Exam 2: Wellness, History, Legal, Resilience, Education & ICF

biomedical model

physical aspect of disease process, treatment based on pathology and curing the underlying pathophysiology and pathoanatomy

what does the biomedical model assume?

psychological, social, environmental and spiritual influences are all independent of disease process

what model is the US healthcare system?

biomedical model

biopsychosocial model

biological, psychological, and social variables are key factors to health and illness

what does the biopsychosocial model explain?

differences in outcomes for individuals with persistent pain

what is encouraged by the biopsychosocial model?

health care professionals and patients work together to find the solution

implication of direct access for physical therapist

provides primary musculoskeletal care

what is the effect of reducing chronic disease?

protect physical and mental health and mobility of the human movement system

how do physical therapists challenge patients?

never under prescribe exercise

what must be addressed in physical therapy?

the effects of disease/injury on the human movement system (look at entire person and lifestyle behaviors)

what must be acknowledged in physical therapy?

connection between lifestyle and health outcomes

components of wellness

active process, ongoing, balance, big picture, personalized lifestyle

what is wellness?

freedom from illness, disability or death

health

measured at specific times (ex: blood pressure readings)

process of wellness

active process consisting of habits and practices

wellness is...

dynamic

health is...

static

lifestyle medicine

evidence based approach to preventing, treating and reversing diseases by replacing unhealthy behaviors with positive ones

6 pillars of lifestyle medicine

healthy eating, physical activity, managing stress, avoiding risky substance, restorative sleep, and social connection

conventional medicine

medication/surgical interventions, disease occurs due to pathogens/environmental factors/genetics and treatment targets these diseases

what is the approach for conventional medicine?

disease focused

diseased focused approach

passive care of patient

complimentary and alternative medicine

uses complimentary and conventional medicine or alternative medicine in place of conventional medical treatment

complimentary/alternative medicine is not evidence based. true or false?

true

integrative medicine

addresses needs of the whole person through a combination of conventional, complementary and alternative medicine

what is included in integrative medicine?

evidence based complementary and alternative medicine methods with evidence based conventional approaches

functional medicine

focus on physiological and biochemical functions of the body

what is the focus of functional medicine?

investigate balance and process of metabolism, digestion, detoxification, oxidative stress, and hormones

mind-body medicine

interaction between body and mind (behavior, emotional, mental, social, spirituality)

what are treatments in mind-body medicine?

relaxation, hypnosis, visual imagery, meditation, yoga, biofeedback, spirituality, tai chi

lifestyle medicine treatment aim

treat root cause of chronic disease

what is the cause of most modern diseases?

lifestyle

what is the emphasis on physical therapy care?

restorative

3 types of prevention services

primary, secondary, tertiary prevention

primary prevention

prevent a target condition in a susceptible population through general health promotion

secondary prevention

decrease duration of illness and severity of disease through early diagnosis and early intervention

tertiary prevention

limits degree of disability and promotes rehabilitation in patients with chronic/irreversible disease

life expectancy

77.9

healthy years

66.2

impaired life years

11.7

what is the most common cause of death?

heart disease and cancer

what is the most important determinant of health outcomes?

lifestyle practices

what factors cause 80% of premature deaths?

tobacco, poor eating, lack of physical activity

what chronic disease can be treated by lifestyle medicine?

cardiovascular disease, cancer, obesity, type 2 diabetes, stroke

transtheoretical model

uses stages of change to integrate the most powerful principles and processes of change from leading theories of counseling and behavior change

6 stages of change

pre-contemplation, contemplation, preparation, action, maintenance, termination

pre-contemplation

no intended action in the foreseeable future

contemplation

intended change in the next 6 months

preparation

intending to take action in immediate future (1 month)

action

change is initiated

maintenance

works to prevent relapse back to old behaviors

termination

regular practice of new behavior

motivational interviewing

empathetic, client-centered counseling style for eliciting behavior change to help clients explore and resolve behaviors

what is the goal of motivational interviewing?

cause patient's desire to change unhealthy behaviors

what must be established before motivational interviewing?

collaborative relationship

when is motivational interviewing most helpful?

precontemplation and contemplation stage

four general principles of motivational interviewing

1. express empathy and understanding

2. support self-efficacy

3. roll with resistance and remain nonjudgemental

4. show discrepancy between patient's current state and what they want

what has been proven to be effective in patients' resistance to change?

