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Physical therapy (PT) is used to provide, develop, maintain and restore movement in an individual throughout his or her lifespan by treating them (patients or clients). They provide services to the aging people and the injured patients (Russon, 2003). Therapeutic program is an exercise where services such as treating and diagnosing patients with abnormal conditions are carried out. It is a flexible program based on the person's health conditions at the time of treatment (Jerome, 1988).  

Either programs or therapies provide services to the patients so as to improve their lifespan. Both of them are involved in interacting with the patients or clients at the health institutions, families and care centers. Physical therapist is exclusively performed by a physiotherapist only while in therapeutic programs; it can be performed by any qualified medical or health officer because it is general in nature (Jerome, 1988).

Physical therapy aims at improving and maximizing people's life spans by treating, habilitating, and rehabilitating them. This entails being concern about the well being of a patient or client in all aspects such as social, emotional, physical and psychological needs (Sirvis, 1988). However, therapeutic program or therapy does offer extra services to their clients such as guiding and counseling, rehabilitation and restoration after treating them. Physical therapists also perform or practice non patient medical care role of interpreting health policies, insurance, and general health care to the independent medical practitioners and patients or clients while therapeutic therapy does not participate in training and facilitating extra programs to their patients or clients (Jerome, 1988).

Academic and professional qualifications of physical therapists are standard all over the world; hence patients or clients get similar services in all countries (Jerome, 1988). On the other hand, therapeutic therapists academic and professional qualifications vary in different countries, hence services vary (they are not standard) (Russon, 2003).

Nagi is a disable scheme that reflects on all abnormalities that may affect the human functioning such as congenital and injury abnormalities. It explains how pathological interruptions that can interfere with normal body functioning can regain its normal state. It handles disabilities ranging from x-rays, acromial shape to fracture healing (Sirvis, 1988).

The International Classification of Impairments, Disabilities and Handicaps (ICIDH) was first published by WHO in 1980 (Sirvis, 1988). It explains the three dimensions of disability framework. These are impairment, disability and handicap. It provides clinical diagnosis, treatment, record keeping and rehabilitation assessment, monitoring the three dimensions and formulation of development programs in the three concepts of handicap, disability and impairment (Sirvis, 1988). They check on environmental factors that need to be improved in the health institutions and to establish international standards for easy coordination with the World Health Organization (WHO) which is the main regulator (Russon, 2003).

The National Center for Medical Rehabilitation Research (NCMRR) main focus is to build integrating cutting edge technologies, research infrastructure and to address rehabilitation research agenda on:

It has an advisory board that assesses its achievement and the possible researches to be conducted so as to enhance quality service provision (Russon, 2003).

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The three bodies are similar in that, they conduct research on various impairments, handicaps and disability and they are recognized by World Health Organization. The three bodies differ on how they are managed and each deal with specific field of impairment or disability. The risk factors include the inability to perform routine tasks and duties, total disability due to lack of professional medication and care and failure to be recognized in the society leading to their isolation and discrimination (Russon, 2003).

Impairment is a condition where a person is unable to perform some routine functions, roles or tasks as a result of malfunctioning or other related factors of impairment (Sirvis, 1988).

Mental health impairment is also known as mental illness. These are mental disorders caused by the alterations in the moods, thinking and behavior linked with stress and distress or malfunctioning of the mind. The common types of impairments include; generalized anxiety disorder, depressive disorder, bipolar disorder, schizophrenia, seasonal affective disorder, post traumatic stress disorder and panic disorder. They can be effectively treated by cognitive behavioral therapy, relaxation techniques and psychotherapy (Sirvis, 1988).

Physical and health impairments include spinal bifida, cerebral palsy, muscular dystrophy and amputations. Some can be temporary handicaps while others are chronic, terminal, progressive or intermittent (Sirvis, 1988). People who are physically impaired can be provided with special equipment such as wheel chairs, positioning devices and wedges among others.

Depression and memory impairments - people who are in a moody or depressed state are normally affected by memory impairment. The attentional resources of these people are neurochemically reduced and the performance impaired. Matters of personal concern cause depression to many people. Such people can attend guiding and counseling sessions for them to be assisted (Sirvis, 1988).

