Skip to main content
Select Source:

Physical Therapy

Physical therapy

Physical therapy is the use of exercise, heat, cold, water, massage, or electricity in the treatment of damaged muscles, bones, or joints due to injury or disease. The goal of physical therapy is to restore full or partial function of the affected body part or to build up other muscles to make up for weak ones. Physical therapy is usually performed by a trained physical therapist, who sets up a therapy program based on instructions from a medical doctor.

Types of physical therapy

Mechanical manipulation. Massage, manipulation of the injured limb, weight lifting, and water therapy are mechanical forms of physical therapy. Massage is the rubbing, tapping, or kneading of an injured area to increase blood circulation and relieve pain. Manipulation consists of manually bending an injured joint to restore full range of motion and eliminate pain from movement. Weight lifting involves the use of machines or free weights to strengthen and build muscle. Water therapy includes walking or exercising in water and using the resistance it provides to build muscle and increase range of motion of joints.

Cold therapy. Cold therapy is an effective means of reducing tissue inflammation following an injury or surgery. Cold therapy is applied in the form of ice packs, sometimes combined with massage or a cold water bath of the injured area. The cold temperature reduces blood flow to the injured site, reducing inflammation and bleeding. Oxygen demand of the injured tissue is decreased, preserving the muscle cells. In addition, the anesthetic effect of the cold temperature helps to ease pain.

Heat therapy. Heat therapy may be used after active swelling of an injury has stopped, usually within 24 to 48 hours. Heat can be applied with moist heat packs, hot water (as in a whirlpool bath), a heat lamp, or by conversion. Conversion is the generation of heat by the passage of sound waves or electric currents through tissue. Diathermy is an example of electric currents directed into tissue and converted into heat. Ultrasound is a technique that uses high-frequency sound waves to heat joints, which can help to relieve joint pain.

Heat increases blood flow to the area, which helps to reduce muscle spasms, increases the amount of oxygen reaching the injured tissue, and carries waste products from the site.

Words to Know

Conversion: Process by which sound waves or electric currents passed through the skin are transformed into heat.

Diathermy: The production of heat in body tissue through the use of electric currents.

Iontophoresis: The administration of a drug through the skin by an electric current.

TENS (transcutaneous electrical nerve stimulation): The use of electric currents passed through the skin to relieve pain in a specific area of the body.

Ultrasound: A technique in which high-frequency sound waves raise the temperature of body tissue by producing vibrations within it.

Electrical stimulation. The application of electricity can restore muscle tone by stimulating muscles to contract rhythmically. This method is often used to exercise the muscles of a person confined to a wheelchair or bed. Over time, muscles that are not used will atrophy (become smaller and weaker). The application of electrical stimulation can prevent muscle atrophy in wheelchair-bound patients and reduce the length of therapy required for patients who regain mobility.

Electricity also can be used to drive molecules of medication through the skin into the tissues. This is called iontophoresis. Pain caused by an injury or illness (such as cancer) can be controlled using TENS (transcutaneous electrical nerve stimulation). A TENS machine passes electric current through the skin (transcutaneously) of the injured or diseased site, stimulating certain nerve fibers and blocking the transmission of pain impulses through others.

Cite this article
Pick a style below, and copy the text for your bibliography.

  • MLA
  • Chicago
  • APA

"Physical Therapy." UXL Encyclopedia of Science. . Encyclopedia.com. 21 Sep. 2018 <http://www.encyclopedia.com>.

"Physical Therapy." UXL Encyclopedia of Science. . Encyclopedia.com. (September 21, 2018). http://www.encyclopedia.com/science/encyclopedias-almanacs-transcripts-and-maps/physical-therapy

"Physical Therapy." UXL Encyclopedia of Science. . Retrieved September 21, 2018 from Encyclopedia.com: http://www.encyclopedia.com/science/encyclopedias-almanacs-transcripts-and-maps/physical-therapy

Learn more about citation styles

Citation styles

Encyclopedia.com gives you the ability to cite reference entries and articles according to common styles from the Modern Language Association (MLA), The Chicago Manual of Style, and the American Psychological Association (APA).

Within the “Cite this article” tool, pick a style to see how all available information looks when formatted according to that style. Then, copy and paste the text into your bibliography or works cited list.

Because each style has its own formatting nuances that evolve over time and not all information is available for every reference entry or article, Encyclopedia.com cannot guarantee each citation it generates. Therefore, it’s best to use Encyclopedia.com citations as a starting point before checking the style against your school or publication’s requirements and the most-recent information available at these sites:

Modern Language Association

http://www.mla.org/style

The Chicago Manual of Style

http://www.chicagomanualofstyle.org/tools_citationguide.html

American Psychological Association

http://apastyle.apa.org/

Notes:
  • Most online reference entries and articles do not have page numbers. Therefore, that information is unavailable for most Encyclopedia.com content. However, the date of retrieval is often important. Refer to each style’s convention regarding the best way to format page numbers and retrieval dates.
  • In addition to the MLA, Chicago, and APA styles, your school, university, publication, or institution may have its own requirements for citations. Therefore, be sure to refer to those guidelines when editing your bibliography or works cited list.

physical therapy

physical therapy or physiotherapy, treatment of disorders of the muscles, bones, or joints by means of physical agents—heat, light, water, manual and electronic massage, and exercise. Stroke, arthritis, fractures, and nerve damage are common conditions treated. The type of treatment needed is prescribed by a physician and carried out by trained physiotherapists. The therapist attempts to prevent pain or further damage and may also train different muscles to compensate for ones that have been damaged. Whirlpool baths are valuable in treating injuries and chronic inflammatory conditions. Ultrasound and short-wave diathermy may be employed for some disorders. Massage (a passive form of exercise) provides stimulation of nerves and prevents muscular atrophy in body areas disabled by paralysis or rheumatic disorders. Active exercises are also prescribed as treatment for various conditions. Physiotherapy is important in sports, not only as part of the conditioning program but also in treating injuries.

Cite this article
Pick a style below, and copy the text for your bibliography.

  • MLA
  • Chicago
  • APA

"physical therapy." The Columbia Encyclopedia, 6th ed.. . Encyclopedia.com. 21 Sep. 2018 <http://www.encyclopedia.com>.

"physical therapy." The Columbia Encyclopedia, 6th ed.. . Encyclopedia.com. (September 21, 2018). http://www.encyclopedia.com/reference/encyclopedias-almanacs-transcripts-and-maps/physical-therapy

"physical therapy." The Columbia Encyclopedia, 6th ed.. . Retrieved September 21, 2018 from Encyclopedia.com: http://www.encyclopedia.com/reference/encyclopedias-almanacs-transcripts-and-maps/physical-therapy

Learn more about citation styles

Citation styles

Encyclopedia.com gives you the ability to cite reference entries and articles according to common styles from the Modern Language Association (MLA), The Chicago Manual of Style, and the American Psychological Association (APA).

Within the “Cite this article” tool, pick a style to see how all available information looks when formatted according to that style. Then, copy and paste the text into your bibliography or works cited list.

Because each style has its own formatting nuances that evolve over time and not all information is available for every reference entry or article, Encyclopedia.com cannot guarantee each citation it generates. Therefore, it’s best to use Encyclopedia.com citations as a starting point before checking the style against your school or publication’s requirements and the most-recent information available at these sites:

Modern Language Association

http://www.mla.org/style

The Chicago Manual of Style

http://www.chicagomanualofstyle.org/tools_citationguide.html

American Psychological Association

http://apastyle.apa.org/

Notes:
  • Most online reference entries and articles do not have page numbers. Therefore, that information is unavailable for most Encyclopedia.com content. However, the date of retrieval is often important. Refer to each style’s convention regarding the best way to format page numbers and retrieval dates.
  • In addition to the MLA, Chicago, and APA styles, your school, university, publication, or institution may have its own requirements for citations. Therefore, be sure to refer to those guidelines when editing your bibliography or works cited list.

physical therapy

phys·i·cal ther·a·py • n. the treatment of disease, injury, or deformity by physical methods such as massage, heat treatment, and exercise rather than by drugs or surgery. DERIVATIVES: phys·i·cal ther·a·pist n.

Cite this article
Pick a style below, and copy the text for your bibliography.

  • MLA
  • Chicago
  • APA

"physical therapy." The Oxford Pocket Dictionary of Current English. . Encyclopedia.com. 21 Sep. 2018 <http://www.encyclopedia.com>.

"physical therapy." The Oxford Pocket Dictionary of Current English. . Encyclopedia.com. (September 21, 2018). http://www.encyclopedia.com/humanities/dictionaries-thesauruses-pictures-and-press-releases/physical-therapy

"physical therapy." The Oxford Pocket Dictionary of Current English. . Retrieved September 21, 2018 from Encyclopedia.com: http://www.encyclopedia.com/humanities/dictionaries-thesauruses-pictures-and-press-releases/physical-therapy

Learn more about citation styles

Citation styles

Encyclopedia.com gives you the ability to cite reference entries and articles according to common styles from the Modern Language Association (MLA), The Chicago Manual of Style, and the American Psychological Association (APA).

Within the “Cite this article” tool, pick a style to see how all available information looks when formatted according to that style. Then, copy and paste the text into your bibliography or works cited list.

Because each style has its own formatting nuances that evolve over time and not all information is available for every reference entry or article, Encyclopedia.com cannot guarantee each citation it generates. Therefore, it’s best to use Encyclopedia.com citations as a starting point before checking the style against your school or publication’s requirements and the most-recent information available at these sites:

Modern Language Association

http://www.mla.org/style

The Chicago Manual of Style

http://www.chicagomanualofstyle.org/tools_citationguide.html

American Psychological Association

http://apastyle.apa.org/

Notes:
  • Most online reference entries and articles do not have page numbers. Therefore, that information is unavailable for most Encyclopedia.com content. However, the date of retrieval is often important. Refer to each style’s convention regarding the best way to format page numbers and retrieval dates.
  • In addition to the MLA, Chicago, and APA styles, your school, university, publication, or institution may have its own requirements for citations. Therefore, be sure to refer to those guidelines when editing your bibliography or works cited list.

physiotherapy

physiotherapy (physical therapy) Use of various physical techniques to treat disease or injury. Its techniques include massage, manipulation, exercise, heat, hydrotherapy, the use of ultrasonics, and electrical stimulation.

Cite this article
Pick a style below, and copy the text for your bibliography.

  • MLA
  • Chicago
  • APA

"physiotherapy." World Encyclopedia. . Encyclopedia.com. 21 Sep. 2018 <http://www.encyclopedia.com>.

"physiotherapy." World Encyclopedia. . Encyclopedia.com. (September 21, 2018). http://www.encyclopedia.com/environment/encyclopedias-almanacs-transcripts-and-maps/physiotherapy

"physiotherapy." World Encyclopedia. . Retrieved September 21, 2018 from Encyclopedia.com: http://www.encyclopedia.com/environment/encyclopedias-almanacs-transcripts-and-maps/physiotherapy

Learn more about citation styles

Citation styles

Encyclopedia.com gives you the ability to cite reference entries and articles according to common styles from the Modern Language Association (MLA), The Chicago Manual of Style, and the American Psychological Association (APA).

Within the “Cite this article” tool, pick a style to see how all available information looks when formatted according to that style. Then, copy and paste the text into your bibliography or works cited list.

Because each style has its own formatting nuances that evolve over time and not all information is available for every reference entry or article, Encyclopedia.com cannot guarantee each citation it generates. Therefore, it’s best to use Encyclopedia.com citations as a starting point before checking the style against your school or publication’s requirements and the most-recent information available at these sites:

Modern Language Association

http://www.mla.org/style

The Chicago Manual of Style

http://www.chicagomanualofstyle.org/tools_citationguide.html

American Psychological Association

http://apastyle.apa.org/

Notes:
  • Most online reference entries and articles do not have page numbers. Therefore, that information is unavailable for most Encyclopedia.com content. However, the date of retrieval is often important. Refer to each style’s convention regarding the best way to format page numbers and retrieval dates.
  • In addition to the MLA, Chicago, and APA styles, your school, university, publication, or institution may have its own requirements for citations. Therefore, be sure to refer to those guidelines when editing your bibliography or works cited list.

Physical Therapy

Physical Therapy

Definition

Physical therapists provide services to restore function, improve mobility, relieve pain, and prevent or limit permanent physical disabilities among those suffering from injuries, disabilities, or disease.

Description

Organized physical therapy began during World War I with 800 reconstruction aides. Today there are more than 80,000 licensed physical therapists in the United States.

Physical therapists treat patients with a variety of health conditions and diseases including accident victims and individuals with disabling conditions such as low back pain, arthritis, heart disease, fractures, head injuries, and cerebral palsy.

In an effort to restore, maintain, and promote overall fitness and health, physical therapists examine patients' medical histories, as well as test and measure patients' strength, range of motion, balance, coordination, posture, muscle performance, respiration, and motor function. Physical therapists determine patients' ability to be independent and reintegrate into the community or workplace. Based on a patient's medical history and test results, physical therapists develop treatment plans that describe treatment strategy, purpose, and anticipated outcome.

A physical therapist's treatment often includes exercise for patients who have been immobilized or who lack flexibility, strength, or endurance. As part of the treatment, physical therapists encourage patients to improve flexibility, range of motion, strength, balance, coordination, and endurance. The goal is to improve an individual's function at work and home.

Physical therapists may use electrical stimulation, hot packs, cold compresses, or ultrasound to relieve pain and reduce swelling. They may use traction or deep-tissue massage to relieve pain. Therapists also teach patients to use assistive and adaptive devices including crutches, prostheses, and wheelchairs. They may also show patients how to perform exercises to do at home.

During treatment, physical therapists document the patient's progress, conduct periodic examinations, and modify treatments when necessary. Physical therapists rely on this documentation to track the patient's progress and identify areas requiring more or less attention.

Physical therapists often consult and practice with physicians, dentists, nurses, educators, social workers, occupational therapists, speech-language pathologists, and audiologists.

Some physical therapists treat a wide range of ailments while others specialize in areas such as pediatrics, geriatrics, orthopedics, sports medicine, neurology, and cardiopulmonary physical therapy.

Physical therapist assistants and aides

Physical therapist assistants, under the direction and supervision of a physical therapist, may be involved in implementing patient treatment plans. For example, physical therapist assistants perform treatment procedures including exercises, massages, electrical stimulation, paraffin baths, hot and cold packs, traction, and ultrasound. Physical therapist assistants record patients' treatment responses and report these responses to the physical therapist.

Physical therapist aides work under the direct supervision of a physical therapist or a physical therapist assistant. Aides help make therapy sessions productive and are often responsible for keeping the treatment area clean and organized, preparing for each patient's therapy, and assisting patients who need help in moving to or from a treatment area. Because they are not licensed, aides are only able to perform a limited range of tasks.

Physical therapist aides' duties include clerical tasks such as ordering supplies, answering the phone, filling out insurance forms, and other paperwork. The extent of an assistant's or an aide's clerical responsibilities depend on the size and location of the facility.

Work settings

Physical therapists practice in hospitals, clinics, and private offices. They may also treat patients in the patient's home or at school.

Most physical therapists work a 40-hour week, which may include some evenings and weekends depending on their patients' schedules. The job can be physically demanding, because therapists often have to stoop, kneel, crouch, lift, or stand for long periods of time. In addition, physical therapists move heavy equipment, lift patients, or help them turn, stand, or walk.

In 1998, approximately 75% of the physical therapists employed in approximately 120,000 jobs worked full time. Approximately 10% of physical therapists held more than one job.

Over two-thirds of physical therapists are employed in either hospitals or physical therapists' offices. Other work settings include home health agencies, outpatient rehabilitation centers, physicians' offices and clinics, and nursing homes. Some physical therapists maintain a private practice and provide services to individual patients or contract to provide services in hospitals, rehabilitation centers, nursing homes, home health agencies, adult daycare programs, or schools. They may be engaged in individual practice or be part of a consulting group. Some physical therapists teach in academic institutions and conduct research.

Physical therapist assistants and aides

Physical therapist assistants and aides work varying schedules, depending on the facility and whether they are full or part-time employees. To accommodate patients' schedules, many outpatient physical therapy offices and clinics remain open during evenings and weekends.

Physical therapist assistants and aides are required to have a moderate degree of strength due to the physical exertion needed in assisting patients with their treatment. In some cases, for example, assistants and aides help lift patients. In addition, these jobs typically require a good deal of kneeling, stooping, and standing for long periods.

Physical therapist assistants and aides held 82,000 jobs in 1998. Although they work alongside physical therapists in a variety of settings, over two-thirds of all assistants and aides work in hospitals or physical therapists' offices. Other assistants and aides work in nursing and personal care facilities, outpatient rehabilitation centers, physicians' offices and clinics, and home health agencies.

Education and training

Before they can practice, physical therapists are required to pass a licensure exam after graduating from an accredited physical therapist educational program.

According to the American Physical Therapy Association, in 1999 there were 189 accredited physical therapist programs. Of the accredited programs, 24 offered bachelor's degrees, 157 offered master's degrees, and eight offered doctoral degrees. By 2002, the Commission on Accreditation in Physical Therapy Education will require all physical therapist programs seeking accreditation to offer degrees at the post-baccalaureate level.

Physical therapist programs start with basic science courses such as biology, chemistry, and physics, followed by specialized courses such as biomechanics, neuroanatomy, human growth and development, manifestations of disease, examination techniques, and therapeutic procedures. Besides classroom and laboratory instruction, students receive supervised clinical experience.

Admission to physical therapist education programs is very competitive. Interested students may improve their admission potential by attaining superior grades, especially in science courses. Interested students should take courses such as anatomy, biology, chemistry, social science, mathematics, and physics. Before granting admission, many programs require that the student at least have experience as a volunteer in a hospital or clinic physical therapy department.

Physical therapists need strong interpersonal skills to successfully educate patients about their physical therapy treatments and to interact with the patient's family. Therapists should also be compassionate and posses a desire to help patients.

Physical therapists are expected to remain current in their professional development by participating in continuing education courses and workshops. A number of states require continuing education to maintain licensure.

In 1998, physical therapists earned a median annual income of $56,600. The lowest 10% earned less than $35,700 while the highest 10% earned in excess of $90,870 a year. Those in the middle 50% earned between $44,460 and $77,810 a year. In 1997, physical therapists' median annual earnings in the industries employing the largest number of physical therapists included home health care services, $65,600; nursing and personal care facilities, $60,400; health care practitioner offices, $56,600; physicians' offices and clinics, $55,100; and hospitals, $50,100.

Physical therapist assistants and aides

Physical therapist assistants typically have earned an associate's degree from an accredited physical therapist assistant program. As of January 1997, 44 states and Puerto Rico regulated assistants. Physical therapist assistants are also required to have certifications in CPR and other first aid, along with a specified minimum number of hours of clinical experience. Physical therapist aides are also trained on the job.

In 1999, according to the American Physical Therapy Association, there were 274 accredited physical therapist assistant programs in the United States. Accredited physical therapist assistant programs are designed to last two years or four semesters. Those who successfully complete the program are awarded an associate's degree. Admission into physical therapist assistant programs is competitive. Programs are divided into academic study and hands-on clinical experience. Academic coursework includes algebra, anatomy, physiology, biology, chemistry, and psychology. Before students begin their clinical field experience, many programs require that they complete a semester of anatomy and physiology and have certifications in CPR and other first aid. Employers and educators view clinical experience as essential to ensuring that students understand the responsibilities of a physical therapist assistant.

Employers typically require physical therapist aides to have a high school diploma, strong interpersonal skills, and a desire to assist people in need. Most employers provide clinical on-the-job training.

Future outlook

Employment for physical therapists is expected to grow by 21-35% through 2008. For a variety of reasons, the demand for physical therapists should continue to rise. As the baby boom generation ages, the number of individuals with disabilities requiring therapy services should increase, as well as patients who will require cardiac and physical rehabilitation after a heart attack or stroke. In addition, the need for physical therapy will be increased as technological advances save the lives of a larger number of newborns with severe birth defects.

Future medical developments will also increase trauma victims' survival rate, thereby creating additional demand for rehabilitative care. Growth may also result from advances in medical technology which permit treatment of more disabling conditions.

Widespread interest in health promotion may also increase demand for physical therapy services. A growing number of employers are seeking the services of physical therapists to evaluate worksites, develop exercise programs, and teach safe work habits to employees in the hope of reducing injuries.

Physical therapist assistants and aides

Employment for physical therapist assistants and aides is expected to increase by at least 36% through the year 2008. As with the future outlook for physical therapists, the demand for physical therapist assistants and aides will continue to rise to keep pace with the increase in the number of individuals with disabilities and the rapidly growing elderly population, many of whom are particularly vulnerable to chronic and debilitating conditions that require therapeutic services. These patients often need additional assistance in their treatment, making the roles of assistants and aides vital. As the large baby-boom generation reaches the prime age for heart attacks and strokes, the demand for cardiac and physical rehabilitation will also increase. In addition, future medical developments should permit an increased percentage of trauma victims to survive, creating an additional demand for therapy services.

