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

Abstract

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.

Acknowledgments

Clint Wutzke, MS, for his assistance with gait analysis. The child and family for their flexibility and eagerness to improve. The YMCA of Greater Omaha for use of facilities.

Declaration of interest: The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper.