There is a chance to maximize the performance outcomes with your patients that we are not taking advantage of. What if we create a mental video of their habitual movement patterns with each and every patient? The habits are automatic and allow for high performance if they support the actions needed. Adding an analysis of habitual movement strategies, the speed of functional recovery is advanced. The most amazing thing is that the majority of us is not aware or work with the strong personal biases we have in creating our daily living performance.
The client comes to PT to improve the performance and then we invent with them a better strategy. The obvious missing is that their whole world outside of PT is set up for the pre-PT ergonomics and social strategies that supported the old and less desirable patterns and related pain problems. Part of PT is to distinguish what needs to happen with seating, pacing, diet, fluid intake, use of time, play etc as it applies to implementing the new use of any functional improvement ( ie. Allowing neck to turn easily to the right and the left-yet in your home you sit and always look to the right at the dining room table, at the desk at work you also look right at your partner, the telephone has no head set so you are tilting to the right and when you watch television you also look to the right).
In this day of cost containment and the importance of demonstrating functional improvements, it is critical to engage the patient about adaptations that support their PT outcomes. This can be done thru video or still pictures of work station, eating area, relaxation area, bedroom etc. The real pictures of the repetitive use patterns tell such a clarifying story about how we accidentally, mindlessly ruin our own PT outcomes and they never bloom in the home and workplace where they are needed the most. The short term goal is to invent strategies for functional carry over from PT into their real life.
Osa Jackson Schulte, PhD, PT
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