In 1998, physical therapist assistants and aides earned a median annual income of $21,870. The lowest 10% earned less than $13,760 while the highest 10% earned more than $39,730 a year. The middle 50% earned between $16,700 and $31,260 a year. In 1997, the median annual income earned by physical therapist assistants and aides working in the industries employing the largest number of physical therapist assistants and aides included hospitals, $21,200; health care practitioners offices, $20,700; and nursing and personal care facilities, $19,200.

Resources

BOOKS

American Physical Therapy Association. Guide to Physical Therapist Practice, 2nd Edition. American Physical Therapy Association, 2001.

Carr, Janet and Shepherd, Roberta. Movement Science: Foundations for Physical Therapy in Rehabilitation, 2nd Edition. Aspen Publishers, Inc., 2000.

Krumshansl, Bernice. Opportunities in Physical Therapy Careers. VGM Career Horizons, 1999.

U.S. Department of Labor. Occupational Outlook Handbook 2000–2001 Edition. Bureau of Labor Statistics.

ORGANIZATIONS

The American Physical Therapy Association, 1111 North Fairfax Street, Alexandria, VA 22314-1488. 〈http://www.apta.org〉.

Cite this article
Pick a style below, and copy the text for your bibliography.

  • MLA
  • Chicago
  • APA

"Physical Therapy." Gale Encyclopedia of Nursing and Allied Health. . Encyclopedia.com. 21 Sep. 2018 <http://www.encyclopedia.com>.

"Physical Therapy." Gale Encyclopedia of Nursing and Allied Health. . Encyclopedia.com. (September 21, 2018). http://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-maps/physical-therapy-0

"Physical Therapy." Gale Encyclopedia of Nursing and Allied Health. . Retrieved September 21, 2018 from Encyclopedia.com: http://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-maps/physical-therapy-0

Learn more about citation styles

Citation styles

Encyclopedia.com gives you the ability to cite reference entries and articles according to common styles from the Modern Language Association (MLA), The Chicago Manual of Style, and the American Psychological Association (APA).

Within the “Cite this article” tool, pick a style to see how all available information looks when formatted according to that style. Then, copy and paste the text into your bibliography or works cited list.

Because each style has its own formatting nuances that evolve over time and not all information is available for every reference entry or article, Encyclopedia.com cannot guarantee each citation it generates. Therefore, it’s best to use Encyclopedia.com citations as a starting point before checking the style against your school or publication’s requirements and the most-recent information available at these sites:

Modern Language Association

http://www.mla.org/style

The Chicago Manual of Style

http://www.chicagomanualofstyle.org/tools_citationguide.html

American Psychological Association

http://apastyle.apa.org/

Notes:
  • Most online reference entries and articles do not have page numbers. Therefore, that information is unavailable for most Encyclopedia.com content. However, the date of retrieval is often important. Refer to each style’s convention regarding the best way to format page numbers and retrieval dates.
  • In addition to the MLA, Chicago, and APA styles, your school, university, publication, or institution may have its own requirements for citations. Therefore, be sure to refer to those guidelines when editing your bibliography or works cited list.

Physical Therapy

Physical Therapy

Modalities of physical therapy

Physical therapy and the aging adult

Professionals in the field

Resources

Physical therapy, sometimes called physiotherapy, is a medical specialty that provides treatment using various devices or the hands to strengthen muscles and supply flexibility to a part of the body that is subnormal. The need for physical therapy can be the result of a genetic condition, disease, surgery, or a trauma such as a burn or automobile accident. The goal of physical therapy is not necessarily to restore normality but to allow the patient to return to a comfortable and productive life even if the problem persists.

This exacting science has evolved from centuries of using natural therapeutic methods such as sunlight, warm springs, and warm mud to treat injuries. The modern form of physical therapy bloomed after World War I (19141918) when wounded soldiers were in great need of such services. Further incentive was provided by World War II (19391945), and the epidemic of poliomyelitis in the mid-1950s again brought on great numbers of patients in need of therapy. The development of antibiotics and other modern therapeutic measures preserved the lives of those who earlier would have died. These wounded, limbless, or diseased individuals needed a means to regain their independence and ability to earn a living.

Modern physical therapists use heat and cold, electricity, massage, and various types of machines designed to assist flexibility or restore strength to a given body part. Efforts must go far beyond the simple exercising or heating of an injured limb, however. Most physical therapy is carried out by a team headed by a physiatrist, a physician who specializes in the application of various means of physical therapy. The physical therapist, a technician who is schooled in the muscles and joints and how to exercise them, carries out the exercise program with the patient. Devices that apply pressure in certain directions and on which resistance can be adjusted are employed in the exercise program, as is simpler methodology such as walking or running. An engineer can build special equipment as needed or alter existing machinery to better suit the patients needs. The rehabilitation nurse provides basic medical care and tracks the patients progress. If needed, a psychologist is brought in to help the patient adjust to a new, less-comfortable lifestyle. An occupational therapist can assess the patients needs and provide instruction on how to move about his/her home, use prosthetic devices, and specially constructed assist devices such as doorknobs or fork handles that allow someone with a paralyzed hand to open doors or feed himself/herself.

Modalities of physical therapy

Four basic modalities are employed in physical therapy, each applied where and when it will do the most good. Not all of the modalities are used in every case.

Cold therapy

Cold therapy or cryotherapy is an effective means of reducing inflammation following an accident or injury. Cold therapy is applied in the form of ice packs, sometimes combined with massage, cold water bath of the injured area, and other methods. The reduced temperature will quell the firing of the nerve-muscle units and reduce muscle spasms, and that along with the anesthetic effect of the cold temperature will ease pain. Also, the cold reduces blood flow into the injury and reduces any bleeding that may be present and reduces oxygen demands of the injured tissue, thus preserving the muscle cells. An ice pack often is applied with a compression wrap to reduce swelling, and with elevation of the injured extremity above heart level for maximal reduction in swelling.

Heat therapy

Heat or thermotherapy may be employed only after the active swelling of the injury has abated, 24 to 48 hours following the injury. Heat is conveyed into the injured area by the use of moist heat packs, hot paraffin, hot air or hot water as in a whirlpool bath, by infrared lamp, and by conversion. Conversion is the development of heat brought about by the passage of sound waves or electric current through tissue. Diathermy is an example of electrical waves directed into tissue and converted into heat. Ultrasound, very high-frequency sound waves, bring about the vibration of the tissues, which increases the temperature within them. A form of application of sound waves called phonophoresis consists of application of a medication to the injured area followed by ultrasound to drive the medication deep into the tissues.

Heat increases blood flow to an area, so should not be used when internal bleeding accompanies an injury. However, like cryotherapy, heat reduces muscle spasms by increasing the blood flow to an area, which helps to wash out metabolic waste products and increase the amount of oxygen reaching the tissues.

