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Pathology Implication for Physical Therapist 4th Edition. Author : Ca the rine C. Pathology : Implications for the Physical Therapist ,Understand how a patient's conditions might. Physical Therapist , Third Edition, offers guidelines, precautions, and contraindications for. Learn about the cause of the se. In addition to addressing specific diseases and conditions, this text.
The only pathology textbook written specifically for physical the rapists, Pathology : Implications for the Physical Therapist , Third Edition, offers guidelines, precautions, and contraindications for interventions with patients who have musculoskeletal or neuromuscular problems as well as o the r conditions such as diabetes, heart disease, or pancreatitis.
Learn about the cause of the se conditions, the pathogenesis, medical diagnosis and treatment, and most importantly, the special implications for the the rapist. Tables and text boxes throughout the text summarize important information and highlight key points. Full color interior design, photos, and illustrations Chapter on Behavioral, Social, and Environmental Factors Contributing to Disease and Dysfunction includes clinical models of health, variations in client populations, and lifestyle factors that are important to consider when treating a patient.
Evidence-based content with over 6, references EXPANDED chapter on the lymphatic system features additional sections on lymphatic diseases plus exercise guidelines, education, and a home program for patients with a compromised lymphatic system.
UPDATED chapter on lab values features new information on potassium levels and exercise, albumin levels related to nutrition and wound healing, and coagulation studies in relation to exercise.
EXPANDED chapter on Psychosocial—Spiritual Impact on Health Care offers new information on fear avoidance behaviors, substance abuse, malingering, personality disorders, abuse, eating disorders, and the impact of nonphysical trauma to health and disease as well as combat trauma, torture, and the effects of war. Appendix B: Guidelines for Activity and Exercise includes updated information on aquatic physical therapy from leaders in the field, emphasizing precautions and contraindications for this modality.
E-Book Description. E-Book Details. Table of Contents. Introduction to Concepts of Pathology 2. Environmental and Occupational Medicine 5. Problems Affecting Multiple Systems 6. The individual is influenced in various ways by family, community, and society.
Each of these nested social structures influences the individual and can shape Sociodemographics behavior, including the ability to make health decisions, compliance with regimens, or even with initial health choices. Census have provided us with a composite picture of Amer- ica never before so broad based or so complete. In short, altering behav- Statistics collected for the Census now also include a Two iors among individuals will influence environmental or More Races population.
It is estimated that in the next level characteristics, which will in turn further influence decade, the number of people of Asian descent will double groups of individuals within a community or population. The most common Rapid population shifts to the mountain states and construction of social ecology, provided by Sallis and resurgent growth in suburbs have changed the urban— Owen, proposes that behaviors are influenced by intra- rural configurations.
Finally, the factors. The health status of the United States is a description of The model proposed by McLeroy et al in is the health of the total population using information that composed of five classes of factors: intrapersonal factors, is representative of most people living in this country. Each The leading causes of death are often used to describe reflects the interrelationship between individual-level the health status of a nation. For example, in the United characteristics and large-scale social forces Fig.
States, obesity, alcoholism, sedentary lifestyle, and tobacco Increasingly larger social structures influence the individ- use have contributed significantly to the most common ual and can shape behavior, including the ability to make causes of morbidity and mortality in This is in con- health decisions such as adherence with regimens or even trast to the year , when infectious diseases ran rampant initial health choices. This view greatly broadens the Deaths, permanent disability, and unnecessary suffer- types of interventions that can improve health and helps ing from medical errors e.
Pneumonia, influenza Heart disease Tobacco use Tuberculosis Cancer Poor diet and physical inactivity Heart disease Stroke Alcohol consumption Diarrhea, enteritis Chronic lower respiratory disease Toxic agents e.
Causes may vary when evaluated by age e. Data from National Center for Health Statistics. Death in the United States, It is estimated that medical ties toward these specific behaviors may help offset esca- errors account for almost , death each year in the lating health care costs.
The intent is to reorient U. These risks may be attributable to lack of effec- toward wellness while restraining cost and expenses cre- tive communication among caregivers who help transi- ated by the high prevalence of chronic disease. Deaths with at least one disability and it is predicted that most from medication errors that occur both in and out of hos- Americans will experience a disability some time in their pitals more than annually exceed those caused by lives.
TBI is the leading cause of injury- Over the last century, a shift from infectious to noncom- related death in children and young adults in the United municable chronic diseases such as heart disease, cancer, States and other industrialized countries.
