Practice^

Edition
[Guide to Physical Therapist Practice. 2nd ed,
Phys Ther. 2001 ;81:9-744,1

American Physical Therapy Association

Al exandria, Vi rginia
lanuary 2001
 Guide to Physical Therapist Practice, Second Edition

APTA Board of Directors Oversight Project Editors/

Committee Parts One and Tv/o
Ben Massey, Jr, PT (2000) (1999-2000)
APTA President
Joanell Bohmert, PT, MS
Joanell Bohmert, PT, MS (2000) Marilyn Moffat, PT, PhD, FAPTA
Stephen Levine, PT (1998-2000) Cynthia Zadai, PT, MS, CCS
Jan Richardson, PhD, PT, OCS (1999-2000)
APTA President, 1998-2000
Jayne Snyder, PT, MA (1998-2000)

Task Force on Development of Part Three,

Guide to Physical Therapist Practice, Second Edition
(1998-2000)
Laurence Benz, PT, MPT, ECS, OCS Sandra Kaplan, PT, PhD
Katherine S Biggs, PT Kathleen Kline Mangione, PT, PhD, GCS
Joanell Bohmert, PT, MS Lisa Saladin, PT, BMR, MSC
David Boyce, PT, MS, ECS, OCS Steven Tepper, PT, PhD
Lori Thein Brody, PT, MS, SCS R Scott Ward, PT, PhD
Michael FiUyaw, PT, MS Cynthia Zadai, PT, MS, CCS
Lisa Giallonardo, PT, PhD, OCS

APTA Staff
Practice and Researcii Division Research Services Department
Andrew Guccione, PT, PhD, FAPTA Mire boldstein, BdD
Senior Vice President \pirector
Sarah Miller iidrea Mink
Assistant to the Senior Vice President Senior AdtrUnistrative Assistant
Department of Practice
Donna Bernhardt Bainbridge, PT, PhD, ATC Communications Division
Director Nancy Perkip Beaumont, CAE
Lisa Culver, PT, MBA Senior Vice President
Nancy Goode, PT, MA
Publication^ Department
Associate Directors
Lois Douthitt
Bobbie Jo Ellis Director
Michele Katsouros
Jan Reynolds
Senior Administrative Assistants
Associate Director
Informotion Services Department Evy^nn Blaher
Tracy Temanson Assistant Managing Editor
Director
Nicole Orton
Senior Administrative Assistant

Second edition 2001 by the American Physical Therapy Association.

First edition 1999,1997 by the American Physical Therapy Association (APTA),The first edition was published in the November 1997
issue oi Physical Tberapy [Guide to Physical Therapist Pmctice. Phys Ther 1997;77; 1163-1650], RevisedApril and July 1999,
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any
means, electronic, mechanical, photocopying, recording, or otherwise, without prior permission of the American Physical Therapy
Association, For more information about this and other APTA publications, contact APTA, 1111 North Fairfax Street, Alexandria, VA
22314-1488, or access APTA's Resource Catalog online viaAPTA'sWeb site, www,apta,org/res_cat, [Publication order no, P-139]
ISBN 1-887759-85-9
Art adapted with permission from:
Dorland's Illustrated Medical Dictionary. 28th ed, Philadelphia, Pa: WB Saunders Co; 1994:131, Plate 2; 1535, Figure,
Williams PL, Warwick R, eds. Gray's Anatomy. 37th ed. New York, NY: Churchill Livingstone Inc; 868: Figure 7-12,
Clemente CD, ed. Gray's Anatomy. 30th ed, Philadelphia, Pa: Lea & Febiger; 1985:514, Figure 6-42,

S2/10 Guide to Physical Therapist Practice Physical Therapy Volume 81 Number 1 January 2 0 0 1
 Guide to Physical Therapist Practice, First Edition

APTA Board of Directors Oversight Project Advisory Group

Committee (1995-1997) (1995-1997)
Marilyn Moffat, PT, PhD, FAPTA Joanell Bohmert, PT, MS
APTA President, 199l-l99'7 Jan Gwyer, PT, PhD
Laurita Hack, PT, PhD
Andrew Guccione, PT, PhD
Roger Nelson, IT, PhD, FAPTA
Jayne Snyder, PT, MA
Jules Rothstein, PT, PhD, FAPTA (1995-1996)
Cynthia Zadai, PT, MS, CCS

Musculoskeletal
Lisa Giallonardo, PT, MS, OCS
Chair
JohnGose,Pl,MS,OCS
Terry HoUey PT, MHS, GCS
Undsay McNult), PT, MPH, GCS
Erin Patterson, PT, MS, OCS
Julie Pauls, PT, MS, ICCE
LoriThein,Fr,MS,SCS
Poneis
(1995-1997)
Neuromuscular
Donna Cech, PT, MS, PCS
Chair
Richard Bohannon, PT, EdD, NCS
Nancy Byl, PT, PhD, MPH
Kathleen Fincher, PT, MS, PCS
Diane Nicholson, PT, PhD, NCS
Kirsten Potter, PT, MS, NCS
Gerrv Stone, PI, MEd, (iCS
Cardiopulmonary
Ellen Hillegass, PT, EdD, CCS
Chair
Garv' Brooks, PT, MS, CCS
Lawrence Cahalin, PT, MA, CCS
Diaiine C;arrio, PT, MEd, GCS
lie))' Ciesia, PT
H-^^
Integumentary
Debra Metzger-Donovan, PT, MS
Chair
Katherine Biggs, PT
Carrie Sussman, PT
Pamela Unger, PT
RScottWard,PT,PhD