Electrical stimulation

Application of electrical stimulation can restore muscle tone by stimulating muscles to contract rhythmically. This method is used often when an injured person has been confined to bed for a long period of time. Over time, muscles will atrophy and the patient will require long, arduous periods of exercise once he is mobile. The use of electrical stimulation can prevent muscle atrophy and reduce the necessary physical therapy regimen required later. Electricity is also used to drive molecules of medication through the skin into the tissues. This is called iontophoresis. A special machine called a TENS machine (transcutaneous electrical nerve stimulation) beams electric current through the skin (transcutaneously) into the injured area specifically to stop pain. Why TENS has this ability to assuage pain remains open to question, but it is thought that it prevents pain perception by the sensory nerves in the injured area. That is, the nerves that normally would detect pain and carry the impulse to the spinal cord do not sense pain. The electrical signal from the TENS machine can be adjusted for frequency and strength to achieve its effect without patient discomfort. All electrical stimulation is delivered by placing pads on or around the injured area to conduct the electrical current.

Mechanical manipulation

The use of massage, manipulation of the injured limb, traction, and weight lifting are part of the mechanical form of physical therapy. Massage is the rubbing, tapping, or kneading of an injured area to increase blood circulation and relieve pain. Manipulation consists of putting an injured joint through its movements from one extreme to the other. This is designed to restore full range of motion to the joint and eliminate pain from movement. Traction is the application of weight to stretch muscles or to help increase the space between verte-brae and relieve nerve compression. Manipulation may be carried out by a trained technician or by using a machine especially constructed to exercise the injured joint. Resistance can be altered in the machine to make joint extension or flexing more difficult, thus helping to build the muscles that control the joint movement.

Many forms of physical therapy can be carried out at home, but the exercises must first be carefully explained by a trained therapist. Incorrect application of a physical therapy modality can be as harmful as any traumatic injury. Most modalities are applied two or three times daily over a period of time to help restore movement, flexibility, or strength to an injured area.

Physical therapy and the aging adult

Aging is a normal process. Some age-related bodily changes may be misunderstood and unnecessarily limit daily activities. Normal aging need not result in pain and decrease in physical mobility. A physical therapist is a source of information to understand these changes and offer assistance for regaining lost abilities or develop new ones. A physical therapist working with older adults understands the anatomical and physiological changes that occur with normal aging. The physical therapist will evaluate and develop a specially designed therapeutic exercise program. Physical therapy intervention may prevent life long disability and restore the highest level of functioning.

Through the use of tests, evaluations, exercises, treatments with modalities, screening programs, as well as educational information, physical therapists: increase, restore or maintain range of motion, physical strength, flexibility, coordination, balance and endurance; recommend adaptations to make the home accessible and safe; teach positioning, transfers, and walking skills to promote maximum function and independence within an individuals capability; increase overall fitness through exercise programs; prevent further decline in functional abilities through education, energyconservation techniques, joint protection, and use of assistive devices to promote independence; and improve sensation and joint sensitivity, and reduce pain.

Common conditions

A large number of conditions are treated effectively with physical therapy intervention. Examples of specific diseases and conditions that may be improved with physical therapy include: arthritis, sports/orthopedic injuries, joint replacements, cerebral vascular accident (stroke), coordination and balance disorders, and Alzheimer disease.

Professionals in the field

Although many physical therapists work in hospitals, more than 70% can be found in private physical therapy offices, community health centers, corporate or industrial health centers, sports facilities, research institutions, rehabilitation centers, nursing homes, home health agencies, schools, pediatric centers, and colleges and universities.

As a specialist in rehabilitation, the physical therapist typically works with other health care personnel (including physicians, occupational therapists, rehabilitation nurses, and psychologists) to determine the patients goals; evaluates patients and implements treatment programs; teaches patients to use prosthetic devices; and provides instruction to patients to continue the recovery when they are no longer under the direct care of the physical therapist.

As a community health worker, the physical therapist may administer rehabilitative care in the home; teach prenatal and postnatal exercise classes; evaluate and treat children in public schools; and teach back-care classes to prevent back pain and injury.

As an industrial therapist, the physical therapist may determine physical requirements for specific jobs; evaluate and treat an employees job-related physical problems; identify potentially dangerous work conditions; modify job-related tasks to prevent injuries; and provide treatment to injured workers.

As a sports therapist, the physical therapist may evaluate an athletes performance abilities; condition athletes to improve their performance; recommend special equipment to reduce injuries; and develop fitness programs for the general public.

As a researcher, the physical therapist may participate in scientific studies that will lead to new knowledge, new technologies, and more effective patient care. As an educator, the physical therapist may help prepare students for careers in physical therapy; teach entry-level and graduate-level physical therapy courses; participate in scholarly activities that contribute to the understanding of physical therapy; and participate in a variety of service activities in the university and community. As an administrator, the physical therapist may manage physical therapy departments and clinics and act as a consultant to colleagues and health care providers.

With Americans becoming more health- and exercise-consciousespecially participating in more sports and fitness activitiesadditional physical therapists will be needed to treat and help prevent knee, leg, back, shoulder, and other musculoskeletal

KEY TERMS

Cryo A prefix meaning cold.

Modality Any of the forms into which physical therapy is divided.

Thermo A prefix meaning heat.

Transcutaneous A term meaning through the skin.

injuries. Now in the twenty-first century, the post War World II baby boom generation is now aging and beginning to experience conditions common to older people such as arthritis, stroke, heart disease, and other prolonged-care conditions. Physical therapists will be called on increasingly to care for them.

See also Syndrome.

Resources

BOOKS

Beers, Mark H., et al., eds. The Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck Research Laboratories, 2006.

Litin, Scott C., ed. Mayo Clinic Family Health Book. New York: HarperResource, 2003.

OSullivan, Susan B., and Thomas J. Schmitz, eds. Physical Rehabilitation. Philadelphia, PA: F.A. Davis, 2007.

Pagliarulo, Michael A. Introduction to Physical Therapy. St. Louis, MO: Elsevier Mosby, 2007.

Larry Blaser

Cite this article
Pick a style below, and copy the text for your bibliography.

  • MLA
  • Chicago
  • APA

"Physical Therapy." The Gale Encyclopedia of Science. . Encyclopedia.com. 21 Sep. 2018 <http://www.encyclopedia.com>.

"Physical Therapy." The Gale Encyclopedia of Science. . Encyclopedia.com. (September 21, 2018). http://www.encyclopedia.com/science/encyclopedias-almanacs-transcripts-and-maps/physical-therapy-1

"Physical Therapy." The Gale Encyclopedia of Science. . Retrieved September 21, 2018 from Encyclopedia.com: http://www.encyclopedia.com/science/encyclopedias-almanacs-transcripts-and-maps/physical-therapy-1

Learn more about citation styles

Citation styles

Encyclopedia.com gives you the ability to cite reference entries and articles according to common styles from the Modern Language Association (MLA), The Chicago Manual of Style, and the American Psychological Association (APA).

Within the “Cite this article” tool, pick a style to see how all available information looks when formatted according to that style. Then, copy and paste the text into your bibliography or works cited list.

