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Health-care consumers typically seek out or are referred to physical therapy because of physical impairments associated with movement performance caused by injury, disease, or health conditions that restrict their ability to participate in activities that are necessary or important to them. A therapeutic exercise program is almost always an appropriate intervention for individuals with movement dysfunctions. The ultimate goal of designing an individualized therapeutic exercise program is to remediate or prevent impairments of body functions and structures, enhance activities and participation, reduce risk, optimize overall health, and improve fitness and well-being.5

A patient is an individual with impairments and functional deficits that result in diminished movement performance who is receiving physical therapy services to improve function and prevent disability. A client is an individual, business, school, or other organization who seeks the physical therapist’s expertise for consultation, advice, fitness, wellness, or prevention services.5 Because the main focus of this textbook is on the management of individuals with movement system deficits, the authors have chosen to use the term “patient,” rather than “client” or “patient/client,” throughout this text.

The purpose of this foundational chapter is to present an overview of the scope of therapeutic exercise interventions used in physical therapy practice. This chapter also explores the evolution of several models of disability and the language used to classify disability, health, and function. A physical therapist must understand the interrelationship between health, disability, and physical function to provide effective patient care. A comprehensive approach to patient management is discussed as a means to guide the practitioner in the development and implementation of therapeutic exercise programs from initial examination to discharge. The chapter concludes with a discussion of methods and strategies for teaching and progressing exercises and functional motor skills based on principles of motor learning.

Therapeutic Exercise: Influence on Physical Function

Of the many procedures used by physical therapists in the continuum of care, therapeutic exercise takes its place at the center of programs designed to improve or restore an individual’s participation in meaningful activities.5,126 All individuals receiving physical therapy services should be active participants in the rehabilitation process, from initial assessment to discharge, and should learn to self-manage their health needs. Movement and physical activity have been repeatedly shown to be related to lifestyle; and routine exercise contributes to both overall health and functional movement.36,51,150 The beneficial effects of therapeutic exercise for individuals with a wide variety of health conditions and related physical impairments are documented extensively in the scientific literature.36,130,132,173

The Human Movement System

When the American Physical Therapy Association (APTA) adopted the 2013 vision statement, the human movement system became the focus for achieving universal identification of the physical therapy profession. The vision statement is compelling and clearly speaks to human ...

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