Lecture 1 Foundations of Physical Therapy – Flashcards
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Transforming society by optimizing movement to improve human experience
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Vision Statement of APTA
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what you are all about
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Mission statement
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what you want to be
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Vision statement
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Early PT prevents more expensive care, faster recovery Pay less if have direct access to PT (don't need a referral but not always covered by insurance)
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PTs are cost effective
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-Lifestyle conditions: we are more sedentary than we used to be; direct relationship between increased exercise and decreased risk of heart disease as shown by stress tests; emphasizes importance of exercise -> use multi-pronged strategies to reduce/prevent poor lifestyle conditions -Older Adults: baby-boomers are getting older, we have a larger, older population to deal with -Workforce: we need more PTS; issues = larger aging population, long education program, more popular use in everyday life, small number of spots in PT programs
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Future Challenges of PTs
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Started in 1914 in New England in response to polio (infantile paralysis) -Treatment = casting, prolonged bed rest, splinting -After = muscle atrophy, loss of flexibility -Robert W. Lovett used muscle training to help regain those skills Also used in WWI Originally called reconstruction aides
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Early 1900s in PT History
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First president and founder of APTA -Wrote first PT textbook Massage and Therapeutic Exercise
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Mary McMilian
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More focus on amputations
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WWI in PT History
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More focus on head injuries because more research is being done about them, technology is helping people survive injuries that they previously would not have survived
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Today in PT History
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-As of 1/1/2016, DPT is the required entry-level degree for physical therapy -Need a DPT because: -need for increased skills to meet needs of society, -more evidence driving practice -longer clinical internships -follow military model for effective care
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PT Education
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-1918 = 6 month certificate program -WWI and WWII = certificate program as reconstruction aide -1928 = APTA establish Minimum Standards for an Acceptable School of Physical Therapy Technicians (9 month program) -1960s - 1990s = Bachelor's Degree b/c complex-multisystem dysfunctions -1979 = require postbaccalaureate degree by 1990 -1990s = Master's Degree -1995/1996 = Doctorate of Physical Therapy begins -Early 2000 to now = Doctorate degree
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Past Education Requirements for PT
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-Take licensing exam (clinical practice, research, ethics, state practice questions) -Licensure is on a state by state basis (can hold as many state licenses as you want but you have to maintain all of the requirements for each license)
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After Graduating from Accredited DPT Program
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Can get board certified in as many specialties as you want, residency programs, become a faculty member, research/clinical opportunities,
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After you earn your DPT
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Organizes national license exam, website has outline of what is on the exam, practice exams
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NSBPT
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Information on college accreditations, board exam pass rates
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CAPTE
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-Develop best individualized POC for patient through evidence-based practice -Use ICF (International Classification of Functioning, Disability, and Health) as scaffold and internationally standardized language
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Role of patient/client management
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-Prevent injury -Promote wellness by reducing risk -Decrease severity and duration of episode of care -Help prevent targeted health condition in susceptible population/individual -Limit degree of disability through restoration/maintenance of function
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Role in prevention and risk reduction
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-Educate clients/other PTs/other healthcare professionals -consultation -research -policy -advocacy
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Additional Roles
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Amount of money allotted from government-issued insurance for services of PT, OT, speech therapy; APTA fighting for higher amounts because could be dangerous if patient does not complete treatment
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Medical Therapy Act
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Ability of a patient to see a physical therapist directly without a referral from a physician; now in all 50 states 3 issues = PTs need legal ability, have to get insurance companies to pay for this, work on interprofessional relations; treat with a self-referral
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Direct Access
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Coming for treatment without a referral
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Self-referral
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-80-90% of all care -basic/entry level healthcare; outpatient care -provided by primary care physicians (gatekeeper to other specialists)
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Primary Care Setting
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-Medical specialties, inpatient or outpatient -For problems that require more specialized clinical experience
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Secondary Care Setting
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-Management of complex/rare disorders (i.e. organ transplant)
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Tertiary Care Setting
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-Acute hospital = short-term care -Subacute hospital = long-term care -Rehabilitation centers -Homecare/hospice = healthcare at home for those who have trouble getting out of their home -School systems = enhance level of functioning in school -Private practice = privately owned, independent -Skilled nursing facility -Sports settings (college, professional)
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Types of Settings
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Primary Care Physician -Primary care services -Manage routine healthcare needs
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PCP
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Physician Assistant -Perform 80% of what a PCP does -Under the supervision of the physician
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PA
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Physician specializing in physical medicine/rehab
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Physiatrist
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Advanced Practice Registered Nurse -Provide appropriate treatments for patients in collaboration with physician
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Nurse Practitioner
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Registered Nurse -License to provide nursing services -Do everything according to orders given by physicians
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RN
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Physical Therapy Assistant -Works under direction/supervision of PT -Can't create programs but can modify
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PTA
