Role of the Physical Therapist
Contributed by Lynn Rochester, PhD and Mariella Graziano, MSc, BSc (Hons)
Movement disorders cover a wide spectrum from disorders of the basal ganglia such as Parkinson’s disease through to disorders of the cerebellum. Physical therapy is a science-based healthcare profession which views movement as central to health and well-being.
The role of the physical therapist is to prevent, treat and rehabilitate the physical symptoms associated with a movement disorder in order to restore maximum movement, functional ability and participation in work, family and society. Physical therapy therefore aims to maximise independence and quality of life from diagnosis and throughout the course of the disorder/disease.
Physical therapy involves a process of physical examination, goal-setting, plan of care and intervention. The physical therapist assesses the impact of a movement disorder on gait, posture, balance, falls, transfers, and upper limb function. The consequences of inactivity and disuse, such as muscle weakness, joint stiffness, pain and cardiovascular deconditioning are also addressed. 1,2
Physical therapists use the best available evidence to inform patient management which they plan according to the individual background, needs, disease stage, and medical profile. The physical therapist takes into account the effect of medication on functional performance and communicates with the movement disorders specialist to optimize drug and surgical management. Physical therapy is a regulated profession and physical therapists operate autonomously both as independent practitioners and as members of the multidisciplinary team. Physical therapists have an active role in (1) patient management ; (2) education of patients and professionals and (3) advancing clinical practice through research.
1 Bilney B, Morris ME, Denisenko S. Physiotherapy for people with movement disorders arising from basal ganglia dysfunction. New Zealand Journal of Physiotherapy. 2003. 31(2): 94-100.
2 Keus SHJ, Munneke M, Nijkrake MJ, Kwakkel G, Bloem BR. Physical Therapy in Parkinson’s Disease: Evolution and Future Challenges Movement Disorders. 2008. 23(9): 000–000.