Familiar with the term "precision rehabilitation"? If not, now's a good time to get up to speed, because chances are you'll be hearing it — and providing it — more and more as the physical therapy profession enters its second century.
The January issue of APTA's PTJ: Physical Therapy & Rehabilitation Journal, which includes a featured collection focused on precision rehab, is both a good place to start for the unfamiliar and a fascinating resource for providers already acquainted with the concept. The special issue, free to APTA members, includes multiple perspectives and an original research article that shed light on the ways that, as guest editor Richard Shields, PT, PhD, FAPTA, writes, "Everything that a person experiences — from childhood stress, to educational opportunities, to lifestyle habits — converges on their genetic code through the epigenetic code to influence health, disease, and quality of life."
Here are four takeaways from the collection — with links to relevant articles.
1. Precision rehab is about linking behavior to biology to deliver patient-centered care (which should sound familiar to PTs and PTAs).
Shields' editorial sets the stage for why you should be paying attention to this issue of PTJ, while a dive into holistic rehab makes the case that "social adversity can negatively impact our health."
2. Precision rehab breaks unhealthy cycles by dismantling genetics that have been modified through social and behavioral adversity.
The same article that describes how adversity can create changes at the molecular level asserts that providers can counter the damage through a deeper understanding of precision medicine. Another perspective points out how PTs can take an important step toward precision rehab by screening for five "key healthy living behaviors."
3. Physical therapy stands at the intersecting frontiers of biologic, behavioral, and population health research, making it an ideal environment for precision rehab to thrive.
Just about every article in the collection touches on this concept in one way or another, including explorations of the integration of epigenetic and epigenomic understanding within population health concepts, use of the International Classification of Functioning, Disability, and Health model to help harmonize "nature" and "nurture," and the possibility of low-force electrically induced exercise as a way to offer "a more precise rehabilitation strategy" for individuals with chronic paralysis and severe osteoporosis.
4. Precision rehab isn't going away — and it challenges PTs to develop standards for practices ASAP.
The issue's editorial makes the case for the first part of this takeaway, while the perspective on screening provides readers with real-world information on steps toward precision rehab that can and should be taken right away.
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