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Physical Therapy aide -Support services under direction/supervision of PT or PTA (no clinical decisions)
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PT aide
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Works to level of education in the state of Massachusetts
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PT co-op
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Occupational Therapist -Asses patient's ability to function at daily living -Dressing, grooming, meal prep, writing, driving -Can help with adaptations
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OT
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Certified Occupational Therapist Assistant -Work under direction of an OT -Assist with activities in established treatment plan
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COTA
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-Evaluate speech, language, cognitive communication, swallowing skills of patient
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Speech Therapist
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-Identify, diagnose, treat disorders in ear
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Audiologists
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- Believe that abnormalities in musculoskeletal and neurological systems affect functions of other body systems
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Chiropractor
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-Designs, fabricates, fist braces, splints, collars, corsets prescribed by physicians
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Orthotist
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-Person who makes prosthetic limbs
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Prosthetist
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-Evaluate, treat, care for patients with breathing disorders
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Respiratory Therapist
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-Helps people deal with personal, physical, mental, social, vocational effects of disabilities
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Rehab/Vocational Counselor
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Personal Care Aide -Provide healthcare-related service to elderly, disabled in their homes -Housekeeping, ambulation/transfer, personal hygiene
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PCA or Home Health Aide
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-Specializes in athletic healthcare
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Athletic Trainer
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-Helps patients/families cope with chronic, acute, terminal illnesses
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Social Worker
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-Specializes in massage with specific standards of practice and code of ethics
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Massage Therapist
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-Take care of yourself before you take care of others (sleep, exercise, meditation, relaxation, balanced diet) -Avoid caregiver burnout (lack of energy, emotional exhaustion, increasingly pessimistic outlook, increased absenteeism, difficulty concentrating, excessive use of alcohol, medications or sleeping pills)
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Caring for the Caregiver
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-American Physical Therapy Association -Organization that represents physical therapists and physical therapy assistants -Voluntary membership (not required for licensure)
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APTA
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-Diagnosis and management of movement dysfunction and enhancement of physical and functional abilities -Restoration, maintenance, and promotion of optimal physical function, optimal fitness/wellness, and optimal quality of life as it relates to movement and health -Prevention of the onset, symptoms, and progression of impairment, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries
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Physical Therapy
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-Rehabilitate soldiers as recognized by US Army -US Congress drafted legislation for the draft and to rehab all injured soldiers -1917 = Division of Special Hospitals and Physical Reconstruction (part of Army Medical Department) developed "reconstruction aides" -PT type to provide exercise program/hydrotherapy/massage -OT type to work in alms homes/asylums to train patients with vocational skills for employment -1918 = 3 month course to earn title -End of war = focus on preserving/maintaining a workforce
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World War I in PT History
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Director of Reconstruction Aid Program in 1917 at Walter Reed General Hospital
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Marguerite Sanderson
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-Rehabilitation Bill in NJ = enthusiasm for rehab (partnership between PTs and medical/surgical communities) -1921 = first textbook written by Mary McMillian (Massage and Therapeutic Exercise) with four branches (massage, therapeutic exercise, electrotherapy, hydrotherapy) -1925 = found American College of Physical Therapy, established American Registry of Physical Therapy Technicians -Physiotherapists = technicians under supervision of physicians
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1920s in PT History
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-1937 = PT physicians recognized as medical specialties; start the use of "physiatrists" to distinguish from physiotherapists -1940s = physical therapists because AMA worried that public would think that they are regular physicians
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1930s/1940s in PT History
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-Increased demand for physical therapist -Improvements in medical management/surgical treatment -Change in technique because that used for polio doesn't necessarily work for every disorder -1945 = introduction of progressive resistive exercise -Need for more PTs + discontinuation of army-based schools = APTA talks to colleges about starting programs
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World War II in PT History
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-From technician to professional practitioner -Increased use of aides, attendants, volunteers to help with those affect by the war/polio and upkeep of clinics -1955 to 1957 = polio vaccine -1955 = Self-Employed Section of APTA created for private practice -1957 = Physical Therapy Fund created for research/education
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1950s/Korean War in PT History
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-Increased number of states with practice acts -Polio gone by 1961 -PT shifts focus to management of other conditions -Medicare influenced by state licensure laws that regulate PT/PTA services -1967 = added definition of "outpatient physical therapy" to Social Security Act -Improvements/creation of neuro, cardio-pulm, orthopedic specialties
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1960s/1970s in PT History
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-OSHA = Increased opportunities to practice b/c prevention, management, compensation for on-the-job injuries -Epidemic of AIDS = services for patients with multisystem involvement -Improvements in women's health, oncology, hand rehab -Beginning of direct access to PT -1985 = start of PT specialty licensure boards -1986 = Federation of State Boards of Physical Therapy (licensing authority)
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1970s/1980s in PT History
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-Americans with Disabilities Act -National Center for Medical Rehabilitation Research -Challenges = increasing government cost savings, decreasing reimbursements, increasing government regulations, influence by corporate/for-profit America, -1997 = Balanced Budget Act to eliminate Medicare deficit (annual cap of $1500 for PT and speech therapy services, reduced rehab services for Medicare patients) -1999 = first Guide to Physical Therapy PRactice
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1990s in PT History
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Revised version of Guide to Physical Therapy Practice -Scope of practice/patient management -Diagnostic preferred practice patterns of patients typically treated by PTs
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21st Century in PT History