Hearing impairment - these are people who are unable to hear and cannot understand even the loud shouted voice or tones. Moderate hearing impairment persons can hear repeated words shouted to a better ear at a close distance. Slight hearing impairment people can only hear words spoken in a normal voice at a distance of one meter. To solve these hearing impairments, people affected should seek counseling, hearing aides, teaching them lip reading and signing language recommended at all levels of impairment (Sirvis, 1988).

Musculoskeletal diseases affect the bones, muscles, connective tissue and joints. Its symptoms include fatigue, physical functioning limitation and pain (it can be mild or severe). It is associated with emotional impairments such as anxiety, depression and stress. Some of the diseases associated are systemic lupus erythematosus, osteoarthritis, and repetitive strain injury and back pain. They are caused by awkward postures and hazards related to work. They are characterized by cartilage breakdown of the joints and chronic pains at the joints and at the back. They impair some body parts; hence people cannot move or walk to perform their daily chores (Woldt, 2005).

Neuron muscular diseases or disorders are muscles diseases which are hereditary in nature. It weakens the muscles that enable the body to move. They are characterized by muscle protein defects, death of muscles tissues and cells and weak skeletal muscle. These muscular dystrophies include: distal, Becker, limb girdle, congenital, Duchene, emery dreifuss, oculopharyngeal and myotonic (Woldt, 2005). Becker is less severe and weak muscles as Duchene dystrophy and they are caused by partial truncated dytrophin and defective genes. Distal and congenital muscular dystrophy have severe or mild muscle degeneration and restricted skeletal muscles (Sirvis, 1988).

Cardiovascular or heart diseases are associated with blood vessels (arteries and veins taking blood to and fro the heart). Some of these disorders are alcohol and cardiovascular disease, heart failure and heart score. All these diseases affect the liver and the heart causing heart failure and cancers. Physicians have been advising patients who take alcohol to abstain because their body malfunctioning will be impaired. The common symptoms in all heart diseases are the failure of the heart to pump blood and blood vessels swell (Woldt, 2005).

Integumentary systems diseases affect the human body. Some of these diseases include alopecia areata, warts and dermatitis. Warts and dermatitis are characterized by inflammation on the skin, rashes on the skin but warts have a round tumor and red swelling. Psoriasis is characterized by psoriatic plaques, scaly patches and itchy rashes. Alopecia areata is characterized by hair loss on the head and private parts and reddish spots on the skin. All these disorders affect the named parts mentioned, hence malfunctioning them (Woldt, 2005).

Evidence based practices (EBP) is also known as evidenced based medicine (EBM). Its main objective or purpose is to utilize the most appropriate information or researched evidence using a scientific method to make clinical decisions (Sackett and Straus, 2000). This is a scientific approach which can be applied to other disciplines (fields) other than medicine. These fields include: (psychology, dentistry and nursing). This is an encompassing term which is evidence based and it aims at assessing the evidence strength associated with benefits and risks of diagnosis and treatment or lack of it (Sackett and Straus, 2000).

Health care programs depends on many aspects which recognizes evidence based medicine or evidence based practices on personal factors which includes value and quality of life judgment that are not dependent on scientifically proven methods of treatment. However, evidence based practices aim at clarifying some parts of medical practices that are directly linked to scientific methods. These methods are then applied to ensure the best outcomes are predicted for medical treatment as debate about which results are desirable and objective continues to give contradictory outcomes (Sackett and Straus, 2000).

Evidence based guidelines (EBG) and evidence based individual decision making (EBID) are the two types of evidence based practices proposed by medical practitioners. EBID making is practiced by the health care providers because it supports the evidence based medicine principles (Sackett and Straus, 2000). Though the American Academy of Family Physicians (AAFP) have come up with DynaMed which is of more assistance to the family in solving clinical questions, evidence based medicine is still the reference point. EBG is practiced at the organizational level. It is important in decision making decisions which affects the organizations such as regulations, policies, healthcare programs and production guidelines. Clinical decision making therefore relies on evidenced based practices provided (Sackett and Straus, 2000).

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