Because each style has its own formatting nuances that evolve over time and not all information is available for every reference entry or article, Encyclopedia.com cannot guarantee each citation it generates. Therefore, it’s best to use Encyclopedia.com citations as a starting point before checking the style against your school or publication’s requirements and the most-recent information available at these sites:

Modern Language Association

http://www.mla.org/style

The Chicago Manual of Style

http://www.chicagomanualofstyle.org/tools_citationguide.html

American Psychological Association

http://apastyle.apa.org/

Notes:
  • Most online reference entries and articles do not have page numbers. Therefore, that information is unavailable for most Encyclopedia.com content. However, the date of retrieval is often important. Refer to each style’s convention regarding the best way to format page numbers and retrieval dates.
  • In addition to the MLA, Chicago, and APA styles, your school, university, publication, or institution may have its own requirements for citations. Therefore, be sure to refer to those guidelines when editing your bibliography or works cited list.

Physical Therapy

Physical Therapy

Definition

Physical therapists provide services to restore function, improve mobility, relieve pain, and prevent or limit permanent physical disabilities among those suffering from injuries, disabilities, or disease.

Description

Organized physical therapy began during World War I with 800 reconstruction aides. Today there are more than 80,000 licensed physical therapists in the United States.

Physical therapists treat patients with a variety of health conditions and diseases including accident victims and individuals with disabling conditions such as low back pain, arthritis, heart disease, fractures, head injuries, and cerebral palsy.

In an effort to restore, maintain, and promote overall fitness and health, physical therapists examine patients' medical histories, as well as test and measure patients' strength, range of motion, balance, coordination, posture, muscle performance, respiration, and motor function. Physical therapists determine patients' ability to be independent and reintegrate into the community or workplace. Based on a patient's medical history and test results, physical therapists develop treatment plans that describe treatment strategy, purpose, and anticipated outcome.

A physical therapist's treatment often includes exercise for patients who have been immobilized or who lack flexibility, strength, or endurance. As part of the treatment, physical therapists encourage

patients to improve flexibility, range of motion, strength, balance, coordination, and endurance. The goal is to improve an individual's function at work and home.

Physical therapists may use electrical stimulation, hot packs, cold compresses, or ultrasound to relieve pain and reduce swelling. They may use traction or deep-tissue massage to relieve pain. Therapists also teach patients to use assistive and adaptive devices including crutches, prostheses, and wheelchairs. They may also show patients how to perform exercises to do at home.

During treatment, physical therapists document the patient's progress, conduct periodic examinations, and modify treatments when necessary. Physical therapists rely on this documentation to track the patient's progress and identify areas requiring more or less attention.

Physical therapists often consult and practice with physicians, dentists, nurses, educators, social workers, occupational therapists, speech-language pathologists, and audiologists.

Some physical therapists treat a wide range of ailments while others specialize in areas such as pediatrics, geriatrics, orthopedics, sports medicine, neurology, and cardiopulmonary physical therapy.

Physical therapist assistants and aides

Physical therapist assistants, under the direction and supervision of a physical therapist, may be involved in implementing patient treatment plans. For example, physical therapist assistants perform treatment procedures including exercises, massages, electrical stimulation, paraffin baths, hot and cold packs, traction, and ultrasound. Physical therapist assistants record patients' treatment responses and report these responses to the physical therapist.

Physical therapist aides work under the direct supervision of a physical therapist or a physical therapist assistant. Aides help make therapy sessions productive and are often responsible for keeping the treatment area clean and organized, preparing for each patient's therapy, and assisting patients who need help in moving to or from a treatment area. Because they are not licensed, aides are only able to perform a limited range of tasks.

Physical therapist aides' duties include clerical tasks such as ordering supplies, answering the phone, filling out insurance forms, and other paperwork. The extent of an assistant's or an aide's clerical responsibilities depend on the size and location of the facility.

Work settings

Physical therapists practice in hospitals, clinics, and private offices. They may also treat patients in the patient's home or at school.

Most physical therapists work a 40-hour week, which may include some evenings and weekends depending on their patients' schedules. The job can be physically demanding, because therapists often have to stoop, kneel, crouch, lift, or stand for long periods of time. In addition, physical therapists move heavy equipment, lift patients, or help them turn, stand, or walk.

Over two-thirds of physical therapists are employed in either hospitals or physical therapists' offices. Other work settings include home health agencies, outpatient rehabilitation centers, physicians' offices and clinics, and nursing homes. Some physical therapists maintain a private practice and provide services to individual patients or contract to provide services in hospitals, rehabilitation centers, nursing homes, home health agencies, adult daycare programs, or schools. They may be engaged in individual practice or be part of a consulting group. Some physical therapists teach in academic institutions and conduct research.

Physical therapist assistants and aides

Physical therapist assistants and aides work varying schedules, depending on the facility and whether they are full or part-time employees. To accommodate patients' schedules, many outpatient physical therapy offices and clinics remain open during evenings and weekends.

Physical therapist assistants and aides are required to have a moderate degree of strength due to the physical exertion needed in assisting patients with their treatment. In some cases, for example, assistants and aides help lift patients. In addition, these jobs typically require a good deal of kneeling, stooping, and standing for long periods.

Physical therapist assistants and aides held 101,000 jobs in 2004. Although they work alongside physical therapists in a variety of settings, over two-thirds of all assistants and aides work in hospitals or physical therapists' offices. Other assistants and aides work in nursing and personal care facilities, outpatient rehabilitation centers, physicians' offices and clinics, and home health agencies.

Education and training

Before they can practice, physical therapists are required to pass a licensure exam after graduating from an accredited physical therapist educational program.

According to the American Physical Therapy Association, in 2004 there were 205 accredited physical therapist programs. Of the accredited programs, 94 offered master's degrees, and 111 offered doctoral degrees. In 2002, the Commission on Accreditation in Physical Therapy Education required all physical therapist programs seeking accreditation to offer degrees at the post-baccalaureate level.

Physical therapist programs start with basic science courses such as biology, chemistry, and physics, followed by specialized courses such as biomechanics, neuroanatomy, human growth and development, manifestations of disease, examination techniques, and therapeutic procedures. Besides classroom and laboratory instruction, students receive supervised clinical experience.

Admission to physical therapist education programs is very competitive. Interested students may improve their admission potential by attaining superior grades, especially in science courses. Interested students should take courses such as anatomy, biology, chemistry, social science, mathematics, and physics. Before granting admission, many programs require that the student at least have experience as a volunteer in a hospital or clinic physical therapy department.

Physical therapists need strong interpersonal skills to successfully educate patients about their physical therapy treatments and to interact with the patient's family. Therapists should also be compassionate and posses a desire to help patients.

Physical therapists are expected to remain current in their professional development by participating in continuing education courses and workshops. A number of states require continuing education to maintain licensure.

In 2004, physical therapists earned a median annual income of $60,180. The lowest 10% earned less than $42,010 while the highest 10% earned in excess of $88,580 a year. Those in the middle 50% earned between $50,330 and $71,760 a year. In 2004, physical therapists' median annual earnings in the industries employing the largest number of physical therapists included home health care services, $64,650; nursing and personal care facilities, $61,720; health care practitioner offices, $60,130; physicians' offices and clinics, $61,270; and hospitals, $60,350.

