Why physical/ functional diagnosis is utter nonsense
What is physical diagnosis?
Physiotherapy has coined the term "physical diagnosis" or "functional diagnosis," which refers to identifying specific impairments or movement dysfunctions believed to be contributing to activity limitations or pain. Essentially, it involves assessing and understanding how certain movements and its context issues may be impacting a person's ability to perform activities or pain,
Why was it developed?
The development of "physical diagnosis" or "functional diagnosis" in physiotherapy can be attributed to a combination of political and biological justifications. During the renaissance of manual therapy, practitioners were eager to identify new causal variables, and the concept emerged as a clever and somewhat strategic marketing tactic. Edwards combined movement theory to Sherly Sharman’s theories of movements are the movies which were released in this era. In North America, there was a desire to establish a distinctive diagnosis to enable first-contact practices and justify higher charges for services. This not only served practical purposes but also contributed to boosting professional esteem by emphasizing the ability to discern unique issues and asserting a sense of mastery in the field.
In India, the introduction of "physical diagnosis" or "functional diagnosis" in physiotherapy followed a trend of uncritical acceptance. Several universities incorporated these concepts into their curricula, eventually leading to their inclusion in the national curriculum. (by the way i think the whole thing is retrograde and just sad piece of document).
Why is physical or functional diagnosis a joke?
The simple answer is impairment is not linearly related to activity limitation or pain. In the context of low back pain, enhancing flexion or flexion combined with rotation does not necessarily translate to improved disability. Additionally, impairment is essentially just that—impairment, not a comprehensive diagnosis. Similar to parameters like RBC count or oxygen levels, knee flexion is an impairment, rendering the introduction of another seemingly unnecessary terminology.
In the biology, the demand is for complexity, not irrational reductionism. Complex systems, as widely acknowledged, necessitate holistic study and treatment for effective outcomes. Unfortunately, there appears to be a reluctance to embrace this comprehensive approach.
Moreover, scrutinizing research and guidelines reveals a focus on conditions like osteoarthritis of the knee, low back pain, or post-stroke rehabilitation, as opposed to addressing fabricated movement dysfunctions. This discrepancy further highlights the questionable utility and relevance of the terminology in question.
Stop this madness, we are part of medical team, we all need to have same nomenclature and end point for the treatment. We have to differentiate our self not by making shit up but proving the effectiveness of PT. We need go back to our roots- we are a profession for the betterment of our patient not making shit up to boost our ego.