Overall rates of and diabetes has occurred. As a result of the control of disability including TBI are higher among older adults many infectious agents, eradication of childhood diseases, who also have higher rates of chronic diseases.
One tality in the United States Table Many of these ill- difficulty in identifying how many people have a disability nesses are modifiable through changes in behavior and is the wide range of definitions for disability used in social lifestyle.
This trend has led to a new focus in rehabilitation: research situations. In some cases, disability is any difficulty chronic disease management.
In some places, chronic dis- with activities of daily living ADLs or limitations associ- ease management is a new term for rehabilitation.
Census, there are For dollars. An estimated 3. With increasing life expectancy and the aging of Amer- in the United States and globally. III developed in , the s, and the s, respec- Living longer means increasing percentages of individuals tively used race and ethnicity data when evaluating the with disabilities.
This survey is updated annually. Although somewhat controversial and highly cans, and Cuban Americans. Included in the survey were debated, some of the most stressful U. Some published lists base their find- Arizona, and California; Cuban Americans from Dade ings on cost of living, crime index, education, divorce, County, Florida; and Puerto Ricans from the New York population density, unemployment, and average com- area, including parts of New Jersey and Connecticut.
Likewise, suggestions have been made as to In the past, it was believed that race or ethnic back- the least stressful locations and occupations. Data on human varia- thereof , and even local smoking ordinances, contribute tion come from studies of genetic variation, which are to the geographic variations people experience that can clearly quantifiable and replicable.
Genetic data show impact their health. A half-century ago, a few Current information about biologic and genetic char- physicians cultivated an interest in diseases that seemed to acteristics of various groups e. As a result, a discipline Americans, Alaskan Natives, Native Hawaiians, or Pacific called geographic pathology developed.
Geographic pathol- Islanders does not explain the health disparities experi- ogy was concerned with diseases endemic present in a enced by these groups.
These differences are thought to community at all times to certain areas of the world, most be the result of the complex interaction among genetic often parasitic and infectious diseases that seemed unique variations, environmental factors, and specific sociocul- to individual geographic regions.
A component called occu- tural and health behaviors. Disease caused by contaminants to die of hypertension than whites of the same age group. For further discussion, see Chapter 4. Other factors contributing broad gap between the death rates for blacks and whites, to racial and ethnic health disparities include cultural and but blacks differ more from each other than they do from linguistic barriers, discrimination, bias, stereotyping, and whites.
The Health Care Education and health care resources often are not Access Barriers Model HCAB describes three categories accessible to minorities and rural residents with limited of modifiable health care access barriers: financial, struc- financial means. Routine programs, such as antismoking tural, and cognitive. The three types of barriers reinforce campaigns and cancer screenings e.
These barriers are associated with better educated and can afford regular medical care. The general understanding regarding health care was Each of these factors contributes to poor health outcomes that those who could afford health care had access to and health disparities.
By targeting those barriers that are health care and those who could not afford health care measurable and modifiable, the model facilitates root- did not have access to health care. Thus, there was dispar- cause analysis and intervention design. As previously mentioned, the new Patient Protec- practitioners engage in stereotyping and bias that may be tion and Affordable Care Act of has been passed in conscious or unconscious.
The health care provider may an effort to address these kinds of disparities but remains experience uncertainty in the clinical encounter and rely on under considerable debate and controversy. The bias, stereotyping, and uncertainty may be the Factors Contributing to Health Disparities and result of cultural differences and linguistic issues and affect Inequities the clinical management and ultimate health outcomes.
Citizens that continues to examine, investigate, research, and report contribute to the culture and the society to create the on health disparities. A brief presentation is provided here fabric of national life. The health of the citizens of the but more information is available on their website at nation is of paramount importance; every effort must be www. The IOM has recommended the following strate- The IOM has also identified several factors that con- gies to that end; other proposed local solutions to reduce tribute to health disparities and inequities.
First, health inequities in health are available78 on their website e. Health systems also provide financial incentives to ity; engage health practitioners in reflective practice physicians for limiting services including diagnostic pro- that can alter conscious and unconscious behavior. For example, the IOM report edge, and skills in working with diverse populations. Clients in lower socio- See Evolve Box , Strategies to Eliminate Health Dis- economic groups are less likely to receive a complete array parities, on the Evolve website for more information on of medical tests routinely ordered for individuals with a this topic.
Beyond Cultural Competence: Transnational neuroendocrine theory, and the waste accumulation theory. Competence To those who accept the damage-based view, aging is an Understanding of cultural diversity and cultural compe- accumulation of damage to macromolecules, cells, tissues tence has become a familiar topic in the physical thera- and organs. Likewise, some consideration of these Examples of environmentally induced damage range topics has become a part of all U.
