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Physical Therapy Treatment and the Impact of Behavioral Health Concerns

Chapter

Abstract

Physical therapists (PTs) and physical therapist assistants (PTAs) are involved in the treatment of people with movement dysfunction and pain and also provide services to promote health and wellness in order to prevent injury and the progression of symptoms, impairments, and activity limitations in a person with an illness or injury. Musculoskeletal conditions impact people of all ages at a higher incidence than any other medical condition. The prevalence of arthritis is expected to increase to 25% of the adult population by 2030 (Lezin N, Watkins-Castillo S. The impact of musculoskeletal disorders on Americans-opportunities for action, executive summary of the burden of musculoskeletal diseases in the United States: prevalence, societal and economic cost. Bone and Joint Initiative. www.boneandjointburden.org. Accessed 14 June 2017, 2016). Given the economic and human costs of musculoskeletal injuries and illness, it is important that physical therapy treatment be effective. Successful physical therapy treatment requires the participation of the person being treated, so biopsychosocial barriers to the individual’s participation need to be both recognized and addressed. The purpose of this chapter is to ascertain how PTs and PTAs can recognize when recovery is impacted by these psychological and behavioral conditions and identify treatment strategies to effectively address them during physical therapy treatment, including optimal communication to members of the healthcare team. Consideration is also given to how the clinician’s beliefs and approach can affect outcome. This exploration will include consideration of the multifactorial issues affecting both the PT and the individual’s approach and responses during treatment. Moreover, the discussion will address how these concerns may manifest during treatment and address methods available to the therapist to identify the individual’s perceived pain and function. Specific strategies for managing those individuals with pain-focused behavior, sometimes referred to as a cognitive behavioral approach, are addressed.

Keywords

Physical therapy Physical therapist Physical therapist assistant Rehabilitation Cognitive functional training Therapeutic alliance Non-organic signs Delayed recovery Pain neuroscience education Pain 

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Authors and Affiliations

  1. 1.VP, Occupational Health ServicesMalvernUSA

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