Physical therapist assistants and aides

Physical therapist assistants typically have earned an associate's degree from an accredited physical therapist assistant program. Physical therapist assistants are also required to have certifications in CPR and other first aid, along with a specified minimum number of hours of clinical experience. Physical therapist aides are also trained on the job.

In 2004, according to the American Physical Therapy Association, there were 238 accredited physical therapist assistant programs in the United States. Accredited physical therapist assistant programs are designed to last two years or four semesters. Those who successfully complete the program are awarded an associate's degree. Admission into physical therapist assistant programs is competitive. Programs are divided into academic study and hands-on clinical experience. Academic coursework includes algebra, anatomy, physiology, biology, chemistry, and psychology. Before students begin their clinical field experience, many programs require that they complete a semester of anatomy and physiology and have certifications in CPR and other first aid. Employers and educators view clinical experience as essential to ensuring that students understand the responsibilities of a physical therapist assistant.

Employers typically require physical therapist aides to have a high school diploma, strong interpersonal skills, and a desire to assist people in need. Most employers provide clinical on-the-job training.

Future outlook

Employment for physical therapists is expected to grow by 21–35% through 2008. For a variety of reasons, the demand for physical therapists should continue to rise. As the baby boom generation ages, the number of individuals with disabilities requiring therapy services should increase, as well as patients who will require cardiac and physical rehabilitation after a heart attack or stroke. In addition, the need for physical therapy will be increased as technological advances save the lives of a larger number of newborns with severe birth defects.

Future medical developments will also increase trauma victims' survival rate, thereby creating additional demand for rehabilitative care. Growth may also result from advances in medical technology which permit treatment of more disabling conditions.

Widespread interest in health promotion may also increase demand for physical therapy services. A growing number of employers are seeking the services of physical therapists to evaluate worksites, develop exercise programs, and teach safe work habits to employees in the hope of reducing injuries.

Physical therapist assistants and aides

Employment for physical therapist assistants and aides is expected to increase by at least 36% through the year 2008. As with the future outlook for physical therapists, the demand for physical therapist assistants and aides will continue to rise to keep pace with the increase in the number of individuals with disabilities and the rapidly growing elderly population, many of whom are particularly vulnerable to chronic and debilitating conditions that require therapeutic services. These patients often need additional assistance in their treatment, making the roles of assistants and aides vital. As the large baby-boom generation reaches the prime age for heart attacks and strokes, the demand for cardiac and physical rehabilitation will also increase. In addition, future medical developments should permit an increased percentage of trauma victims to survive, creating an additional demand for therapy services.

In 2004, physical therapist assistants and aides earned a median annual income of $37,890. The lowest 10% earned less than $24,110 while the highest 10% earned more than $52,110 a year. The middle 50% earned between $31,060 and $44,050 a year. In 1997, the median annual income earned by physical therapist assistants and aides working in the industries employing the largest number of physical therapist assistants and aides included hospitals, $37,790; health care practitioners offices, $37,120; and nursing and personal care facilities, $40,360.

Resources

BOOKS

American Physical Therapy Association. Guide to Physical Therapist Practice, 2nd Edition. American Physical Therapy Association, 2001.

Carr, Janet and Shepherd, Roberta. Movement Science: Foundations for Physical Therapy in Rehabilitation, 2nd Edition. Aspen Publishers, Inc., 2000.

Krumshansl, Bernice. Opportunities in Physical Therapy Careers. VGM Career Horizons, 1999.

U.S. Department of Labor. Occupational Outlook Handbook 2000-2001 Edition. Bureau of Labor Statistics.

ORGANIZATIONS

The American Physical Therapy Association, 1111 North Fairfax Street, Alexandria, VA 22314-1488. http://www.apta.org.

Bill Asenjo MS, CRC

Cite this article
Pick a style below, and copy the text for your bibliography.

  • MLA
  • Chicago
  • APA

"Physical Therapy." The Gale Encyclopedia of Senior Health: A Guide for Seniors and Their Caregivers. . Encyclopedia.com. 21 Sep. 2018 <http://www.encyclopedia.com>.

"Physical Therapy." The Gale Encyclopedia of Senior Health: A Guide for Seniors and Their Caregivers. . Encyclopedia.com. (September 21, 2018). http://www.encyclopedia.com/caregiving/encyclopedias-almanacs-transcripts-and-maps/physical-therapy

"Physical Therapy." The Gale Encyclopedia of Senior Health: A Guide for Seniors and Their Caregivers. . Retrieved September 21, 2018 from Encyclopedia.com: http://www.encyclopedia.com/caregiving/encyclopedias-almanacs-transcripts-and-maps/physical-therapy

Learn more about citation styles

Citation styles

Encyclopedia.com gives you the ability to cite reference entries and articles according to common styles from the Modern Language Association (MLA), The Chicago Manual of Style, and the American Psychological Association (APA).

Within the “Cite this article” tool, pick a style to see how all available information looks when formatted according to that style. Then, copy and paste the text into your bibliography or works cited list.

Because each style has its own formatting nuances that evolve over time and not all information is available for every reference entry or article, Encyclopedia.com cannot guarantee each citation it generates. Therefore, it’s best to use Encyclopedia.com citations as a starting point before checking the style against your school or publication’s requirements and the most-recent information available at these sites:

Modern Language Association

http://www.mla.org/style

The Chicago Manual of Style

http://www.chicagomanualofstyle.org/tools_citationguide.html

American Psychological Association

http://apastyle.apa.org/

Notes:
  • Most online reference entries and articles do not have page numbers. Therefore, that information is unavailable for most Encyclopedia.com content. However, the date of retrieval is often important. Refer to each style’s convention regarding the best way to format page numbers and retrieval dates.
  • In addition to the MLA, Chicago, and APA styles, your school, university, publication, or institution may have its own requirements for citations. Therefore, be sure to refer to those guidelines when editing your bibliography or works cited list.

Physical Therapy

Physical therapy

Definition

Physical therapists provide services to restore function, improve mobility, relieve pain , and prevent or limit permanent physical disabilities among those suffering from injuries, disabilities, or disease.

Description

Organized physical therapy began during World War I with 800 reconstruction aides. Today there are more than 80,000 licensed physical therapists in the United States.

Physical therapists treat patients with a variety of health conditions and diseases including accident victims and individuals with disabling conditions such as low back pain, arthritis, heart disease, fractures , head injuries, and cerebral palsy .

In an effort to restore, maintain, and promote overall fitness and health, physical therapists examine patients' medical histories, as well as test and measure patients' strength, range of motion, balance, coordination, posture, muscle performance, respiration, and motor function. Physical therapists determine patients' ability to be independent and reintegrate into the community or workplace. Based on a patient's medical history and test results, physical therapists develop treatment plans that describe treatment strategy, purpose, and anticipated outcome.

A physical therapist's treatment often includes exercise for patients who have been immobilized or who lack flexibility, strength, or endurance. As part of the treatment, physical therapists encourage patients to improve flexibility, range of motion, strength, balance, coordination, and endurance. The goal is to improve an individual's function at work and home.

