The Physical therapy reference article from the English Wikipedia on 24-Jul-2004
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Physical therapy

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Physiotherapists (also known as Physical therapists in the United States and Canada) provide therapy intended to help restore function, improve mobility, relieve pain, and prevent or limit permanent physical disabilities of patients suffering from injuries or disease. Treatment aims to restore, maintain, and promote overall fitness and health. They treat conditions in patients that include accident victims and individuals with disabling conditions such as low back pain, arthritis, heart disease, fracture (bone)s, head injuries, and cerebral palsy.

A physiotherapist can function either privately (as in a private practice) or publicly (in a hospital setting). There are fundamental differences between the two but as these are concerned mainly with the types of conditions seen, time to discharge and the obvious financial issue, they can be ignored. Some physical therapists treat a wide range of conditions, while others specialize in certain fields such as pediatrics, geriatrics, orthopedics, sports medicine, neurology, and cardiopulmonary physical therapy.

Table of contents
1 Assessment
2 Treatment
3 Training
4 Teamwork
5 Qualifications in the United States

Assessment

A therapist will initially conduct a subjective examination (interview) of a patients' medical history, and then go on to the objective assessment. A good interview will allow the therapist to eliminate many possible causes of the problem, as well as to narrow down the symptomatic structures. The objective exam will then use certain quantifiable measurements to determine the exact nature of the problem . These include assessment of posture, muscle strength and flexibility, joint range of motion, balance and coordination, respiration, and motor function.

Treatment

The therapist will then develop a plan of treatment, describing a treatment strategy, purpose and anticipated outcome. There are various therapeutic modalities available to the physiotherapist, including education, exercise, manual techniques, soft tissue massage, cryotherapy, heat therapy and electrotherapy. The benefits of electrotherapy are widely debated, with research supporting both sides of the argument. Many therapists will choose to use or avoid a specific modality based on their own clinical experience of it. Therapists will also teach patients to use assistive and adaptive devices such as crutches, prostheses, and wheelchairs. As treatment continues, physical therapists document progress, conduct periodic examinations, and modify treatments when necessary. Such documentation is used to track the patient's progress, and identify areas requiring more or less attention. A patient will sometimes be discharged from the care of the physiotherapist with a home exercise programme, if the therapist feels they have little to benefit from visits to the practice.

Training

A physiotherapy degree is usually undertaken over a 4 year period, with the first 2 and a half years being mainly theoretical. During the third year, students will find themselves in increasingly applied situations, with the entirety of the fourth year based in a clinical setting (e.g. hospital). Some tertiary institutions recognize the (BSc.) Physiotherapy degree to be an Honours degree, since the fourth year includes a research project.In the United States an undergraduate student they will not major in physical therapy but in a science related course such as biology or physics. Once they finish their undergraduate degree they must be accepted into a graduate program specializing in physical therapy. There a physical therapist will learn how to treat conditions in people ranging from children (paediatrics) to elderly people (geriatrics).

Teamwork

A common but incorrect belief is that physiotherapists prepare patients for reintegration into their work or home environments. This is more commonly the goal of Occupational therapists, although there is considerable overlap with regard the therapies. This is one of the reasons that physiotherapists are generally seen as being part of a larger, multi-disciplinary team involving physicians, nurses, educators, social workers, occupational therapists, speech and language therapists, dieticians and audiologists.

In the United States, experienced physical therapists can apply to take a specialty exam to earn board certification in any of seven sub-specialty areas: Cardiovascular and Pulmonary, Clinical Electrophysiologic, Geriatric, Neurologic, Orthopaedic, Pediatric, and Sports physical therapy. Therapists who have board certification will have a designation such as "OCS" (Orthopedic certified specialist) after their names. You can search a directory of accredited specialists on the APTA website: http://www.apta.org/Education/specialist/dir_cert_cln_pt-85-97

A number of physical therapists have found the Alexander Technique, acupuncture, aromatherapy and reflexology to be a useful tool to incorporate into their practice. There are probably as many who find such alternative methods to be lacking in empirical evidence and therefore avoid them.

Physical therapist assistants, under the direction and supervision of a physical therapist, may be involved in the implementation of the treatment plan. Physical therapist aides perform routine support tasks, as directed by the therapist.

Qualifications in the United States

All States (in the United States) require physical therapists to pass a licensure exam after graduating from an accredited physical therapist educational program before they can practice.

According to the American Physical Therapy Association, there were 189 accredited physical therapist programs in 1999. Of the accredited programs, 24 offered bachelor's degrees, 157 offered master's degrees, and 8 offered doctoral degrees. By 2002, all physical therapist programs seeking accreditation will be 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 such as kinesiology, biomechanics, neuroanatomy, human growth and development, manifestations of disease, examination techniques, and therapeutic procedures. Besides classroom and laboratory instruction, students receive supervised clinical experience. Individuals who have a 4-year degree in another field and want to be a physical therapist, should enroll in a master's or a doctoral level physical therapist educational program.

Competition for entrance into physical therapist educational programs is very intense, so interested students should attain superior grades in high school and college, especially in science courses. Courses useful when applying to physical therapist educational programs include 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 to successfully educate patients about their physical therapy treatments. They should also be compassionate and possess a desire to help patients. Similar traits are also needed to interact with the patient's family.

Physical therapists are expected to continue professional development by participating in continuing education courses and workshops. A number of States require continuing education to maintain licensure.


Note: There are many overlapping areas in physiotherapy, occupational therapy and respiratory therapy. The US and Canada are two of only a few countries whose physiotherapists are not also trained in respiratory therapy.