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Basic nutrition counseling
Optimal nutrition is essential for healing and repair, immunity, maintaining an optimal body weight as well as providing energy for metabolism. Physical therapists who exploit exercise as a primary therapeutic intervention to prevent, remediate, or mitigate the effects of disease and disability perturb metabolic demands in their clients and patients. Physical therapists need an understanding of metabolism and the factors that influence it, and of healthy nutrition, nutritional assessment, and nutritional regimens to maximize human performance in patient populations. This is often common knowledge for physical therapists who work with athletes, but it is a less common aspect of knowledge and intervention in clients who are not athletes but perform at a maximal capacity on a daily basis. Without this knowledge, assessment and exercise prescription are suboptimal, and in turn, therapeutic outcomes suboptimal. Familiarity with established nutritional guidelines is essential for basic advice. Some individuals will require consultation with nutritionists or dieticians for regimens for specific conditions including significant weight loss and related monitoring and follow-up.Comprehensive care of the individual who is overweight with abnormal blood sugars includes normalization of blood sugar (with recommendation for low glycemic foods and small frequent nutritious snacks rather than infrequent large meals), weight reduction, saturated fat and trans-fat restriction, strict blood pressure and lipid control, regular physical activity and exercise, and avoidance of tobacco (Wilson and Kannel, 2002). The effectiveness of these interventions needs to be monitored like any other component of physical therapy management.
Mental health, stress management, and sleep hygiene recommendations
Mental health has long been known to impact physical well-being and functional capacity, and some argue that contemporary life in high-income countries can negatively affect mental health and well-being (e.g., undue or prolonged unhappiness, anxiety and depression, and associated life skills dysfunction). Optimism is associated with better health outcomes and pessimism with poorer ones. Anxiety and depression impact physical well-being, and conversely illness and chronic conditions adversely impact mental health. Stress is considered a normal part of life, yet chronic unabated stress leads to chronic physical com-plaints. Physical as well as mental ill health can impact sleep health, and in turn impaired sleep can affect physical and mental health. Thus, these aspects of mental health can confound a client or patient’s clinical presentation physically, and their improvement or remediation alone may improve functional capacity and well-being. Thus, early identification and ongoing evaluation of mental health and sleep issues are important. The physical therapist needs to recognize when an individual may need to be referred to a mental health professional or to work together with such a professional to maximize a client’s functional capacity and participation in life. Good health recommendations including physical activity may address certain transient mental health problems, such as stress, anxiety, and some forms of depression either directly or indirectly.
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