidance) and had no prior episodes of lateral shift.
Should I classify her in a manipulation or a stabilization group? Are the two groups mutually exclusive?
Anyway, I have started using the new ICF Browser to classify my patients according to my findings.
I have begun to avoid diagnostic labels altogether.
The physical therapy diagnostic process has more potential to inform physical therapist decision-making than does classification with diagnostic labels.
Here is my decision-making process and the ICF codes that go with my findings:
Activities - code | Body Functions - code | Body Structures - code |
Difficulty Lying - d4150 | Pain in leg - b28015 | Lumbar vertebral column - s76002 |
Difficulty rolling - d4201 | Stability of several joints - b7151 | |
Tone of trunk muscles- b7355 |
Note how the link between the measured activity limitation is the physical therapist's diagnosis. Treat the findings and don't worry about the label.
Re-measure the findings (activity limitations and impairments) to assess success.
Every physical therapist should be comfortable making a functional diagnosis.
Our patients deserve one.
Hey, Tim,
ReplyDeleteI stumbled upon your blog today and I am glad I did. I really enjoyed this idea on using the ICF model. I am curious about what you would put for diagnosis for a Medicare patient's paperwork if you are really going through with this process as you have indicated? Thanks and keep up the great work.
Steven,
ReplyDeleteThanks for asking...
Diagnosis descriptors are currently a hot topic in physical therapy with labels such as 'Loss of joint mobility associated with hypertrophic scar' which is then expected to improve decision making and direct treatment selection.
I find labels long and confusing - I rely of the ICF Activity and Participation domain to state the patient's complaint and list the impairments in keeping with Body Structure and Function limitations.
Interestingly, pain is listed as a Body Function limitation which I can then treat alongside ROM, strength and other impairment-level limitations.
For example, my physical therapy diagnosis might look like this...
"Patient has difficulty looking up, turning head, driving and sleeping due to...
- thoracic manipulation classification
- stiff cervical extension ROM
- stiff cervical rotation ROM -bilateral
- weak shoulder flexion - bilateral
- weak deep cervical flexor muscles.
BTW, I use classification predictor variables to show Medical Necessity and Skilled Physical Therapy for Medicare compliance.
Tim
This training allows the individual acting as a Physician Assistant to perform a wide assortment of important tasks as delegated by a Physician. university of toledo pa program
ReplyDeleteThe body of the personal statement is where you'll describe your qualifications and how certain traits or skills make you well-suited to a particular position or career field. useful site
ReplyDeleteThis site for those people who wanna do phd in history online yes online now you can get evrything online regarding phd.
ReplyDeleteMany candidates struggle with writing the statement part of their CV but it doesn't necessarily have to be a difficult as you may think. pharmacist letter of intent
ReplyDeleteIf you are looking for a job you should already be aware of the fact that a resume can be the most effective tool in landing the job of your dreams, or any job for that matter. Resumes can be hard to write for a variety of reasons.cv fonts
ReplyDeleteYou know, essay writing is not always addict-fan-harmonious. If you way essay writing push on going not far and wide away away away off from,personal statement for computer science click here
ReplyDeleteInvaluable recommendation on a way to write an honest personal statement for a prospective medical student's UCAS kind. The article covers stuff you got to mention, structure, language and do's & don'ts. crna personal statement
ReplyDeleteUnlearn the mistakes you down on the work and increase sales. Write persuasively. Connect. Update your genre and switch your correspondence into a reliable sales tool. whether or not it is a proposal, AN e-mail or a prospecting letter, gmat waiver letter
ReplyDeleteDrug and alcohol treatment centers square measure typically moon-faced with the business call of whether or not to waive copay and deductible obligations. for several patients in one in all the foremost vulnerable times of their lives.scholarship rejection letter writing
ReplyDeleteThanks for an interesting reading! Also, wanted to share some physical therapy personal statement examples that might be helpful for those who are applying. Best of luck with admissions! You will do great!
ReplyDeleteThis blog is provide so informative information. It’s important when you write ATS. It’s really so helpful. If you don’t belief me then you can visit this site for your confirmation. It’s help you too.
ReplyDeleteTo be a good physician you have to work hard in your medical college with the consulting of better books to prepare for the exams. You have to make writing a statement of purpose for grad school so that you can make or create the skills in this medical field with hard work or dedication.
ReplyDeleteI must say that you select the perfect occupation and I am sure you are experienced in this field and I want to say that keep your expectation high with aerospace engineering personal statement that one day you will become the top physical therapist of the country. Just keep doing hardworking.
ReplyDeleteThis time you give the information about the body fitness. Everybody should give some time to their body and it is very important to maintain the health physically with uc applications personal statement that is good. God give you the good talent and I must say that you utilize your skills in good ways.
ReplyDeleteAmazing post for the readers. Thanks for posting the article with lots of information to us. Visit Here
ReplyDeletePresently a day, instruction has changed its way in correlation of old era's method for training. New every now and again refreshed sites and sites help you to receive an alternate approach to learn in an unexpected way. Speech Therapy Doctors in Jaipur
ReplyDeleteThe swinging movement while draping upset on the Body Champ IT8070 inversion therapy makes development inside the liquid inside the vertebral plate. Since the liquid moves, poisons are being pushed out while attracting crisp liquids. hanging boots for back
ReplyDeleteThank you very much for keep this information. sex therapist brisbane
ReplyDeleteYour post is very helpful to get some effective tips to reduce weight properly. You have shared various nice photos of the same. I would like to thank you for sharing these tips. Surely I will try this at home. Keep updating more simple tips like this. Percussion Therapy
ReplyDeleteI would like to thank you for the efforts you have made in writing this article. I am hoping the same best work from you in the future as well.. Preferred Rehabilitation
ReplyDeleteExcellent article you have shared with us. Thank you so much for sharing this information. If you are looking for a best doctor for your health then you don't need to look here and there. Dr. Sachin Gupta is the best knee and hip replacement surgeon in Jaipur with the years of experience in robotic and computer assisted technique. For more about orthopedic doctor in jaipur and joint replacement surgeon in jaipur please visit our website.
ReplyDelete