General Info
Excerpt from the Journal of the American Physical Therapy Association, (APTA), Nov. 1997, Vol. 77, No. 11
Physical Therapists (PTs) are professionally educated at the college or university level and are required to be licensed in the state or states in which they practice. The Commission on Accreditation in Physical Therapy Education will limit accreditation in 2002 to only those professional programs that award the postbaccalaureate degree.
PTs practice in a broad range of inpatient, outpatient and community-based settings including the following, in order of most common setting:
Hospitals (critical care, intensive care, acute care and subacute care)
- Oupatient clinics or offices
- Rehabilitation Facilities
- Skilled nursing, extended care, or subacute facilities
- Homes
- Education or research centers
- Schools and playgrounds (preschool, primary and secondary)
- Hospices
- Corporate or industrial health centers
- Industrial, workplace, or other occupational environments
- Athletic facilities (collegiate, amatuer and professional)
- Fitness centers and sports training facilities
PT is the care and services provided by or under the direction of a PT. APTA emphasizes that an examination, evaluation or intervention - unless provided by a PT or under the direction of a PT - is not physical therapy, nor should it be represented or reimbursed as such.
Physical Therapists:
Provide services to patients/clients who have impairments, functional limitations, disabilities, or changes in physical function and health status resulting from injury, disease, or other causes.
- Interact and practice in collaboration with a variety of professionals including physicians, dentists, nurses, educators, social workers, occupational therapists, speech-language pathologists, and audiologists. PTs acknowledge the need to educate and inform other professionals, government agencies, third-party payers (eg insurance), and other health care consumers about the cost-efficient and clinically effective services that PTs render.
- Provide prevention and wellness services, including screening and health promotion.
- Consult, educate, engage in critical inquiry, and administrate.
- Direct and supervise physical therapy services, including support personnel
The PT integrates five elements of patient/client management - examination, evaluation, diagnosis, prognosis, and intervention - in a manner designed to maximize outcomes. Examination, evaluation and establishment of a diagnosis and a prognosis are all part of the process that guides the therapist in determining the most appropriate intervention.
Examination: The process of obtaining a history, performing relevant systems reviews, and selecting and administering specific tests and measures to obtain data.
- Evaluation: A dynamic process in which the PT makes clinical judgements based on data gathered during the examination.
- Diagnosis: Both the process and the end result of evaluating information obtained from the examination, which the PT then organizes into defined clusters, syndromes, or categories to help determine the most appropriate intervention strategies.
- Prognosis: Determination of the level of optimal improvement that might be attained through intervention and the amount of time required to reach that level.
- Intervention: Purposeful and skilled interaction of the PT with the patient/client and, if appropriate, with other individuals involved in care of the patient/client, using various PT methods and techniques to produce changes in the condition that are consistent with the diagnosis and prognosis.
- Outcomes: Results of patient/client management, which include remediation of functional limitation and disability, optimization of patient/client satisfaction, and primary or secondary prevention.
Intervention is the purposeful and skilled interaction of the PT with the patient/client related instruction. Decisions about intervention are contingent of the timely monitoring of patient/client response and the progress made toward desired outcomes. PT intervention has three components: coordination, communication and documentation; patient/client-related instruction; and direct interventions.
Coordination, communication and documentation: These services, which are provided for all patients/clients, may include case management; communication (direct or indirect); coordination of care with the patient/client, family, significant others, caregivers, other professionals, and other interested persons; discharge planning; documentation of all elements of patient/client management; education plans; patient care conferences; record reviews; and referrals to other professionals or resources. Through these services, the PT ensures appropriate, coordinated, comprehensive, and cost-effective services between admission and discharge and cost-effective and effecient integration or reintegration to home, community, and work (job, school, play), and leisure environments.
- Patient/Client-related instruction: These services, which are provided to all patients/clients, may include computer-assisted instruction, demonstration by patient/client or caregivers in the appropriate environment, periodic reexamination ad reassessment of the home program, use of audiovisual aids for both teaching and home reference, use of demonstration and modeling for teaching, verbal instruction, and written or pictorial instruction. The PT uses these services to educate the patient/client - and also the family, significant others, caregivers, or other professionals - about the current condition, plan of care, and future transition to home, work, or community roles. The PT may include information and training in activities for maintenance of function and primary and secondary prevention. The educational backgrounds, needs and learning styles of individuals must be taken into account during this process.
- Direct interventions: The PT selects, applies, or modifies direct interventions based on examination and evaluation data, the diagnosis and the prognosis, and the anticipated goals and desired outcomes for a particular patient in a specific patient/client diagnostic group. Forming the core of most PT plans of care: therapuetic exercise, including aerobic conditioning; functional training in self-care and home mangement activities; functional training in community and work and integration or reintegration, including work hardening; manual therapy techniques; prescription, application and as appropriate, fabrication of devices and equipment (adaptive, orthotic, protective, supportive, prosthetic); airway clearance techniques; wound management; electrotherapeutic modalities; physical agents and mechanial modalities
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