Cul- from alterations to deoxyribonucleic acid DNA , for- tural competence has been linked with quality assurance mation of free radicals from oxidative processes causing and cost-containment programs to help reduce dispari- damage to tissues and cells, and increased cross-linking ties in health care.
These concepts are discussed in greater continued health disparities, social scientists propose a detail in Chapter 6. TC teaches the health care grammed-based, which presumes that aging is a genetically professional how to address issues of physical and mental driven process and not primarily the result of ongoing health along with experiences related to geographic dislo- and accumulated cellular or environmental processes.
Consistent with global trends, demographic patterns Changes in gene expression are either preprogrammed or are changing rapidly in the United States.
Disparities in derived from DNA structural changes and affect the sys- health and health care are increasing. More than 35 mil- tems responsible for maintenance, repair, and defenses. Currently, 6 of include the gene mutation theory, the genetic control theory, every 10 babies born in New York City have at least one and the planned obsolescence theory.
Both damage-based foreign-born parent. It is also possible that elements of both theoretic health-belief systems. Relevant links between health and models apply. The basis of this theory is the tion status, or family fragmentation. Telomeres are sequences of nucleic current era of globalization and migration and their acids extending from the ends of chromosomes.
Telo- impact on health beliefs, disparities, and diversity within meres do not encode genes; rather they act to maintain ethnic groups. However, every time our cells divide, Age and Aging telomeres are shortened. Once the safety margin provided Age and gender play important roles in the development by a telomere is consumed, gene coding regions of the of most diseases.
Age often represents the accumulated chromosome are no longer protected during replication effects of genetic and environmental factors over time. Discriminating between causes and effects of Researchers also found that the enzyme telomerase is aging is often impossible.
Separating aging from pathol- a key factor in rebuilding the disappearing telomeres. Telomerase may be manipulating the biologic clock that There are many theories to explain what changes occur controls the life span of dividing cells. Future develop- that lead to aging, but no universal theory of aging or ment of telomerase inhibitor may be able to stop cancer consensus over what causes aging or determines the rate cells from dividing.
The hope is to convert them back into of aging exists. Theories of aging that have gathered more normal cells. Life Expectancy Theories of Aging Life expectancy at birth for persons born in the United Senescence, the process or condition of growing old, may States is now about Understanding aging from this dramatic rise in obesity, especially among young people framework is referred to as a damage-based theory. Exam- and minorities. Individuals 75 years tiple types of cancer, pulmonary disease, adverse repro- of age can be expected to live an average of 11 more ductive effects, and the exacerbation of chronic health years for a total of 86 years.
Mortality rate from cancer remains higher for blacks use will remain an important public health issue for the who are not diagnosed and treated early. Many older adults toler- Preventing tobacco-related cancer and lung diseases ate cancer treatment, but they experience delayed recov- begins with educating children about the risks of initiat- ery and are at increased risk of serious infectious and ing smoking.
Healthy People leads the country in try- bleeding complications. A dramatic extension of longevity has occurred in the last As the young and the aging continue to garner atten- years.
By , that proportion was up to care. Prenatal and well child prevention programs have Preventive health care and inter- ; supercentenarians: those who live to the age of or vention among this age group are the next targets for the more. Women outnumbered men in all ages and ethnic Although the terms gender and sex are often used inter- groups; there were total reported supercentenarians. This aging trend of the U. Confusion; fractures and other women, XY for men ; gender refers to social roles, behav- injuries related to falls; strokes; infections; and effects of iors, and environmental influences.
Sex and gender affect polypharmacy, inappropriate medications, and decline in health independently as well as interactively. Slow well as prevention or cure of diseases. Known nonmodifiable conscious or unconscious can affect health outcomes. The 2 the perpetuation of the view in medicine that the kg long-term benefits of childhood intervention to prevent man is the norm for representing all humans in medicine, adult disease are documented.
For example, preventing and 3 the use of federal funds through Medicare to pro- osteoporosis in the aging adult begins by providing nec- vide better reimbursement for conditions more prevalent essary dietary calcium intake during bone development in men compared with those more prevalent in women. The National Institutes of Health NIH issued guide- Tobacco use remains the leading cause of prevent- lines in requiring the inclusion of women and able morbidity and mortality in the U.
