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David J. Conti, DPT, NCS, CSCS is the owner of Revive, Boost, Rebuild, Physical Therapy, LLC (RBR PT), and an adjunct professor at St. Augustine’s University. He has practiced physical therapy for 10 years, with a clinical focus on orthopedic and neurologic patient cases. He is a certified strength and conditioning specialist, and one of only 57 PTs in NC who is board-certified in neurology.

RBR PT treats patients from infants to geriatrics. RBR PT is known as an inclusive clinic and a strong community resource.

Patient Education:
The Path to Successful Therapy

By David Conti, DPT, NCS, CSCS

David Conti

Personality profile, previous experience, cognitive ability, level of education, and learning style are just a few of the many variables impacting a clinician’s decisions regarding the selection of an appropriate approach to rehabilitation and plan of care construction.

Every patient is an individual, and as such, should be considered unique. An effective therapist should demonstrate flexibility in their methodology, as a rigid approach simply limits the likelihood of purposeful and effective interaction. Some of the more integral aspects of patient care and management are the teaching and learning capabilities of the participants. Patient education is an absolute must when it comes to clinical intervention. When patients understand the components of their therapy, they are much more likely to demonstrate appropriate levels of compliance, as well as to accurately carry out the prescribed interventions.

David Conti guides a client through an exercise routine.

Some patience is required. The goal is for the patient to acquire a firm understanding of the pathology of the diagnosis, the root cause of the impairments, and the significance of each intervention. If they do, they will be much more likely to stay the course.

Information regarding different stages of healing—including acute, subacute, and chronic—will often allow for a greater comprehension of the selected approach. If a patient understands the value of and rationale for parameters such as level of resistance, reps, sets and rest intervals, then they will also be more likely to appreciate the purposeful nature of the plan of care.

In some cases, and phases, movement is therapeutic, while in other cases, immobilization or graded mobility is closer to optimal. Establishing a clear definition of where the patient falls on the scale of mobility, stability, controlled mobility and skill can make an appreciable difference in the patient’s mindset and overall confidence in his/her provider. A scientific understanding can serve as a motivational strategy for the apprehensive and anxious patient, while also minimizing the risk associated with the overly ambitious patient. Patients who can trust that their therapist is vested in their recovery and has given careful thought to the pace of progression, can find it much easier to buy into the theory and the theme.

Approaches Will Vary

The actual clinical approach must also vary, based on factors such as the patient’s personal goals, their prior level of function, comorbidities/ significant medical history, and age and level of motivation, just to name a few. When considering all of these potential variables, it is once again no wonder that each individual can and should be considered unique. It’s the snowflake effect. That said, the “one size fits all” mentality ultimately lacks the necessary efficiency and effectiveness, and in some cases can even be downright dangerous. The use of the broad stroking brush can certainly negatively alter the overall outcome. It’s imperative to consider the many available paths that can each lead to success.

A seasoned, well-rounded, dynamic clinician is equipped with options and able to assess which approach will most likely yield the desired clinical outcome. The clinician must also be adept at making adjustments to the plan on the fly. The process of examination and evaluation is meant to be ongoing throughout the rehabilitation process. The egregious act is not in the selection of a less than optimal interventional course, but instead in the maintenance of said selection due to poor reassessment skills and/or limitations in their depth of clinical capability. In other words, how deep is your bag of tricks?

While there are undoubtedly many disciplines that can be effectively utilized in the pursuit of rehabilitation of any given impairment, patient education remains a constant across the board. To be clear, this may and often does include a combination of verbal, visual, and tactile cues to ensure that the specific learner is effectively reached. This is essential when managing patients throughout the lifespan, from infant to geriatric, as well as when constructing plans for individuals with physical limitations and disabilities requiring the abandonment of more traditional teaching strategies.

I personally hang my hat on the fact that I am a teaching physical therapist. I always prefer to provide an overabundance of information, rather than potentially leave a patient unsure about the how and the why. It is with this strategy that I can say, with a great degree of confidence, that I have selected an appropriate approach to healing.