Harris Susan R, Winstein Carolee J
Department of Physical Therapy (Dr Harris), Faculty of Medicine, University of British Columbia, Vancouver, Canada; and Division of Biokinesiology & Physical Therapy, and Department of Neurology, Keck School of Medicine (Dr Winstein), and Motor Behavior & Neurorehabilitation Laboratory, Ostrow School of Dentistry, University of Southern California, Los Angeles.
Pediatr Phys Ther. 2017 Jul;29 Suppl 3:S2-S9. doi: 10.1097/PEP.0000000000000376.
To present the history and aims of the STEP conferences; describe the interdependence of prevention, prediction, plasticity, and participation; reflect on where we stand today regarding those 4 Ps; and discuss how future neurorehabilitation should look for individuals with movement disorders.
Physical therapists have focused primarily on tertiary prevention, emphasizing primary/secondary prevention far less. Predicting optimal response to intervention is essential for primary prevention. Research examining neurorehabilitation effects mediated by brain plasticity is evolving from an emphasis on impairment outcomes toward examination of participation outcomes. CLINICAL PRACTICE RECOMMENDATIONS:: (1) Capitalize on primary and secondary prevention. (2) Administer simple, environmentally relevant predictive measures. (3) Partner with researchers to examine exercise-induced brain plasticity effects via neuroimaging. (4) Encourage physical activity to promote secondary prevention of lifestyle-related diseases and enhance participation. (5) Integrate psychological/social sciences with physiological sciences to move forward with advances in mindful health and patient-centered practices.