Although most clini- and eating disorders, is increasing. Men are two der and sex, you will still see ways in which the terms are used times more likely than women to die from unintentional in the literature and at large that do not follow the definition injuries and four times more likely to die from firearm- provided above. Gender-based biology has demonstrated major gender Overview differences in such things as risk factors, response to med- According to the World Health Organization WHO , the ications, response to surgical procedures, and response to highest number of deaths are attributed to the risk fac- treatment.
Striking physiologic differences exist between tors of tobacco use, high blood pressure, high body mass men and women. These fac- brain light up in response to an identical task between tors not only contribute to the number of deaths but also men and women. More than any other intervention, changing behav- ior and lifestyle could help prevent death, enhance the Gender-Based Patterns of Disease quality of life, and reduce the escalating costs of treating It is clear now that men and women experience differ- chronic illnesses.
For example, although heart disease ent patterns of disease. Some gender differences may rep- remains the number one cause of death in the U. Other risk factors in lifestyle affecting health status Women are twice as likely as men to contract a sexu- and health care are considered individually modifiable ally transmitted disease STD and 10 times more likely and include personal habits such as rest and sleep; diet, to contract HIV, in particular during unprotected sex with including calcium, fat, and fiber intake; level of activity an infected partner.
Women smokers are more likely to and exercise fitness ; stress and coping ability; substance develop lung cancer than men who smoke. Women are abuse; travel; environmental or occupational status; and more likely to have a second heart attack within a year of high-risk sexual activity. Gay male adoles- nificantly; women have higher blood alcohol levels than cents are two to three times more likely than their peers men after both consume the same amount; and women to attempt suicide.
Some evidence suggests lesbians have tend to regain consciousness after anesthesia more higher rates of smoking, obesity, alcohol abuse, and quickly than men.
Psychologic and behavioral risk factors that influence health outcomes presented include physical The most adverse influence on health is socioeconomic activity, nutrition, tobacco use, alcohol and other drug status, with a higher percentage of low-socioeconomic- use, stress and coping, and domestic violence.
Some cur- class members experiencing health-related problems rent theories about health behavior change that can influ- than any other group. Adults with higher incomes tend ence effectiveness of physical therapy interventions will to experience better health and can expect to live more also be discussed. Although clinical lies.
Differences in attitudes toward health have been found This phenomenon of response based on cultural influ- to be greater between social classes than between races or ence is called cultural relativity—that is, behavior must ethnic groups.
Ninety percent of all health care dollars is be judged first in relation to the context of the culture spent on extraordinary care in the last 2 to 3 years of life.
For example, some groups consider This style of death-based medicine assigns the greatest health as a function of luck good or bad , whereas oth- financial and professional resources to treating the dis- ers see health problems as a punishment for bad behavior eases of aging.
The homeless have become one of the fastest growing Cultural factors may also prevent illness. For example, populations in need of health care in the United States. Tra- people belonging to religious faiths that forbid drink- ditionally, the homeless consisted primarily of older, single ing or smoking have lower cancer rates than the general men, often alcoholics, but now this group includes families population.
Religious beliefs related to health must be and children who are runaways or adolescent throwaways.
Research to study the effects Declining public assistance, a shortage of affordable of religiosity as a predictor of outcome in a variety of rental housing, and an increase in poverty are contrib- disorders is beginning to draw definitive conclusions uting factors to the rise in homelessness.
Although esti- about the efficacy of prayer, religious practices and activi- mates of homeless people vary, the National Coalition for ties, and philosophic orientation toward health.
This number includes many of these therapies in keeping with their personal an estimated , children in the United States who beliefs. Dangerous or apparently societal history, and understand and make global connec- counterproductive behaviors can serve a purpose e.
However, baby boomers have treatment of exposed children to reduce self-destructive grown up questioning authority, and their offspring are behaviors, such as smoking, among adolescents and even more likely to consider themselves consumers ask- adults.
For a more complete understanding of the impact ing for treatment rationales, seeking second opinions, of adverse experiences in general, see Chapter 3. Balancing active Treatment Intervention to the Individual and yielding control styles and matching control strate- In the final decades leading to the 21st century, the gies to client control styles and preferences may lead to demographics of the United States changed rapidly, optimal psychosocial adjustment and quality of life in bringing with it a better understanding of the biopsy- the face of life-threatening illnesses.
Keeping an we come to understand the effect individual modify- open mind, asking questions, and respecting cultural ing risk factors have on pathology and recovery.
A differences are other ways to improve health care qual- biopsychosocial-spiritual model is essential because ity and delivery among minority groups. Although the Americans with Disabilities disease.
