In physical therapy, patient’s with a neurological problem are often treated with respect to 4 principles
- Controlled mobility
The patients are supposed to be trained through each stage in this exact order..
According to me, we could treat every patient with these principles, but the only difference being that we change the meaning of all the 4 principles just abit..
Also this time, these stages would refer to the therapist rather than the patient..
Now according to the books, mobility is the first step and it works on the range of motion.. I believe, mobility is the way you treat the patient.. By the word treat, im not referring to the actual treatment but the way you treat (behave with) the patient..
- Its about how you talk to the patient, to make him comfortable, when you see him/her for the first time..
- Its about how easy you make it for the patient, to open up and tell you about his complaints..
- It’s how you can actually win the trust and confidence of the patient in just few minutes of the first time you meet him..
Next is stability, in books this refers to the muscle strength, which is important to carry out function..
According to me, stability is the strength in the relationship, the therapist – patient relationship.. Now what do I mean by strength in the relationship? Basically, strength is achieved by
- The bond you create between the patient and yourself, which is based on trust..
- The trust that the patient has in you as a therapist.. How much does he trust you? Would he do everything you tell him to? This is why trust is important.. Its the basis of this relationship.. This would actually determine patient’s compliance..
- The trust the patients relatives have in you.. This would determine how well they listen, to what you have to say and do as you say..
For stability to develop you need mobility.. Just the way you use mobility to build strength(stability) in muscles of the patient, the therapist needs to use mobility to build stability as explained above..
Stability is followed by, controlled mobility.. In the books this refers to the control of the movement… How well the patient can control the movement..
I believe controlled mobility refers, to the knowledge of the therapist of knowing when to do what.. By this what I mean is, the therapist should know exactly, when to control and what to control, i.e, when to push the patient upto his physical limit and when to make use of the patient’s emotions to push his own self.. It is the knowledge to be able to control the fine balance between the physical ability and the emotions of the patient to achieve his set goals..
Controlled mobility would help you build, your next step as a therapist..
Next is skill, which refers to the ability of the patient to perform a certain complex task efficiently ..
I believe, it refers to the ability of the therapist, to achieve the goals set for the patient..
- It depends upon therapist’s ability to know, how to persuade a patient who is reluctant to exercise
- It depends on how well the therapist puts his knowledge into action to treat the patient
- It depends on therapists ability to make use of patients emotional needs to achieve his own goals
- It depends on therapist’s ability to be able to push the patient to his functional limits everytime, to achieve what he wants..
- It depends on the therapist’s ability to understand where the actual problem lies, whether its in the mind or the body and then treat it..
Now the question is how do we actually make use of these principles in our practice?
Mobility can be achieved, by just conversing with the patient, making him comfortable in just a few minutes of you meeting him.. This would help you make the patient open up to tell you his exact complaints.. It is not what you do, but how you do that really matters… Just the simple way of talking to the patient, makes the difference.. Just the caring tone of your voice, when you talk to the patient, helps the patient become more comfortable and that’s exactly what you want..
Stability, can be achieved by just getting to know the patient well, talk to the patient, ask them questions, doesn’t have to always be about their condition, it could be about their life, their family, their work, their likes and their dislikes, it could be about how their condition makes them feel, how it has affected their lives.. This is what, helps you know them better and create that bond, and trust, which you want them to have in you..
Controlled mobility can be achieved by knowing when your patient, needs your help and when, you need to actually push him, by motivating him to achieve his goals.. Its about knowing how you can help your patient, without letting him be dependent on you.. The therapist should now when to support the patient, and when not to… This is something you build up on, as a therapist, with experience..
Lastly, skill.. Just the ability of the therapist to poke the patients emotional needs, to make him work harder determines the therapist’s skill.. Skill can be achieved with knowledge based on practice and experience.. Its not something that can be taught, its something that you as a therapist, would learn all by yourself.. Every patient is a different one, and each of them would teach you something new.. This is how you build up your skill.. It is this quality, that the patient admires you for, and the reason he would choose you, over others as a therapist and would always come to you, for treatment..
As a therapist, we need to start using these principles for ourselves, to be able to treat our patients better..