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Chapter 1 Intro to Physical Therapy

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Hippocrates
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Considered the father of medicine Recognized value of muscle strengthening using exercise Recommended therapeutic exercises to patients b/c understood principle of muscle, ligament, and bone atrophy due to inactivity First to us electrical stimulation, applying torpedo-fish poultices for headaches
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Aristotle
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Recommended rubbing massage using oil and water as a remedy for tiredness
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Galen
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Renowned physician of ancient Rome Believed moderate exercises strengthened the body, increased body temp., allowed the pores of the skin to open, and improved a person’s spiritual well-being
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Formative Years: 1914 to 1920
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Reconstruction Era (in US) from 1914-1919 Prior to the “Great War” – most Americans regarded disability as irreversible The war changed this view Physical therapy gave rise due to injury and poliomyelitis epidemics
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Division of Physical Reconstruction
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Needed to apply physiotherapy treatments such as massage and mechanical hydrotherapy to wounded soldiers Personnel from schools of allied health therapies and physical training Three sections: Surgery & Neuropsychiatry – Education – Physiotherapy
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Division of Special Hospitals & Physical Reconstruction
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Authorized by William Gorgas Give disabled soldiers “reconstruction therapy.” Trained physical reconstruction aides and handful of orthopedists PT/OT pioneers Group who assisted physicians – todays PT’s (massage, hydrotherapy, etc.) Other group is todays OT’s (trained in vocational skills to help soldiers get back to work) Woman between ages of 25-40
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Marguerite Sanderson
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Physiotherapist Graduate of Boston Normal School of Gymnastics Worked w/ Dr. Joel Goldthwait First Supervisor of Reconstruction Aides Role was to recruit and arrange for training of reconstruction aides
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Dr. Joel Goldthwait
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Orthopedic surgeon who became chairman of the War Reconstruction Committee of the American Orthopedic Association
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Walter Reed General Hospital
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Where Reconstruction Aides Training Program took place
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Mary Livingston McMillan
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Assigned to Walter Reed Training Program for Reconstruction Aides College degree in physical education Postgraduate degree in Science of Physical Therapy Knowledgeable in corrective exercises, massage, electrotherapy, aftercare of fractures, dynamics of scoliosis, psychology, neurology, and neuroanatomy Director of massage and medical gymnastics, treating children with scoliosis, congenital hip dislocations and other child disorders (Children’s Hospital Portland, ME) First to physiotherapist to write a textbook
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American Women’s Physical Therapeutics Association (AWPTA)
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Co-founder and president was Mary McMillan Role – to establish & maintain professional & scientific standards for individuals who were involved with the profession of physical therapeutics
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P.T. Review
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Official publication of AWPTA March 1921 Included constitution and bylaws, professional interest articles, and even a column called “S.O.S.” for job classified advertisements
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Constitution
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Bylaws
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American Physiotherapy Association (APA)
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APA confronted w/ two calamities:
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– The growing severity of poliomyelitis and its resulting infantile paralysis – The Great Depression of 1929
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US President Franklin Delano Roosevelt
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Treated for poliomyelitis by physiotherapists generated large public recognition of the physical therapy profession
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Poliomyelitis
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Consisted of: Hydrotherapy Exercises Massage Heat and light modalities Assistive and adaptive equipment
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The Great Depression
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Closed many hospitals and private medical practices Reduced the number of physical therapy services
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National Foundation for Infantile Paralysis
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Money from federal funding and organizations, opened new facilities and lent equipment for polio aftercare Financially contributed to development of physical therapy education and schools
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American Physiotherapy Association 1937 Aims
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Catherine Worthingham
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First PT to hold doctoral degree in anatomy Served as president of APA (1940-45)
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1943
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US Congress passed a bill stating that graduates of the Emergency Training Course should be called Physical Therapists
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House of Delegates
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Separate legislative branch Created in 1944 Still amend and repeal the bylaws of the Association
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American Physical Therapy Association (APTA)
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APA changed to APTA in 1946
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Polio Vaccine
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Developed by Jonas Salk in 1954 1955 most poliomyelitis cases were eradicated
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Jessie Wright
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Journal of the American Physical Therapy Association
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Changed from P.T. Review in 1962
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Journal of Physical Therapy
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Changed from Journal of the American Physical Therapy Association in 1964
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1967
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APTA adopted a policy statement that set the foundation for the creation of the physical therapy assistant and establishment of educational programs
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1969
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Occupational title changed from physical therapy assistant to physical therapist assistant
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PT Advancement From Hospital To Private
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Development of practices related to prevention, work management, and job injuries and compensation
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Social Security Act
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In 1972 Congress added PT services as one that should be reimbursed
