What Does the Guide Contain?

The Guide has five major components: the Introduction, which defines physical therapy, outlines the Guide's development, and describes the concepts that underlie the Guide; Part One, which delineates the physical therapist's scope of practice and describes the patient/client management that is provided by physical therapists; Part Two, which delineates preferred practice patterns; Part Three, available only on CD-ROM (June 2001), which catalogs the tests and measures that are used in physical therapist practice; and the Appendixes, which include the core documents of the American Physical Therapy Association and Guide-based documentation templates. The Guide does not contain specific treatment protocols, does not provide clinical guidelines, and does not set forth the standard of care for which a physical therapist may be legally responsible in any specific case.

"Part One: A Description of Patient/Client Management"

Part One is an overview of physical therapists as health care professionals and their approach to patient/client management, specifically:

* Physical therapist qualifications, roles, and practice settings

* The five elements of patient/client management (examination; evaluation; diagnosis; prognosis, including plan of care; and intervention) provided by physical therapists

* Tests and measures that physical therapists frequently use, clinical indications that may prompt the use of the tests and measures, tools that may be used to gather data, and types of data that may be generated

* Interventions that physical therapists frequently provide, clinical considerations that may prompt the selection of interventions, and anticipated goals and expected outcomes of intervention

"Part Two: Preferred Practice Patterns"

Part Two describes the boundaries within which the physical therapist may design and implement plans of care for patients/clients who are classified into specific practice patterns. The patterns are grouped under four categories of conditions: musculoskeletal, neuromuscular, cardiovascular/pulmonary, and integumentary. Some patients/clients may be best managed through classification in more than one pattern.

Each practice pattern describes the following:

* The specific patient/client diagnostic classification, including examples of (1) examination findings that may support inclusion of patients/clients in the pattern or exclusion of patients/clients from the pattern and (2) examination findings that may require classification of patients/clients in a different pattern or in more than one pattern

* The five elements of patient/client management for each pattern: examination (history, systems review, and tests and measures), evaluation, diagnosis, prognosis (including plan of care and expected range of number of visits), and interventions (including anticipated goals and expected outcomes)

* Reexamination 

* Global outcomes (impact on pathology/pathophysiology [disease, disorder, or condition], impairments, functional limitations, and disabilities; risk reduction/ prevention; impact on health, wellness, and fitness; impact on societal resources; patient/client satisfaction)

* Criteria for termination of physical therapy services

In addition, each pattern lists relevant ICD-9-CM codes. (These lists are intended as general information and are not to be used for coding purposes.)

"Part Three: Specific Tests Used in Physical Therapist Practice"

Part Three (available on CD-ROM only) contains a listing of tests and measures used in the assessment of the cardiovascular/pulmonary, integumentary, musculoskeletal, and neuromuscular systems and a listing of tests and measures of health status, health-related quality of life, and patient/client satisfaction. Citations in the peer-reviewed literature regarding the reliability and validity of specific tests are included.

Appendixes

Appendix I contains the Guide glossary. Appendixes 2 through 4 contain the APTA core documents on which physical therapist practice is based: Standards of Practice for Physical Therapy and the Criteria (Appendix 2); Code of Ethics and Guide for Professional Conduct (Appendix 3); and Standards of Ethical Conduct for the Physical Therapist Assistant and Guide for Conduct of the Affiliate Member (Appendix 4). Appendix 5 contains Guidelines for Physical Therapy Documentation. (Note: APTA documents are revised on a regular basis. For the most recent versions of these documents, contact APTA's Service Center, [e-mail].) Appendix 6 contains the "Documentation Templates for Physical Therapist Patient/Client Management"; Appendix 7, the "Patient/Client Satisfaction Questionnaire."

Indexes

Both numerical and alphabetical indexes of the ICD-9-CM codes cited in the Guide are provided.