A physical therapist (physiotherapist) is someone who has specialised in the western medicine that uses manual therapy, biomechanics, and exercise therapy, electrotherapy to practice treatments that are evidence-based remedies impairments and promotes mobility, function and life’s quality by examining, diagnosing, prognosis and physically intervening their patients. Apart from clinical practice, physiotherapists also conduct research, education consultations and administration functions and they can offer physical therapy services as primary care treatment or can be done alongside or together with any other medical services a patient requires. Physiotherapists attempt to address the injuries for any illnesses that might limit someone’s ability to perform functional activities and move in their day-to-day lives. Individual history together with physical examinations are done on patients for a physiotherapist to decide the right diagnosis and initiate a management plan. Whenever it is necessary, they can use electro diagnostic testing and nerve conduction or include the results of laboratory and the imaging studies like CT- scan and X-rays. In situations where movement and function are threatened by injury, ageing, environmental factors or disease, treatment is provided because the functional movement is central to a person’s health. Physiotherapists work with patients to prevent loss of mobility before it happens through developing fitness and wellness-oriented programs that will promote a healthier and more active lifestyle. They do this by providing services to their patients to develop, reinstate and sustain the maximum movement and functional ability throughout their lives. Management in Physical therapy typically includes prescribing of or assisting with specific exercises, mechanical devices like traction, manual therapy and manipulation, education, physical agents that comprise of cold, heat, electricity, radiation, sound waves, prostheses, assistive devices, orthoses and any other interventions.
Physical therapist’s education criteria can be different in various states, countries, and among different levels of professional responsibilities. A majority of the US states have Physical therapy practice Acts that acknowledge physical therapists and physical therapist assistants with some jurisdictions recognising physical therapist techs and aides. In most countries, there are licensing bodies, which mandate for a physiotherapist to at least be a member before starting to practice as independent professional physiotherapists. In the United States, a physical therapist trained and licensed to examine, diagnose, evaluate and treat impairments, disabilities and functional limitations in clients and patients qualifies to be a primary physical therapy practitioner. The education curricula for physical therapists in the United States end in a Doctor of Physical Therapy degree; however, most of the physiotherapists hold a Master of Physical Therapy degree and others a Bachelor’s degree. The current education programs for physical therapy are quite different from the previous ones whereby there is no more offering the Master of Science in Physical Therapy and Master of Physical Therapy degrees and the entry-level degree Doctor of Physical Therapy that usually takes three years after the completion of a bachelor’s degree anymore. The primary goal for every physiotherapist is to have a Doctor of Physical Therapy (DPT) and not just a masters or bachelors in PT. The World Confederation of Physical Therapy (WPTC) acclaims that the entry-level educational programs for physical therapists should be centred on university level studies, to take a minimum of 4 years and to be certified and accredited independently. The Commission on Accreditation in Physical Therapy Education (CAPTE) accredits the USA curricula and according to the board; there are over 30,000 students that are presently enrolled in over 200 credited PT programs in the United States this year (2017). In addition, 12, 945 PTA students in the United States are now enrolled in more than 300 PTA programs.
The professional curriculum for physical therapists includes content in clinical sciences, and the current training is precisely focused on enabling physiotherapists to appropriately identify and refer non-musculoskeletal diagnoses presently similar to those brought about by systems that are not suitable for physical therapy intervention resulting in direct access to a physical therapist in most states. For admission, most programs need one to hold a bachelor’s degree as well as specific educational prerequisites like classes in physiology, anatomy, biology, physics and chemistry. There are programs that admit college freshmen into programs that take six to seven years that allows students to eventually graduate with a bachelor’s degree and a DPT. After graduation, physical therapists can apply to a clinical residency program and complete it; they usually take a period of about a year and equip students with supplementary experience and training in subject areas of care. Residencies have the primary objective of training physical therapists in specialities like women’s health, cardiovascular and pulmonary, clinical electrophysiology, geriatrics and wound care.
Once a therapist is done with the residency program, they have the option of specialising further by completing a fellowship in an advanced clinical area. Similar to the medical model, fellowships train specialists in subspecialties like division 1 sports, critical care and hand therapy. PT programs often include courses in anatomy, biomechanics, neuroscience, physiology and pharmacology and physical therapy students are expected to complete at least 30 weeks of clinical work, which gives them supervised experiences in several areas like orthopaedic and acute care. Physical therapy assistants’ roles include delivering physical intervention and treatment to patients and clients contained under a care plan that is established by and under the guidance and supervision of a professional physical therapist. In the US, physical therapist assistants are tutored under Associate of Applied Sciences curricula that is specific to that profession. Their curricula include anatomy and physiology, exercise physiology, physics, human biology, biomechanics, neuroscience, kinesiology, communication, behavioural sciences, clinical pathology, research and other coursework individual programs require. Physical therapy technician and aides’ educational requirements are different depending on the employer, but they range from high school diploma or equivalent to completing a 2-year degree program. Under the direct supervision of a physical therapist, several jurisdictions permit for employment of therapy assistants, technicians and aides by a physical therapist to carry out designated routine tasks that are related to the profession.
