Physical Therapy/Rehabilitation

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The goals of physical therapy (PT), also called physiotherapy, are to promote health; restore function and movement; and prevent disability from aging, pain, disease, or injury (trauma).

Physical therapists use physical methods, such as exercise, heat, cold, and massage, to strengthen muscles, improve circulation and motion, and help patients regain the ability to perform daily activities (e.g., dressing, eating, bathing).

Physical therapy is used to manage a number of chronic conditions, including the following:

• Arthritis
• Back pain and neck pain
• Incontinence
• Knee pain and shoulder pain
• Lung conditions (e.g., chronic obstructive pulmonary disease [COPD], cystic fibrosis)
• Migraine headache
• Neurological conditions (e.g., cerebral palsy, multiple sclerosis)
• Spinal deformities (e.g., spina bifida, scoliosis)

Physical therapy/rehabilitation often is used following surgery, and can be an important part of recovery for patients who have experienced heart attack or stroke. It also may be used to treat patients who have been involved in an accident or suffered another type of injury (e.g., TBI, spinal cord injury, sports-related injury [broken bone; muscle, ligament, or tendon damage]).

Physical therapy can be provided in a number of different settings, often depending on whether it is designed to promote health, to prevent disability, or to provide treatment. It may be performed at home, in a school or sports facility, or at a physical therapist's office. Physical therapy also may be performed at an outpatient facility (e.g., hospital, clinic) or at a long-term care facility.

Physical Therapist

A physical therapist, also called a registered physical therapist, is a licensed health care provider who evaluates and conducts physical therapy for patients who have medical conditions that cause pain and/or limit movement and function. Physical therapists (PTs) use exercise and other physical means (e.g., heat, cold, massage, electrical stimulation, ultrasound).

Physical therapists also develop programs that promote healthy and active lifestyles. They often work with other health care providers, including physicians, nurses, social workers, occupational therapists, and speech and hearing specialists.

Education and Training
Physical therapists must have a master's degree or doctorate from a physical therapist education program. They then must be licensed in the state in which they wish to practice. To remain licensed, physical therapists often are required to take continuing medical education (CME) courses and attend workshops. Education and training includes classes in the following:

• Biology
• Biomechanics
• Chemistry
• Examination techniques and methods
• Human growth and development
• Neuro-anatomy
• Physics
• Therapy procedures

Some physical therapists treat a variety of conditions and others specialize in areas such as pediatrics, geriatrics, orthopedics, sports medicine, neurology, and cardiopulmonary physical therapy.

Physical therapist assistants work under the supervision of a physical therapist. They conduct therapy (e.g., exercise, massage, electrical stimulation, ultrasound), record the patient's responses, and report to the physical therapist.

Assessment
To assess the patient's condition, the physical therapist takes a family and personal medical history and performs a physical examination. The results of the examination are used to develop a treatment plan and to monitor the patient's progress.

Areas that are assessed depend on the patient's condition and include the following:

• Balance and coordination
• Breathing (respiration)
• Motor control
• Muscle strength
• Posture (body position)
• Range of motion

Diagnostic tests can be used to assess the function of the brain, heart, lung, muscles, and nerves. These tests include imaging tests (e.g., x-rays, magnetic resonance imaging [MRI scan]), electromyography (EMG), nerve conduction velocity (NCV) studies, and electrocardiogram (ECG or EKG).

Types of Treatment

A number of treatment methods are used in physical therapy. Exercise, massage, and joint manipulation can be used to reduce pain, and improve flexibility, strength, motor control, and range of motion. Other types of treatment used to reduce pain and swelling include heat/cold therapy (e.g., cryotherapy), traction, electrical stimulation (e.g., TENS units, iontophoresis), and ultrasound. Some physical therapists also use cold (low-level) laser therapy to reduce pain and inflammation.

In many cases, physical therapy also involves teaching patients how to use devices such as crutches, walkers, wheelchairs, and prostheses properly, and how to perform exercises correctly at home.

Physical Therapy/Rehabilitation Resources

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