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Physical therapy

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Physical therapy is a health care specialty concerned with evaluating, diagnosing, and treating people who have musculoskeletal disorders or injuries that inhibit physical movement. The ultimate goal of physical therapy is to restore as much physical independence as possible to each individual patient. Physical therapy addresses physical, psychological, emotional, and social well being. It involves the interaction between the physical therapist, patient, physicians, families, and care givers where physical movement potential is assessed and goals are set to help the patient reach maximal functional movement.[1]

Physical therapy uses numerous methods such as exercise, mobilization, manipulation, ultrasound, heat, cold, and electrical stimulation. When determining which modality to use, physical therapists evaluate the strength, balance, range of motion, coordination, endurance, and posture of each individual patient, then create a prognosis for the patient. Traction machines and massage are also regularly used to reduce pain and increase the physical ability of the patient.

The hospital setting is one of the more common settings where physical therapists practice, but within the hospital there are specialty areas that physical therapist can pursue. Physical therapists practice in inpatient or outpatient rehabilitation facilities, extended care facilities, private homes, outpatient clinics, research centers, schools, nursing homes, hospitals, fitness centers, sports training facilities, and many other environments. [2]

Modalities

This pediatric physical therapist is assisting two polio-stricken children holding on to a rail while they exercise their lower limbs.

There are many specialty areas in the field of physical therapy. The majority of the general public isn't aware of the top five fields of physical therapy.

Orthopedic

Orthopedic physical therapists diagnose and treat disorders and injuries of the skeletal muscle system as well as rehabilitate patients after orthopedic surgery. This type of physical therapy is most often found in out-patient clinics. Orthopedic physical therapists are trained in treating joints, acute sports injuries, arthritis, and amputations right after surgery. A few of the modalities used in orthopedic physical therapy are joint mobilizations, strength training, hot/cold packs, and electrical stimulation.[3]

Geriatric

Geriatrics is a branch of medicine pertaining to the diagnosis, treatment, and prevention of disease in the elder population. Geriatric physical therapy helps in treating elderly people with arthritis, osteoporosis, cancer, Alzheimer's disease, hip and joint replacement, balance disorders, incontinence, and more. [4]

Neurological

Neurological physical therapy deals with individuals who have neurological disorders or disease. Such diseases include Alzheimer's disease, ALS, stroke, brain injury, cerebral palsy, multiple sclerosis, Parkinson's disease, and spinal cord injury. Inability to to walk about or move from place to place, paralysis, vision impairment, poor balance, and loss of functional independence are all dysfunctions that a neurological physical therapist addresses.[5]

Cardiovascular and Pulmonary Rehabilitation

Cardiovascular and pulmonary rehabilitation physical therapists work in treating individuals with cardiac or pulmonary disorders or have undergone surgery. Patients with cystic fibrosis will receive manual therapy to assist in clearing lung secretions. Heart attacks, post coronary bypass surgery, chronic obstructive pulmonary disease, and pulmonary fibrosis are examples of the many problems that cardiovascular and pulmonary rehabilitation physical therapists help treat.[6]

Pediatric

Pediatric physical therapy uses a wide variety of modalities to treat disorders and detect early health problems in infants, children, and adolescents. Children who suffer from developmental delays, cerebral palsy, spina bifida, scoliosis, and torticollis are a few of the patients treated by pediatric physical therapists. [7]

History

Physical therapist using electricity on injured man

Most of what makes up modern physical therapy was used back in ancient times, acknowledged by researchers to date back as early as 3,000 BC. Various methods of physical therapy were used by the ancient Chinese, Persians, Egyptians, and Greeks. In Greece, Hippocrates stated that hydrotherapy and massage was practiced as early as 460 BC.[8] The practice of physical therapy used in modern times was first established in Britain in the late 19th century. Not long after, American orthopedic surgeons began training young female graduates from physical education colleges to work in doctors' offices and hospitals. In 1916, when an intense epidemic of poliomyelitis hit New York and New England, those women treated thousands of infected patients. [9]

After the start of World War I, the first official school of physical therapy was established in Walter Reed Army Hospital in Washington, D.C. After World War II, physical therapy was widely used to care for patients. Because there was so much success with physical therapy in World War II, the Vietnam War, and the Korean War, many medical care programs teaching physical therapy opened.[10]

In recent years, the field of physical therapy has changed very much due to vast changes and enhancements that have been occurring in the nation's health care delivery system. The physical therapy profession has kept up to date with the most recent advances in science and technology in order to provide the most effective treatment possible to patients. [11]

Education

Because physical therapists are required to understand an extensive number of problems that can affect movement, function, and health, physical therapists, in general, graduate with at least a master's degree. Many physical therapy programs also offer clinical doctorate's degree. Coursework for a typical physical therapy program includes biology, chemistry, physics, biomechanics, neuroanatomy, human growth and development, manifestations of disease, examination techniques, and therapeutic procedures. [12] All physical therapists must not only pass a national examination test, but be licensed by the state in which they practice. In order to specialize in a specific modality such as orthopaedic, neurologic, or pediatrics, physical therapists seek advanced certification. [13]In addition, in order to retain their licenses, many states also require taking continuing education classes and attend workshops.[14]

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