What’s in a Name?
Diagnosis as Classification
Gait/Walk Distance Dysfunction
Associated with COPD
Does the title identify a homogeneous group?
Does the title reflect, “what’s wrong”?
Label implies the COPD is the factor that affects
the gait and/or distance walked (Essentialism).
Label may also imply that the diagnostic exam
was a “Gait/Walk Distance Test”
Are there “gold standard” diagnostic tests?
Does this “Diagnosis” direct treatment/broadness
of the category?
Pusher Syndrome (Nominalist)
Is the group discrete/homogeneous?
Does it meet the definition of a “Syndrome” eg.
Signs, symptoms, clinical tests to rule in/out
Use of a “known term”/helpful or not?
Is this a Movement System Syndrome?
Is there relevance of this classification to natural
history, prognosis, intervention for this group?
Loss of Skin Integrity Associated
with Venous Stasis
Does the title describe the group
Are the tests to identify and classify the patients
w/in scope of PT Practice?
Classified as a Movement System Dx?
Label identifies cause and/or directs treatment
specific to this diagnosis?
What do YOU think?
Diagnosis as Process to Classify
Label Example: Gait Distance Dysfunction
Associated with Intermittent Claudication
The diagnostic process uses history, signs and symptoms,
tests and measures to identify common findings that can
classify patients into groups to be labeled similarly
What is the dysfunction…is the Gait the problem?
Label implies the Intermittent Claudication is the factor that
limits the gait and/or distance.
Label may also imply that the diagnostic exam was a “Gait
Change title to “Walk Distance Dysfunction”?
Diagnosis Label With Model Language
Example: Gait Distance Dysfunction Associated
with Chronic Obstructive Pulmonary Disease
Considering existing models, (eg Nagi, NCMRR,
ICF), this could be classified as a mobility related
“activity/participation” diagnosis assoc/pathology
Does this diagnostic label direct treatment?
Can we identify the cluster of signs, symptoms
and test findings that would classify the patients
that belong in this group?
Example: Loss of Skin Integrity Associated
with Venous Stasis
Does this title allow the PT to group patients by
common impairment, (eg loss of integrity), and
identify the causal factor?
Does the title direct how the PT plans the
treatment program, (eg. differently for this group
when compared to loss of integrity for a different
Can PT intervention address/correct the problem?
Screening for Diagnosis
Example: Loss of Joint Mobility
Associated with Hypertrophic Scar
Screening implies ruling in and out
through diagnostic testing to classify
Title implies a general category of
impairment and a causative pathology
Does title direct treatment planning and