Describing the clinical reasoning process: application of a model of enablement to a pediatric case

Physiother Theory Pract. 2013 Apr;29(3):222-31. doi: 10.3109/09593985.2012.727204. Epub 2012 Oct 4.


Background and purpose: Clinical reasoning is a core tenet of physical therapy practice leading to optimal patient care. The purpose of this case was to describe the outcomes, subjective experience, and reflective clinical reasoning process for a child with cerebral palsy using the International Classification of Functioning, Disability, and Health (ICF) model.

Case description: Application of the ICF framework to a 9-year-old boy with spastic triplegic cerebral palsy was utilized to capture the interwoven factors present in this case. Interventions in the pool occurred twice weekly for 1 h over a 10-week period.

Outcomes: Immediately post and 4 months post-intervention, the child made functional and meaningful gains. The family unit also developed an enjoyment of exercising together. Each individual family member described psychological, emotional, or physical health improvements.

Discussion: Reflection using the ICF model as a framework to discuss clinical reasoning can highlight important factors contributing to effective patient management.

Publication types

  • Case Reports

MeSH terms

  • Activities of Daily Living
  • Cerebral Palsy / diagnosis
  • Cerebral Palsy / physiopathology
  • Cerebral Palsy / psychology
  • Cerebral Palsy / rehabilitation*
  • Child
  • Decision Support Techniques*
  • Disability Evaluation
  • Emotions
  • Family Relations
  • Health Status Indicators*
  • Humans
  • Male
  • Muscle Spasticity
  • Muscle, Skeletal / physiopathology*
  • Physical Therapy Modalities*
  • Quality of Life
  • Recovery of Function
  • Swimming*
  • Time Factors
  • Treatment Outcome