Question

You are a PTA with 6 years experience working with pediatric patients in an inpatient rehabilitation hospital, and a certified athletic trainer experienced in working with young athletes. You have decided to take a position working with adults in their homes so that you can have more flexibility in your schedule. After receiving an orientation to the paperwork and meeting Yvette, your supervising PT, you are given a stack of charts to review before beginning to provide treatments. While reviewing the chart for Mr. Westerfield, a 76 year old man recovering from a trimaleolar ankle fracture, you notice that his plan of care includes performing joint mobilization of the subtalar and talocrural joints of the ankle. Although you are familiar with normal and pathologic arthrokinematics (accessory joint movement) of these joints, you have been instructed in performance of these techniques. In addition, you are aware that although your state practice act is silent regarding joint mobilization and APTA position statement indicates that this technique is “exclusively performed by the physical therapist.”

Discuss the legal and ethical dilemma presented in Cast study 2.

2. How might your inability to perform this technique adversely affect patient outcomes in this situation? (2 pts) Give 2 answers

Answer 1

#. #. Communication to Yvette :

Being a PTA ,we are not instruceted how to perform joint mobilizations. Although we are aware of the normal and pathologic arthrokinematics (accessory joint movement) but our state practice act has not taught to perform these techniques . Also these are performed by the physical therapist exclusively .

#. The legal and ethical dilemma in the case is that being a PTA you can't perform the joint mobilizations ,it is authorised to be performed only by PA as per the practice act and its considered legal .

#. The inability to perform the joint mobilization has a direct impactt on the patient in a negative way by increasing his time of recovery and early outcome .