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Individuals with Disabilities Education Act
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In 1975, allowed PTs to treat children with disabilities in public schools
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1981 & 1982
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House of Delegates adopted the policy that PT practice that was independent of practitioner referral was ethical
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Commission on Accreditation in Physical Therapy Education
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Sole accrediting agency for all PT/PTA educational programs (1977)
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American Board of Physical Therapy Specialties
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Allow members a mechanism to receive certification and recognition as a clinical specialist (1978)
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Balanced Budget Act
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August 1997 Signed by President Clinton Eliminate the Medicare deficit Applied an annual cap of $1,500 per beneficiary for outpatient services Hurt PT/PTA’s ability to find jobs
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Refinement Act
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November 1999 Suspended the $1,500 cap for 2 years in all settings
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2000
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Association adopted the “Evaluative Criteria for the Accreditation of Education for Physical Therapist Assistants
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2001
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Second edition of the Guide to Physical Therapist Practice
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Vision 2020
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By 2020, physical therapy will be provided by physical therapists who are doctors of physical therapy, recognized by consumers and other health care professionals as the practitioners of choice to whom consumers have direct access for the diagnosis of, interventions for, and prevention of impairments, functional limitations, and disabilities related to movement, function, and health.
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Autonomous Physical Therapy Practice Environments
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Include all physical therapy practice settings where PTs accept the responsibility to practice autonomously and collaboratively to provide best practice to the patient/client
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Direct Access
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Means that throughout his or her lifetime, every consumer has the legal right to directly access a PT for the diagnosis of, interventions for, and prevention of impairments, functional limitations, and disabilities related to movement, function, health.
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Doctor of Physical Therapy
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Is a clinical doctorate degree that reflects the growth in the body of knowledge and expected responsibilities that a professional PT must master to provide best practice to the consumer
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Practitioner of Choice
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Means PTs who personify the elements of the vision 2020 and are recognized among consumers and other health care professionals as the preferred providers for the diagnosis of, interventions for, and prevention of impairments, functional limitations, and disabilities related to movement, function, and health
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Evidence-Based Practice
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Means access to, and application and integration of evidence to guide clinical decision making to provide best practice for the patient/client
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Professionalism
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Means that PTs and PTAs consistently demonstrate core values by aspiring to and wisely applying principles of altruism, excellence, caring, ethics, respect, communication, and accountability, and by working together with other professionals to achieve optimal health and wellness in individuals and communities
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APTA Guiding Principles 2013
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Identity – Quality – Collaboration – Innovation – Consumer-centricity – Access/Equity – Advocacy
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Identity
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The physical therapy profession will be recognized as the experts in movement systems in practice, education, and research
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Quality
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The physical therapy profession will identify, adopt and utilize evidence-based principles in practice, education, and research
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Collaboration
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The physical therapy profession will identify and value inter professional collaboration in order to provide integrated services for society and consumers
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Innovation
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The physical therapy profession will develop inventive practices in research, education, and practice to lead health care
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Consumer-centricity
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The physical therapy profession will value patient needs as core to all interactions and will create a culture that values the cultures of all people
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Access/Equity
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The physical therapy profession will identify and develop creative avenues to reach all people in need of physical therapy care and education
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Advocacy
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The physical therapy profession will be an advocate for consumers in research, education, and practice
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PT Caucus
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National Assembly of Physical Therapist Assistants dissolved/PTA Caucus formed in 2005 Purpose – Fully integrate PTA members into the APTA’s governance structure and increase PTAs’ influence in the Association Five delegates; 1 chief delegate
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APTA Membership
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Voluntary Requirements: Graduate of/Enrolled in an accredited PT/PTA program
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APTA’s Mission
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2013 Strategic Plan – four major goals: APTA will better enable physical therapists to consistently use best practice to improve the quality of life of their parents and clients APTA will be the recognized leader in supporting physical therapists in the delivery of patient- and client-centered care across the lifespan APTA will empower physical therapists to demonstrate and promote high standards of professional and intellectual excellence APTA will be the recognized leader in setting the standards for physical therapy service delivery and establishing and promoting the value of physical therapist practice to all stakeholders
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Federation of State Boards of Physical Therapy
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Develops and administers the National Physical Therapy Examination (NPTE) for both PTs and PTAs in 53 jurisdictions (50 states, DC, PR, VI) Purpose – to protect the public by providing leadership and service that encourage competent and safe physical therapy practice