5 minute sessions of motivational interviewing

OARS of motivational interviewing

open-ended questions

affirmations

reflective listening

summaries

social determinants of health

economic stability, social and community context, neighborhood, health care, education

what percent of adults have 1 chronic health noncommunicable disease?

60%

what percent of adults have 2 or more chronic noncommunicable diseases?

40%

what is the role of physical therapists in lifestyle medicine?

movement and exercise (proper prescription)

ensure adherence to exercise and health education

practice within whole spectrum of health and wellness

what are the most important determinants of health outcomes?

lifestyle factors

determinants of health

adverse childhood events, genetics/epigenetics, health literacy, environment, socioeconomic pattern

consequences of overweight and obesity

hypertension, osteoarthritis, high cholesterol and triglycerides, type 2 diabetes, coronary heart disease, stroke, gallbladder disease, cancer

type 1 diabetes

body does not produce insulin

type 2 diabetes

body does not produce enough insulin or cells resist insulin

consequences of diabetes

cardiovascular disorders, kidney failure, blindness, peripheral neuropathy, micro-vascular disease, amputation

consequences of inactivity

obesity, diabetes, hypertension, heart disease, colon cancer, breast cancer, premature death

how much moderate intensity exercise for benefits?

health: 2.5 hours

greater health: 5 hours

how much vigorous intensity exercise for benefits?

health: 1.25 hours

greater: 2.5 hours

consequences of tobacco use

heart disease, chronic lung disease, cancer, danger to pregnancy

process of screening

PARQ, consent, assessment results form, equipment, referral, screening tools

physical fitness

individuals' ability to withstand physical stressors and demands places on body

physical fitness at rest

metabolic fitness

metabolic fitness

vital signs, blood serum levels, body composition

health related fitness

posture, cardiorespiratory fitness, muscular fitness, muscle/joint flexibility

motor skills

balance

vital signs

blood pressure, heart rate, respiratory rate, physical activity level

physical activity guidelines

150 minutes a week of moderate activity

75 minutes a week of vigorous activity

2 times a week strength training

body composition

height, weight, BMI, waist circumference, waist/hip ratio, bioelectrical impedance, calipers, circumferential measurements

waist circumference

indicator of abdominal fat

increased risk in waist measurement

males: 40 in

females: 35 in

body composition measurements

densitometry, hydrostatic weighing, air densitometry (plethysmography), DEXA

what is the gold standard for body composition tests?

DEXA (dual energy x-ray absorptiometry)

cardiorespiratory fitness tests

YMCA step test, 2 minute walking test, 6 minute walking test

muscular strength/edurance tests

push-ups, sit ups (crunch test), squat test, sit to stand test (chair stand test)

muscle/joint flexibility tests

sit and reach, back scratch

balance screening/fall prevention assessments

static balance: romberg test, tandem stance, single leg stance

fall screen: timed up and go, 30 seconds sit to stand

US origin of physical therapy

world war 1 and polio epidemic

what were the first physical therapists called?

reconstruction aides

civilian training programs

certificate programs established consistent with army programs

how long were the civilian training programs?

6 months (620 hours) of technical level course work in anatomy, physiology, massage, hydrotherapy, electrotherapy, and exercise

what was the first national organization?

american women's physical therapeutic association (1921 by Mary McMillian)

professional organizations of PT

american physiotherapy association and american physical therapy association

who established the first minimum standards in 1928 and first code of ethics in 1930s?

american physiotherapy association

government programs impacting physical therapy

hill-burton law, social security act expansion, medicare/medicaid, education for all handicap children act, occupational safety and health administration

who developed the accreditation standards for physical therapy?

american medical association

when did the APTA and HOD pass a resolution that the baccalaureate degree is the minimum educational requirement for PT qualification?

1960