Guide to Physical Therapy Practice Patterns
Neuromuscular Practice Patterns in Physical Therapy
The Guide to Physical Therapy Practice frames seven, impairment-based patterns that are consistent with patients and clients encountered in the physical therapy service. The language in practice patterns reflects the commitment to documenting and tracking how a person functions within their disease versus focusing on the disease.
Physical Therapy practice patterns connect affected body structures and functions with outcomes in the examination process. The result is a clear application of the International Classification of Functioning, Disability, and Health (ICF) which aids in evidence-based treatment planning. Within practice patterns, the physical therapist evaluates how body systems and conditions and the associated impairments impact function and disability within the patient's individual circumstance.
The table below outlines how physical therapy approaches establishing a PT diagnosis. A PT prognosis will factor in specific patient situations and circumstances (such as co morbidities, support systems, etc., work/home activities) in order to set treatment goals, frequency and duration.
|
Practice Pattern |
Practice Pattern Description |
Example Diagnoses |
|
Pattern A
|
Impaired Motor Function and Sensory Integrity Associated With Congenital or Acquired Disorders of the Central Nervous System in Infancy, Childhood, and Adolescence
|
Cerebral Palsy (CP) Spina Bifida Myelomeningocele Spastic Hemiplegia Spastic Diplegia Epilepsy Autism Spectrum Disorders Fetal Alcohol Syndrome |
|
Pattern B
|
Impaired Motor Function and Sensory Integrity Associated With Acquired Nonprogressive Disorders of the Central Nervous System in Adulthood
|
Traumatic Brain Injury (TBI) Cerebral Vascular Accident (CVA) Transient Ischemic Attack (TIA) Burns |
|
Pattern C
|
Impaired Motor Function and Sensory Integrity Associated With Progressive Disorders of the Central Nervous System in Adulthood
|
Multiple Sclerosis (MS) Amyotrophic Lateral Sclerosis (ALS) Parkinson's Disease (PD) Myasthenia Gravis Huntington's Disease Alzheimer's Disease |
|
Pattern D
|
Impaired Motor Function and Sensory Integrity Associated With Peripheral Nerve Injury
|
Ischemic compression stretch inflammation chemotoxicity |
|
Pattern E
|
Impaired Motor Function and Sensory Integrity Associated With Acute or Chronic Polyneuropathies
|
Guillain-Barré Syndrome (GBS) Autoimmune diseases Diabetic Neuropathy Alcoholism Nutritional Deficits (e.g, B12) Infection (Herpes, Polio) |
|
Pattern F
|
Impaired Motor Function and Sensory Integrity Associated With Nonprogressive Disorders of the Spinal Cord
|
Spinal Cord Injury (SCI) Degenerative Joint/Disc Disease in Spine |
|
Pattern G
|
Impaired Arousal, Range of Motion, Sensory Integrity, and Motor Control Associated With Coma, Near Coma, or Vegetative State
|
Minimally Responsive State Anoxic Brain Injury Toxicity or Metabolic Dysfunction |
Coordinating Care
Many providers are involved in coordinating care for patients and clients with neuromuscular dysfunction. All health care providers share a commitment to patient and family education and patient-centered practice. Examples of providers and some of their focused scope of practice include:
- Physiatry - physical medicine and rehabilitation doctors
- Neurologists - physicians that specialize in the brain and nervous system
- Neurosurgeons - surgical procedures to protect optimize function of the nervous system
- Neuropsychologists - provide therapeutic intervention and assessments of cognitive functioning
- Speech language pathologists - provide therapeutic interventions for improving swallowing, speech production (quality, fluency), and communication/problemen solving
- Occupational therapists - provide therapeutic interventions for improving activities of daily living and self-care activities, community reintegration, and fine motor skills
- Respiratory Care- provide therapeutic interventions to support respiratory function and ventilation
- Nutritionists - provide dietary guidelines and monitoring of nutritional status and weight based on condition
- Nursing - provide round-the-clock care and monitoring of physiological status and provide interventions, medications to stabilize and improve health condition per physician orders
- Therapeutic recreation therapists - provide interventions that foster enjoyment and positive interactions and self-efficacy
- Chaplains - provide spiritual support to patients and families on areas of personal need and in adjustment to disability
- Radiology - provide imaging studies that inform the team of anatomical, physiological, and pathophysiological status in multiple body systems