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The leading cause of morbidity and mortality in the United States is chronic, or noncommunicable, diseases. The impact of chronic diseases on health and wellness can be significantly altered by individual health and behavior choices or modifications. Furthermore, the burden of chronic disease goes beyond health and the health care system and may influence an individual's wellness. The purposes of this article are: (1) to provide a basis for understanding the terms "health" and "wellness," (2) to identify the knowledge and skills physical therapists need to address behaviors that promote health and wellness and treat and protect against chronic disease, and (3) to discuss barriers and opportunities associated with integrating the promotion of health and wellness into physical therapist practice.
Noncommunicable diseases (NCDs), also called lifestyle or chronic diseases, are the major cause of morbidity and mortality in the United States and in most countries around the world.1,2 Noncommunicable diseases, such as heart disease and stroke, cancer, diabetes, and lung disease, negatively affect millions of people worldwide and cost billions of dollars annually in treatment and loss of productivity.1,2 Because these diseases are strongly associated with risk factors or behaviors, such as physical inactivity, unhealthy diet, and tobacco use, they are largely preventable.1-3 Yet, the medical system in the United States continues to be oriented toward treating illness and disease, rather than prevention or wellness, and the incidence and prevalence of lifestyle diseases continue to grow. As a result, the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) have labeled lifestyle diseases both epidemic and pandemic and have identified the need for the development of new solutions to address this growing problem.1-3 A call to action has been issued for all health care providers to address these health concerns with their patients and clients in order to better manage health and health care costs.4
Physical therapists are in an ideal position to promote health and wellness in their patients and clients.5 Physical therapists can reduce risk factors and prevent and treat NCDs by providing patient and client education; prescribing physical activity and exercise; and performing noninvasive, hands-on interventions consistent with a biopsychosocial paradigm.6,7 However, patients and clients often fail to recognize the role of the physical therapist in promoting...