Considering the complexity of the body of knowledge of physical therapy, therapists can choose to specialise in different specific clinical areas. Despite there being variety of different types of physical therapy, only nine current specialist certifications are listed by the American board of physical therapy specialists. Practising in a speciality needs one to undergo further training such as an accredited residency program. Below are the speciality areas for physical therapists:
This type of physical therapy deals with issues that concern people as they age but usually it is more focused on older adults. As people grow older, many conditions affect them, such as cancer, arthritis, osteoporosis and Alzheimer’s disease, hip and joint replacement, incontinence and balance disorder among other conditions. A geriatric physical therapist is trained in geriatric therapy for conditions like these in the elderly.
Cardiovascular and Pulmonary Physiotherapy
This kind of physical therapists specialise in a variety of cardiopulmonary disorders, pre and post cardiac or pulmonary surgery with their primary goals including increasing functional independence and endurance. In this field, manual therapy is employed to help in clearing lung secretions that are associated with cystic fibrosis. They also help in treating pulmonary disorders, post coronary bypass surgery, heart attacks, pulmonary fibrosis and chronic obtrusive pulmonary disease.
This area includes wound management, electrotherapy, physical agents and electrophysiological evaluation.
It includes treating conditions that involve the skin and all organs related to the skin. Conditions like wounds and burns that are treated by a physical therapist using surgical instruments, topical agents that remove damaged, contaminated tissue and promote tissue healing, wound irrigations and wound dressings. Exercise, compression garments, oedema control and splinting are among the commonly used interventions apart from the aforementioned. Scientifically proven, physiotherapy is one of the most effective methods of treating and preventing injury and pain because it makes muscles more strong and improves the general functioning of the body.it may only reduce and remove pain for a while but it helps in preventing occurrences of future back pains. Physiotherapists practice various methods depending on the diagnosis to treat inflammations and swellings for some time in patients.
These types of physical therapists identify, manage and treat injuries and disorders of the musculoskeletal system, which includes rehabilitation after orthopaedic surgery has been done, malformations like scoliosis, bursitis, acute trauma like strains, injuries of the insidious onset like tendinothapy and twists. Orthopaedic therapists are specialised in treating post-operative orthopaedic procedures, acute sports injuries, fractures, arthritis, spinal conditions, sprains, back and neck pain, amputations and strains.
Neurological diseases and disorders are treated in this field of medicine; they include Alzheimer’s disease, stroke, brain injury, chronic back pain, Charcot Marie Tooth disease, cerebral palsy, multiple sclerosis, spinal cord injury and facial palsy. Impairments that are related with neurological conditions like vision impairment, ambulation, balance, daily living activities, movement, muscle strength and loss of functional independence. It always requires specialised training to carry out techniques that are involved in neurological physical therapy.
Athletes and physical therapists are closely connected when it comes to the care and wellbeing of sports participants. This area of practise encompasses athletic injury management under five categories, which are, acute care that deals with assessment and diagnosing of any internal injuries. Prevention (identifying and addressing any deficiencies suspected to directly cause or act as precursors to injury), treatment (applying specialist advice and techniques to facilitate healing), rehabilitation (advanced management for a full return to sports) and education (sharing knowledge from specialists to athletes, clubs or sports teams to help prevent and manage injuries). There are physical therapists with specialised sports certification issued through their national registration organisation who work for professional sports teams.
A paediatric physical therapist helps in detecting health problems early enough and uses a variety of modalities to offer physical therapy for conditions in the paediatric population. They are specialised in diagnosing treating and managing infants, adolescents and children that have congenital, skeletal, neuromuscular or acquired disorders and diseases. Mainly the treatment offered focuses on improving fine and gross motor skills, strength and endurance, cognitive and sensory integration and balance and coordination.
Specially trained and specialised physiotherapists intervene disabled conditions and rehabilitate them in community based physiotherapy rehabilitation areas. They educate and transfer basic skills and knowledge to the community and gives treatment in the attempt of managing chronic and acute diseases and disabilities. They also socialise and coordinate group efforts taking managerial roles in community based rehabilitation. It promotes community responsibility of leading good healthy lifestyles and maintain good health.
Mostly in women’s health physical therapy, women issues relating to the female reproductive system, post-partum and childbirth are addressed. Women health conditions include urinary incontinence, osteoporosis, lymphedema, pelvic pain, and prenatal and postpartum periods. Manual physical therapy has been highly recommended to be used in multiple studies to help improve conception in women with infertility problems.
In every states, physical therapists are required to be licensed and licensing requirements are different across states, they all however include excelling in national physical therapy examination which is m[normally administered by the federation of State Boards of Physical Therapy. All physical therapy students in order to keep their licences are needed to take continuing education and after having the appropriate work experience, some PT decide to become certified board specialists. For one to qualify to work as a board specialist, they are required to excel in an exam and complete a residency program in the speciality area accredited by the American Physical Therapy Association or at least have 2,000 hours of clinical work. A law exam and a criminal background check is required in some states.
