Physical therapy



by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

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From the American Physical Therapy Association



Physical therapists (PTs) provide services that help restore function, improve mobility, relieve pain, and prevent or limit permanent physical disabilities of patients suffering from injuries or disease.

They restore, maintain, and promote overall fitness and health. Their patients include accident victims and individuals with disabling conditions such as low-back pain, arthritis, heart disease, fractures, head injuries, and cerebral palsy.

Therapists examine patients’ medical histories and then test and measure the patients’ strength, range of motion, balance and coordination, posture, muscle performance, respiration, and motor function. They also determine patients’ ability to be independent and reintegrate into the community or workplace after injury or illness. Next, physical therapists develop treatment plans describing a treatment strategy, its purpose, and its anticipated outcome. Physical therapist assistants, under the direction and supervision of a physical therapist, may be involved in implementing treatment plans with patients. Physical therapist aides perform routine support tasks, as directed by the therapist.

Treatment often includes exercise for patients who have been immobilized and lack flexibility, strength, or endurance. Physical therapists encourage patients to use their own muscles to increase their flexibility and range of motion before finally advancing to other exercises that improve strength, balance, coordination, and endurance. The goal is to improve how an individual functions at work and at home.

Physical therapists also use electrical stimulation, hot packs or cold compresses, and ultrasound to relieve pain and reduce swelling. They may use traction or deep-tissue massage to relieve pain. Therapists also teach patients to use assistive and adaptive devices, such as crutches, prostheses, and wheelchairs. They also may show patients exercises to do at home to expedite their recovery.

As treatment continues, physical therapists document the patient’s progress, conduct periodic examinations, and modify treatments when necessary. Besides tracking the patient’s progress, such documentation identifies areas requiring more or less attention.

Physical therapists often consult and practice with a variety of other professionals, such as physicians, dentists, nurses, educators, social workers, occupational therapists, speech-language pathologists, and audiologists.

Some physical therapists treat a wide range of ailments; others specialize in areas such as pediatrics, geriatrics, orthopedics, sports medicine, neurology, and cardiopulmonary physical therapy.

Physical therapists practice in hospitals, clinics, and private offices that have specially equipped facilities, or they treat patients in hospital rooms, homes, or schools.

In 2002, most full-time physical therapists worked a 40-hour week; some worked evenings and weekends to fit their patients’ schedules. More than 1 in 5 physical therapists worked part time. The job can be physically demanding because therapists often have to stoop, kneel, crouch, lift, and stand for long periods. In addition, physical therapists move heavy equipment and lift patients or help them turn, stand, or walk.

Physical therapists held about 137,000 jobs in 2002. The number of jobs is greater than the number of practicing physical therapists, because some physical therapists hold two or more jobs. For example, some may work in a private practice, but also work part time in another healthcare facility.

About two-thirds of jobs for physical therapists were either in hospitals or in offices of other health practitioners (which includes offices of physical therapists). Other jobs were in home healthcare services, nursing care facilities, outpatient care centers, and offices of physicians.

Some physical therapists were self-employed in private practices, seeing individual patients and contracting to provide services in hospitals, rehabilitation centers, nursing care facilities, home healthcare agencies, adult daycare programs, and schools. Physical therapists also teach in academic institutions and conduct research.

All states require physical therapists to pass a licensure exam before they can practice, after graduating from an accredited physical therapist educational program.

According to the American Physical Therapy Association, there were 203 accredited physical therapist programs in 2003. Of the accredited programs, 113 offered master’s degrees, and 90 offered doctoral degrees. All physical therapist programs seeking accreditation are required to offer degrees at the master’s degree level and above, in accordance with the Commission on Accreditation in Physical Therapy Education.

Physical therapist programs start with basic science courses such as biology, chemistry, and physics and then introduce specialized courses, including biomechanics, neuroanatomy, human growth and development, manifestations of disease, examination techniques, and therapeutic procedures. Besides getting classroom and laboratory instruction, students receive supervised clinical experience. Among the courses that are useful when one applies to a physical therapist educational program are anatomy, biology, chemistry, social science, mathematics, and physics. Before granting admission, many professional education programs require experience as a volunteer in a physical therapy department of a hospital or clinic.

Physical therapists should have strong interpersonal skills in order to be able to educate patients about their physical therapy treatments. PTs also should be compassionate and possess a desire to help patients. Similar traits are needed to interact with the patient’s family.

Physical therapists are expected to continue their professional development by participating in continuing education courses and workshops. In fact, a number of States require continuing education as a condition of maintaining one’s licensure.




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