The American Physical Therapy Association describes physical therapists as "health care professionals who diagnose and treat people of all ages who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. They also help prevent conditions associated with loss of mobility through fitness and wellness programs that achieve healthy and active lifestyles. Physical therapists examine individuals and develop plans using treatment techniques that promote the ability to move, reduce pain, restore function, and prevent disability." The focus of the physical therapist in the management of PD is to address gross motor, strength, flexibility, and balance deficits that limit functional mobility such as transfers and ambulation (7).
The American Occupational Therapy Association describes the occupational therapist's role in the management of patients with a physical disability as "first focusing on performing critical daily routines such as dressing, grooming, bathing, and eating. Once these skills are mastered, a program is then built around the skills needed to perform tasks such as participating in education, caring for a home and family or seeking and maintaining employment." The focus of the occupational therapist is to evaluate the fine motor deficits that affect the PD patient's ability to manipulate objects with their hands and to perform activities of daily living (8).
The World Health Organization (WHO), in its 1980 international classification of functioning, disability, and health, defined impairment as an abnormality of a structure or function (e.g., abnormal muscle tone) (9). Disability was defined as the functional consequence of the impairment (e.g., the inability to walk safely). Handicap was defined as the social consequence of impairment (e.g., having to make a career change as a result of mobility difficulties). Using these definitions, distinctions can be made as to how one can function as a result of certain impairments. Not all impairments result in disabilities. One may also be disabled but not handicapped. The most recent revision of the WHO classification of functioning views an individual's circumstances along the dimensions of body function, structure and activity, and participation. Hence, an impairment or problem in body functions or structure (abnormal muscle tone) may or may not affect an individual's difficulty in the performance of activities (walking). Participation refers to the individual's involvement in life situations and society's response to the individual's level of functioning. The purpose of the classification is to provide a unified and standard language that characterizes the consequences of health conditions (10).
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