Genetics in Physical Therapy Overview

Advances in the biological underpinnings of medical science are precipitously altering the understanding of the roots of disease, bringing about an increasing number of innovative interventions and influencing primary prevention, all of which have ever-growing implications for the physical therapist. As an example of work in this area with direct implications to our practice are the findings of The Twin Spine Study1,2,3 that shifts our understanding of the etiology of disc degeneration away from mechanical factors and more toward its genetic determinants. In fact, heritability* of responses to measures standardly included in the physical therapy examination, such as lumbar flexion range of motion (.64), have been found to be quite high.1 Similarly, genetic influences on physical performance characteristics are garnering increasing attention.3 These are but only a mere few examples of this body literature relevant to our field that grows exponentially daily.

Not only do advances in this genomic era promise to alter our understanding of physiological processes, but these advances also have ethical and societal implications for the practicing clinician, such as those related to genetic testing and the passage of the Genetic Information Nondiscrimination Act4 and the 2010 Patient Protection and Affordable Care Act. In fact, the National Coalition for Health Professional Education in Genetics6 has created a list of Core Competencies in Genetics for All Heath Care Professionals that outline recommendations to encourage clinicians and other professionals to integrate genetics knowledge, skills, and attitudes into current clinical practice and education.

*Heritability of a trait is that proportion of total phenotypic variance that is attributable to genetic variation. Heritability estimates range from 0% (no genetic influence on a trait) to 100% (complete determination by genes).5 

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References

*Heritability of a trait is that proportion of total phenotypic variance that is attributable to genetic variation. Heritability estimates range from 0% (no genetic influence on a trait) to 100% (complete determination by genes).5

1. Battie MC, Videman T & Parent E. Lumbar disc degeneration: Epidemiology and genetic influences. Spine; 2004: 29(23), 2679-2690.

2. Battie MC, Levalahti E, Videman T, Burton K, Kaprio J. Heritability of lumbar flexibility and the role of disc degeneration and body weight. J Appl Physiol. 2008;104:379-385.

3. Battie MC et al. The twin spine study: Contributions to a changing view of disc degeneration. Spine Journal; 2009: 29, 47-59.

4. Ostrander EA, Huson HJ, Ostrander GK. Genetics of athletic performance. Annu Rev Genomics Hum Genet; 2009: 10, 407-429.

5. National Human Genome Research Institute: http://www.genome.gov/ (Accessed January 9, 2012)

6. National Coalition for Health Professional Education in Genetics: http://www.nchpeg.org/ (Accessed January 9, 2012)

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