Duties of a Physical Therapist
Medical services of physical therapists are aimed at patients of all ages with functional and mobility problems that result from sprains, neck injuries, back injuries, strains, fractures, amputations, arthritis and neurological disorders like strokes or cerebral palsy, work and sports related injuries amidst other conditions. Their work varies by the types of patients they work with, a patient with a different injury or condition will require different are from one that has a different condition the reason some therapists specialise in specific type of care such as geriatrics or orthopaedics. Physical therapists are trained and educated to use a variety of diverse techniques to take care of their patients such as different exercises, training in functional movement and special movements of muscles, joints and soft tissues that contribute towards improving movement and decreasing physical pain.
A Physical Therapist:
- Diagnoses movements and functions of patients by observing them walk or stand and listening to their concerns.
- Reviews medical history of patients and any referrals or notes from surgeons, doctors or any health care workers.
- Educates patients, patient’s families on what to expect out of the recovery process and how to best cope with any challenges that might arise during the process.
- Develops individual care plans for patients, outline goals of patients and what outcomes to be expected out of those plans.
- Eases patients’ pain, prevent further injury or pain, help hem increase their mobility and facilitate their wellness and heath by suing stretching manoeuvres, exercises, equipment and hands on therapy.
- Assesses and records the progress of patients, modifies a plan of care and tries new treatments whenever necessary.
Important Qualities of physiotherapist
Detail Orientation- physical therapists should have strong analytic skills and observational skills that are needed for one to properly diagnose a problem in a patient, provide effective and safe care after evaluating suitable treatment options.
Compassion- a physical therapist should have the passion to help others, they work with people who are in pain every day and they should be emphatic towards their patients.
Interpersonal Skills- a lot of time of a physical therapist is spend with patients; they interact with different people in attempt to try to solve their health problems. Treatment programs must be clearly explained to patients and motivate them. A physical therapist should listen to the concerns of their patients and give them effective therapy.
Agility- handiness is an essential quality in a physical therapist as they are used in providing manual therapy and therapeutic exercises to the patients. They should be comfortable enough to physically help their patients and give them treatment massages.
Physical Stamina- a physical therapist usually spends most of his time on their feet moving from place to place, as they demonstrate appropriate techniques and help patients do some exercises and they should therefore embrace physical activity.
Inventiveness- resourcefulness is generally associated with the profession of physical therapy as PT customize plans for their patients often and they should have the flexibility and be quick to adapt plans of care to meet their patients’’ needs.
Work Environment and Schedules
In 2014, about 20,000 jobs were held by physical therapists with the leading employer of PTs being offices of physical, speech and occupational therapists and audiologists followed by state, private and local hospitals, home healthcare services, nursing and residential care facilities and offices of physicians. Because physical therapists are often needed to move around, working with their patients to help them move or lift them up, use stretching manoeuvres to ease patients pain and they are therefore prone to back injuries. They can however limit the risks of being injured by suing appropriate body mechanics and lifting techniques when helping patients. A typical physical therapist works full time during normal business hours even though there are some who might work in the evenings and on weekends. In2014, about 1 in five therapists worked part time.
Salary, Job Outlook for Physical Therapists
Physical therapists median annual wage in May 2016 was $85, 400 that is the salary at which half-physical therapists earn more than the exact amount and half that was earned less. The lowest 10% of physical therapists earned less than $58, 190 while the highest 10 percent got more than $122, 130 for a salary. In home healthcare services, physical therapists earned a median annual wage of $93, 200, those working in nursing and residential are facilities earned $92, 960, those in hospitals $87, 010, in offices of physicians $82, 630 and the ones working in offices of physical, occupational and speech therapists and audiologists got a salary of $81, 220 in May 2016. The projections of physical therapist employment is estimated to grow 34% for a period of 10 years, from 2014 to 2024 faster than the average of all professions. The large number of baby boomers that keeps on aging will increase the demand for physical therapists because this population mostly discovers that they should lead a more active life than their counterparts of previous generations did and that is when therapists will come in handy. Heartbreaks are most likely to be experienced by older people together with strokes and injuries that are related to mobility, which typically require physical therapy services for rehabilitation.
In recent years, a number of chronic conditions have become more prevalent like obesity and diabetes, patients suffering from this health conditions will require more physical therapy assistance to manage the effects of such chronic conditions and maintain their mobility. A number of people who will need to have access to health insurance is expected to go on increasing because of the reform on federal health insurance, physical therapists services will be needed in helping the patients by rehabilitating and treating any injuries and chronic conditions as well. Medical technology continues to advance and the use of outpatient surgery for treating injuries and illnesses has recently increased. A greater percentage of trauma victims and new-borns that have birth defects are expected to be given more chances to survive by the technological and medical developments. This in turn will create added demand for rehabilitative care where physical therapists will appear by helping these patients have quick recovery process from the surgeries. The job prospects for physical therapists is expected to be good in orthopaedics settings, acute care hospitals and skilled nursing facilities, that their employment opportunities are likely to be advantageous for those that are licensed in all settings. Favourably, the job prospects will be better in rural areas where most physical therapists live, in densely populated urban and sub urban regions.