Task Force to Reviev\^ Practice Parameters and \Practice Parameters Project Core Group
Taxonomy Documents (1994-1995) (1993-1994)
Marilyn Moffat, PT, PhD, FAPTA Roger Nelson, PT, PhD, FAPTA
Andrew (ruccione, VI. PhD Chair and Board Liaison
Roger Nelson, PT, PhD, FAPTA John Barbis, PT, MA, OCS
Jayne Snyder, PT, MA Eileen Hamby, PT, DBA
Catherine Page, PT, PhD (1993)
Robert Post, PT, PhD
Gretchen Swanson, PT, MPH
Marilyn Moffat, PT, PhD, FAPTA (ex officio)

APTA Staff
Volume I: A Description of Patient Atanagement
Department of Practice
Robert Mansell, PT, MS (1991-1996)
Diiector

Part Two: Preferred Practice Patterns

Health Policy Division
Jerome Connolly, 11'
Senior Vice President

Department of Practice
Jack Front, I'T, MBA
Director
Lisa Culver, PT, MBA
Maureen Lynch, PT, MA
Allen Wicken,PT, MS
Associate Directors
Debbie Greene
Senior Administrative Assistant

Guide to Physical Therapist Practice /S3

 Preface to the First Edition
November 1997

fl. 11 health care professions are accountable to the various publics that they
J ' 'll serve. The American Physical Therapy Association (APTA) has developed
^'.-l;|>. Guide to Physical Therapist Practice ("the Guide") to help physical thera-
'* pists analyze their patient/client management and describe the scope of
their practice. The Guide is necessary not only to daily practice but to preparation of
students. It was used as a primary resource by the Commission on Accreditation in
Physical Therapy Education (CAPTE) during its revision of evaluative criteria for phys-
ical therapist professional education programs and is an essential companion docu-
ment to The Nortnative Model of Physical Therapist Professionat Education,
Version 97.

Specifically, the Guide is designed to help physical therapists (1) enhance quality of
care, (2) improve patient/client satisfaction, (3) promote appropriate utilization of
health care services, (4) increase efficiency and reduce unw^arranted variation in the
provision of services, and (5) promote cost reduction through prevention and well-
ness initiatives. The Guide also provides a framevk'ork for physical therapist clinicians
and researchers as they refine outcomes data collection and analysis and develop ques-
tions for clinical research.

Groups other than physical therapists are important users of the Guide, Health care
policymakers and administrators can use the Guide in making informed decisions
about health care service delivery. Third-party payers and managed care providers
can use the Guide in making informed decisions about reasonableness of care and
appropriate reimbursement. Health care and other professionals can use the Guide
to coordinate care with physical therapist colleagues f^oye efficiently.

As the Guide is disseminated throughout the profession and to other groups, the
process of revision and refinement will begin. We thgnk our colleagues who helped
us make the Guide a reality. ;
'\
Marilyn Moffat, PT, PhD, FAPTA
(APTA President, 1991-1997)
Andrew Guccione, PT, PhD
Jayne Snyder, PT, MA
APTA Board Oversight Committee

S4/12 Guide to Physical Therapist Practice Physical Therapy Volume 81 Number 1 January 2 0 0 1
 Foreword to Hie Second Edition
Januory 2001

T
he Guide to Physical Therapist Practice ("the Guide"), Parts One and Two, has
represented a living document, with a life that has already spanned more than 8
years. Tlie first edition of the Guide was the result of the expertise contributed
by almost ] ,000 physical therapist members of the American Physical Thenipy
Association. Each individual shared not only his or her knowledge and skills, but also
time, energy, and commitment to a document that has dramatically affected the practice
environment. The Guide has been used in ways and by people we never had imag-
inedbecoming an invaluable resoui'ce to clinicians, educators, administrators, legisla-
tors, and payers throughout the health care community.

This second edition is a testament to its evolutionary nature. In reviewing the pages
of this edition, you will know that its strengths have been shaped by its usersall of
whose comments and questions received serious consideration. Hundreds of mem-
bers have worked to respond to those suggestions and to the demands of a changing
practice environnient^herebf'enkiring that the Guide encompasses the full scope of
current physical therapisjiuactice "Ut) all of them, I extend the deep appreciation of
our profession and its Assobi^tion.

The Guide will contiiuie to grow and be revised based on research evidence and on
changes in examinapon and intervention strategies within practice. I invite you to be
a part of its life bVi^Jringing to the Association your questions, comments, and sugges-
tions. Our unitedyparticipation in this evolutionary process will keep the Guide at the
forefront of the profession.

Ben F Masseyjr. PI
President
American Physical Therapy Association

Guide to Physical Therapist Practice 1 3/S5