It is essential to remember that people of any Act has improved access, barriers still exist for many culture may deal with pain, impairment, movement people in receiving full age-appropriate primary care dysfunctions, and disability differently than expected. Disabled individuals, especially disabled The culturally sensitive health professional must women age 65 and older, often do not receive appro- screen for cultural practices, such as fasting or the use priate primary care.
The more severe the disability, of alternative remedies; document these practices; and the less likely a person is to receive adequate care and communicate appropriate information to other mem- undergo health screening.
This education focuses on Homelessness increasing knowledge about the inequalities that Physical therapists are increasingly faced with address- currently exist in health care and in the education of ing the needs of the homeless, who often experience culturally competent and transnational professionals frostbite, poor nutrition and hygiene, fatigue, mental who engage in evidence-based physical therapy that illness, and a host of other minor medical problems.
A third style choices; responses to pain, illness, and disability; of the homeless clients have histories of past and cur- and health practices.
It may be beneficial to adapt the rent alcohol addiction and substance abuse. Knowing what is needed to effectively rehabilitate an individual does Physical Activity not assure success unless provided within a cultural The benefits of physical activity have been recognized and socioeconomic framework acceptable to the indi- since the time of Hippocrates, as evidenced by this quote vidual or family.
In all situations where become thereby healthy, well-developed and age more control may be an issue, the rationale and specifics for slowly; but if unused and left idle they become liable direct intervention must be clearly communicated and to disease, defective in growth, and age quickly. Control, modes of control Physical activity is defined as any bodily movement pro- e.
Med needed. See also Garber CE. Quantity and quality of in the aging adult is ongoing. Exercise, especially when exercise for developing and maintaining cardiorespiratory, musculoskel- performed strenuously, is associated with increased free etal, and neuromotor fitness in apparently healthy adults: guidance for radical formation see Fig. Med Sci Sports Ex 43 7 —, Aging adults face additional problems of decondition- cardiovascular disease, type 2 diabetes, obesity, and osteo- ing or loss of balance and stability as a result of disease porosis and decreases the risk of some types of cancers or illness.
The most successful exercise programs take into e. Some helpful strategies for cardiovascular disease severity in individuals with known facilitating an exercise program whether for a specific cardiovascular disease. Physical inactivity contributes to the status. According to the Aerobic and resistive exercise appear to be associated WHO, there is convincing evidence that physical inactiv- with a decreased risk for type 2 diabetes, even among peo- ity increases the risk of obesity and type 2 diabetes.
In ple at high risk for the disease. Minimum increments of 10 minutes are advised. Provide a brief description of levels of physical activity. Encourage the person to verbalize any Mortality. Physical activity patterns appear to have a thoughts or reactions to your suggestions. Help the individual to set personal goals for exercise. Ask the person to suggest ways to overcome least among women. A clear relationship between fit- pictures because of the potential of undisclosed illiteracy of the proposed exercise program.
Review progress and ness and all-cause mortality and deaths from cardio- reward attempts, successes, and progression of the exercise vascular disease has been established. The greatest improvement in mortal- long-term adherence. The greatest Early investigation of the role of physical activity in mor- benefits to bone mineral density and the incidence of tality compared people in sedentary versus physically osteoporosis appear to come from resistance training.
For example, self-reported health was lower in for breast cancer in physically active women. There is debate over low risk of poor physical function, but strenuous work the optimal amount of exercise needed for health ben- activity increased the risk of poor physical function. Current discussion centers on whether the volume with higher rates of low back pain. Musculoskeletal per- The current recommendation of the U. Surgeon Gen- formance is increasingly linked to improved physical eral indicates that adults gain substantial benefits from function and prevents or modifies disability.
There is evidence disease have been identified: 1 consuming fruits and that physical activity decreases blood pressure, improves vegetables five or more times per day and 2 engaging in lipid profile by decreasing triglycerides and total cholesterol regular physical activity. Despite the importance of physi- while increasing high-density lipoprotein, improves insulin cal activity, only a minority of Americans are meeting sensitivity, and enhances endothelial function, all of which physical activity guidelines.
One and muscles. Learn about the cause of these conditions, the pathogenesis, medical diagnosis and treatment, and most importantly, the special implications for the therapist.
In addition to addressing specific diseases and conditions, this text emphasizes health promotion and disease prevention strategies and covers issues with implications for physical therapy management, such as injury, inflammation, and healing; the lymphatic system; and biopsychosocial—spiritual impacts on health care. Alright, now in this part of the article, you will be able to access the free PDF download of Pathology: Implications for the Physical Therapist 4th Edition PDF using our direct links mentioned at the end of this article.
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