The physical therapist should manage the Disablement Process for patients with cardiac, pulmonary, spinal, or whatever problems. He is well trained and prepared to fill the role as cardiac care manager; having to complete a six year course of study that focuses on the causes and treatments of virtually any movement dysfunction encountered by man. From the seen to the unseen, the physical therapist knows and understands what drives and powers movement of the human body as well as its limiting factors. His preparation includes coursework that focuses on normal and pathological movement from the cellular level on up to the person as an individual, through to his role in functioning as part of a society.
With a didactic preparation of coursework in psychology, physics, chemistry, biology, anatomy, kinesiology, orthopedics, neuroscience, cardiopulmonary rehabilitation, path/pharm, work biology and motor control just to name a few, as well as clinical experience which includes, but is not limited to, three eight-week student affiliations in different settings such as acute-inpatient, out-patient orthopedics and neurorehabilitation, graduating physical therapists know well the physiologic rationale behind the interventions made to correct the impairments of the cardiac patient.
Interventions made by the physical therapist vary within a few main areas in regard to movement and the dysfunction that can occur. In the cardiac patient, interventions are directed at educating patients about their problem and then helping them identify and manipulate certain risk factors that are detrimental to their health. As therapists, we also intervene in the cardiac disease progression by halting and actually decreasing the patient’s impairments first of all by identifying them and then by formulating an exercise program according to their individual needs which has been proven to increase cardiac efficiency and function.
The disablement model is a definite help to the physical therapist in identifying and addressing disease and its consequences in an effort to delay and even prevent disability. The disablement model does this by extending “traditional epidemiological, medical and public health perspectives so that they focus on functional outcomes.” It is the focus on functional outcomes that is important. We can affect a decrease in disability by increasing functional abilities through impairment intervention. The disablement model helps break the disease process down into understandable and therefore manageable chunks.
When the physical therapist is charged with being a cardiac care manager, the application of the disablement will result in increased effectiveness of treatment, controlled costs of management and better patient satisfaction. This is a natural extension of what the physical therapist is trained to do. He can approach problems from a biomechanical, work physiological, neurophysiological, soft-tissue, or motor control point of view. Also, his knowledge of other health care professionals and ability to employ their skills in addressing the patient’s problems makes the physical therapist the obvious choice for providing cohesion and continuous flow to the treatment of disease processes.
It is his understanding of disease processes and time frames as well as his ability to recognize which aspects of care should be addressed by who that provides for effective treatment and controlled costs of patient management. Patient satisfaction stems from the patients knowing that their care is being comprehensively managed by a single competent health care professional who is addressing all aspects of the disease from their pathology to the impairments caused by that pathology as well as any functional limitations and the disabilities they may create.