Physical Therapy

I

Introduction

Physical Therapy, scientific physical procedures used in the treatment of patients with a disability, disease, or injury to achieve and maintain functional rehabilitation and to prevent malfunction or deformity. Treatments are designed to minimize residual physical disability, to hasten convalescence, and to contribute to the patient's comfort and well-being. Physical therapy is prescribed for patients with varied orthopedic, neurological, vascular, and respiratory conditions, which may be the result of congenital malfunction, disability acquired through disease or trauma, or inherited dysfunction. Physical therapists are employed in hospitals, rehabilitation centers, clinics, nursing homes, and schools for handicapped children; in federal, state, and local health agencies; and in private practice. In addition to direct patient care, physical therapists are involved in other areas including consultation, supervision, teaching, administration, and research.

II

Types of Treatment

Among the diagnostic tests used by the physical therapist are manual muscle testing, electrical testing, perceptual and sensory testing, and measurement of the range of motion of joints. Functional activity testing is important in ascertaining patients' capabilities for performing the necessary tasks of caring for themselves. In treating a patient, the physical therapist may employ one or more of the following procedures: heat treatments involving the use of water at various temperatures, melted paraffin wax, infrared and ultraviolet lamps, ultrasonic waves that produce heat internally (see Ultrasonics), and diathermy (application of electric current to generate heat in body tissues). One of the most important tasks of the physical therapist is therapeutic exercise in various forms. It is used to increase strength and endurance, to improve coordination, to improve functional movement for activities of daily living, and to increase and maintain range of motion. Gait training is practiced with the assistance of canes, crutches, walkers, braces, and artificial limbs. Physical therapy also uses massage, bandaging, strapping, and application and removal of splints and casts. Physical therapists instruct patients and their relatives in techniques of exercise and the use of prosthetic devices, such as artificial limbs, and orthotic, or bracing, devices.

III

History

Most of the physical agents employed in modern physical therapy were used in ancient times. Early Greek and Roman writings refer to the beneficial effects of sun and water, and both exercise and massage were used by the ancient Chinese, Persians, Egyptians, and Greeks.

The field of physical therapy in modern times was established in Britain in the latter part of the 19th century. Shortly thereafter American orthopedic surgeons began to train young women graduates of physical-education schools to care for patients in doctors' offices and in hospitals. These young women treated thousands of patients in 1916 when a severe epidemic of poliomyelitis struck New York and New England. The first school of physical therapy was established at Walter Reed Army Hospital, Washington, D.C., after the outbreak of World War I, and 14 additional schools were established soon afterward. About 800 therapists, called reconstruction aides, were trained and utilized in military service.

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After World War II physical therapy became widely used in the care of patients. Among the reasons for the great increase in demand for physical-therapy services were the impressive results obtained in treating those injured in battle and industry during World War II and the Korean and Vietnam wars; the increase in chronic disability resulting from the larger number of older persons in the population; and the rapid development of hospital- and medical-care programs.

IV

Education and Training

The Council on Medical Education of the American Medical Association in collaboration with the American Physical Therapy Association provides accreditation and establishes standards for physical therapy education and practice. Certified programs include training for physical therapist assistants and physical therapists. Licensing or registration is required for practice in almost all states and in Puerto Rico.

Physical therapist assistant programs are generally two-year programs combining course work and clinical experience. Courses vary in each program, but may include topics such as anatomy, kinesiology, patient care skills, clinical sciences, and advanced therapeutic exercises.

To become a physical therapist, one must enter either a Master in Physical Therapy (MPT) or Doctor of Physical Therapy (DPT) program at an accredited institution. Programs last from two to three years. In all these programs students take courses in the basic physical sciences, including physics, chemistry, and mathematics; the basic health sciences, including human anatomy, physiology, kinesiology, psychology, and pathology; the clinical sciences, including principles and practice of physical therapy, clinical medicine, and surgery; and the clinical arts, including the administration of therapeutic procedures to patients. DPT programs offer more in-depth study of these subjects as well as courses in pharmacology, radiology, and histology.

See also Occupational Therapy; Rehabilitation, Vocational.

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