Overview on the Guide to Physical Therapist Practice and its implications for neurologic physical therapy

Neurology Report, Aug 1999 by Harro, Cathy C

The impact of the Guide to Physical Therapist Practice on our profession is already evident. In education of professional level physical therapists, educators have embraced this comprehensive document that defines our practice and have begun to integrate the Guide and its models into curriculum. (See the Nicholson article in this issue.) The APTA's Normative Model of Physical Therapist Professional Education6 uses the Guide as a central companion document. The revised Evaluative Criteria for Accreditation of Education Programs for the Preparation of Physical Therapists' also incorporates components from the Guide, including its models, language, and frameworks. The new Clinical Performance Instrument for assessing clinical education incorporates Guide concepts and language. The APTA Department of Practice has been active in educational efforts for large insurance companies and the Attorney General, who are requesting information on the Guide as a reference document for physical therapy services. In clinical practice, the Guide has been applied and is helpful in utilization review and peer review processes. Documentation forms are emerging that reflect the Patient/Client Management Model and apply the Preferred Practice Patterns by identifying a physical therapy diagnosis and prognosis along with the medical diagnosis.8 Case reports that reflect the Guide's framework for clinical decision making are published regularly in PT Magazine. The purpose of this issue of Neurology Report is to further these efforts on application of the Guide by sharing examples of its application to case management, clinical practice, administration, and education in neurologic physical therapy.

In conclusion, the Guide to Physical Therapist Practice is a foundation practice document that will help lead our profession into the future. This document promotes application of the disablement model and the patient/client management model with the goal of improving the consistency and quality of physical therapy services for patients/ clients across the country. Additionally, the Guide promotes better utilization of physical therapy services and cost reduction through prevention and wellness initiatives. The Guide promotes use of a common language among physical therapy clinicians, educators, and researchers to allow us to more effectively discuss and compare patients and interventions and to analyze outcomes of our interventions. Application of the Guide will facilitate dialogue and increased understanding of how we classify our patients and develop physical therapy diagnoses, as well as how we determine prognosis for common groups of patients/clients. Application of the disablement framework and the practice patterns will help our profession generate clinical research questions and controlled clinical trials to enhance our understanding of the relationships between impairments, functional limitations, and disabilities in various groups of patients. In this changing health care arena, the Guide serves as an important reference document for physical therapists to educate third party payers, managed care organizations, case managers, and other health care professionals about our role in the health care system and the types of services and interventions that we provide. Finally, the Guide can be used to educate legislators, health care policy makers, and most importantly, the public about the scope of physical therapy practice and the benefits of our services.