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Arch Hellen Med, 33(4), July-August 2016, 447-457


Clinical reasoning in neurological physiotherapy
A framework for the management of patients with movement disorders

Z. Dimitriadis,1,2 V. Skoutelis,1 E. Tsipra3
1Department of Physiotherapy, School of Health and Caring Professions, Technological Educational Institute of Athens, Athens, Greece
2Department of Physiotherapy, School of Sciences, European University of Cyprus, Nicosia, Cyprus
3Laboratory of Physiotherapy, Athens, Greece

Neurological physiotherapy is a scientific field which has evolved considerably over recent decades. This advancement is based to a great extent on the simultaneous increase in knowledge about neuroscience, motor control and motor (re)learning, which has led to the development of further assessment and treatment techniques and new considerations for practice, necessitating sound clinical reasoning and well-structured management for their appropriate incorporation into clinical practice. Although the current literature provides information regarding clinical reasoning and decision-making in physiotherapy, few articles discuss these matters in relation to patients with neurological disorders. This article presents a framework for the management of patients with neurological disorders and develops the rationale for establishing treatment goals. The model described places function as the basis for establishing treatment goals, highlights the importance of the views of the patients and their carers in clinical decision-making and supports individualization of treatment, with flexibility in the incorporation of the assessment/ treatment strategies of many clinical schools of thought. It is hoped that this model will be a useful addition to current knowledge and provide a guide for the clinical reasoning and decision-making of current and future clinicians.

Key words: Activity-based, Clinical reasoning, Decision-making, Elective approach, Functional approach.

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