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A survey: Do physical therapists base therapeutic intervention on the reflex/hierarchical or systems model of the central nervous system when working with neurologically impaired patients

1 May 1996


Physical therapists base their assessment and treatment of patients with neurological impairments on their understanding of how movement is controlled. This study investigated if physical therapists are incorporating contemporary theories of the systems model in their understanding of movement control or if the traditional reflex/hierarchical model is still the prevailing framework for therapeutic intervention. A questionnaire was developed to determine. if the respondent's answers were predominantly in the systems or reflex/hierarchical category. Demographic questions were included to determine if years of practice, patient population, degrees earned, geographic location, year of graduation, and special certifications had a significant influence on the outcome. The questionnaire was mailed to 500 physical therapists and of the 196 returned, 175 were used in the data analysis. A significant difference was found between the number of therapists who chose a preponderance of reflex/hierarchical versus systems model responses (p=.00011. No statistically significant correlations were found for the demographic questions. Although the results indicate the reflex/hierarchical model is the major influence on therapeutic intervention with neurologically impaired patients, this report found indications that the systems model was beginning to be incorporated into clinical practice.


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