Physical therapists may use electrical stimulation, hot packs, cold compresses, or ultrasound to relieve pain and reduce swelling. They may use traction or deep-tissue massage to relieve pain. Therapists also teach patients to use assistive and adaptive devices including crutches, prostheses, and wheelchairs. They may also show patients how to perform exercises to do at home.

During treatment, physical therapists document the patient's progress, conduct periodic examinations, and modify treatments when necessary. Physical therapists rely on this documentation to track the patient's progress and identify areas requiring more or less attention.

Physical therapists often consult and practice with physicians, dentists, nurses, educators, social workers, occupational therapists, speech-language pathologists, and audiologists.

Some physical therapists treat a wide range of ailments while others specialize in areas such as pediatrics, geriatrics, orthopedics, sports medicine, neurology, and cardiopulmonary physical therapy.

Physical therapist assistants and aides

Physical therapist assistants, under the direction and supervision of a physical therapist, may be involved in implementing patient treatment plans. For example, physical therapist assistants perform treatment procedures

dures including exercises, massages, electrical stimulation, paraffin baths, hot and cold packs, traction, and ultrasound. Physical therapist assistants record patients' treatment responses and report these responses to the physical therapist.

Physical therapist aides work under the direct supervision of a physical therapist or a physical therapist assistant. Aides help make therapy sessions productive and are often responsible for keeping the treatment area clean and organized, preparing for each patient's therapy, and assisting patients who need help in moving to or from a treatment area. Because they are not licensed, aides are only able to perform a limited range of tasks.

Physical therapist aides' duties include clerical tasks such as ordering supplies, answering the phone, filling out insurance forms, and other paperwork. The extent of an assistant's or an aide's clerical responsibilities depend on the size and location of the facility.

Work settings

Physical therapists practice in hospitals, clinics, and private offices. They may also treat patients in the patient's home or at school.

Most physical therapists work a 40-hour week, which may include some evenings and weekends depending on their patients' schedules. The job can be physically demanding, because therapists often have to stoop, kneel, crouch, lift, or stand for long periods of time. In addition, physical therapists move heavy equipment, lift patients, or help them turn, stand, or walk.

In 1998, approximately 75% of the physical therapists employed in approximately 120,000 jobs worked full time. Approximately 10% of physical therapists held more than one job.

Over two-thirds of physical therapists are employed in either hospitals or physical therapists' offices. Other work settings include home health agencies, outpatient rehabilitation centers, physicians' offices and clinics, and nursing homes . Some physical therapists maintain a private practice and provide services to individual patients or contract to provide services in hospitals, rehabilitation centers, nursing homes, home health agencies, adult day-care programs, or schools. They may be engaged in individual practice or be part of a consulting group. Some physical therapists teach in academic institutions and conduct research.

Physical therapist assistants and aides

Physical therapist assistants and aides work varying schedules, depending on the facility and whether they are full or part-time employees. To accommodate patients' schedules, many outpatient physical therapy offices and clinics remain open during evenings and weekends.

Physical therapist assistants and aides are required to have a moderate degree of strength due to the physical exertion needed in assisting patients with their treatment. In some cases, for example, assistants and aides help lift patients. In addition, these jobs typically require a good deal of kneeling, stooping, and standing for long periods.

Physical therapist assistants and aides held 82,000 jobs in 1998. Although they work alongside physical therapists in a variety of settings, over two-thirds of all assistants and aides work in hospitals or physical therapists' offices. Other assistants and aides work in nursing and personal care facilities, outpatient rehabilitation centers, physicians' offices and clinics, and home health agencies.

Education and training

Before they can practice, physical therapists are required to pass a licensure exam after graduating from an accredited physical therapist educational program.

According to the American Physical Therapy Association, in 1999 there were 189 accredited physical therapist programs. Of the accredited programs, 24 offered bachelor's degrees, 157 offered master's degrees, and eight offered doctoral degrees. By 2002, the Commission on Accreditation in Physical Therapy Education will require all physical therapist programs seeking accreditation to offer degrees at the post-baccalaureate level.

Physical therapist programs start with basic science courses such as biology, chemistry, and physics, followed by specialized courses such as biomechanics, neuroanatomy, human growth and development , manifestations of disease, examination techniques, and therapeutic procedures. Besides classroom and laboratory instruction, students receive supervised clinical experience.

Admission to physical therapist education programs is very competitive. Interested students may improve their admission potential by attaining superior grades, especially in science courses. Interested students should take courses such as anatomy, biology, chemistry, social science, mathematics, and physics. Before granting admission, many programs require that the student at least have experience as a volunteer in a hospital or clinic physical therapy department.

Physical therapists need strong interpersonal skills to successfully educate patients about their physical therapy treatments and to interact with the patient's family. Therapists should also be compassionate and posses a desire to help patients.

Physical therapists are expected to remain current in their professional development by participating in continuing education courses and workshops. A number of states require continuing education to maintain licensure.

In 1998, physical therapists earned a median annual income of $56,600. The lowest 10% earned less than $35,700 while the highest 10% earned in excess of $90,870 a year. Those in the middle 50% earned between $44,460 and $77,810 a year. In 1997, physical therapists' median annual earnings in the industries employing the largest number of physical therapists included home health care services, $65,600; nursing and personal care facilities, $60,400; health care practitioner offices, $56,600; physicians' offices and clinics, $55,100; and hospitals, $50,100.

Physical therapist assistants and aides

Physical therapist assistants typically have earned an associate's degree from an accredited physical therapist assistant program. As of January 1997, 44 states and Puerto Rico regulated assistants. Physical therapist assistants are also required to have certifications in CPR and other first aid , along with a specified minimum number of hours of clinical experience. Physical therapist aides are also trained on the job.

In 1999, according to the American Physical Therapy Association, there were 274 accredited physical therapist assistant programs in the United States. Accredited physical therapist assistant programs are designed to last two years or four semesters. Those who successfully complete the program are awarded an associate's degree. Admission into physical therapist assistant programs is competitive. Programs are divided into academic study and hands-on clinical experience. Academic coursework includes algebra, anatomy, physiology, biology, chemistry, and psychology. Before students begin their clinical field experience, many programs require that they complete a semester of anatomy and physiology and have certifications in CPR and other first aid. Employers and educators view clinical experience as essential to ensuring that students understand the responsibilities of a physical therapist assistant.

Employers typically require physical therapist aides to have a high school diploma, strong interpersonal skills, and a desire to assist people in need. Most employers provide clinical on-the-job training.

Future outlook

Employment for physical therapists is expected to grow by 21–35% through 2008. For a variety of reasons, the demand for physical therapists should continue to rise. As the baby boom generation ages, the number of individuals with disabilities requiring therapy services should increase, as well as patients who will require cardiac and physical rehabilitation after a heart attack or stroke. In addition, the need for physical therapy will be increased as technological advances save the lives of a larger number of newborns with severe birth defects.

Future medical developments will also increase trauma victims' survival rate, thereby creating additional demand for rehabilitative care. Growth may also result from advances in medical technology which permit treatment of more disabling conditions.

Widespread interest in health promotion may also increase demand for physical therapy services. A growing number of employers are seeking the services of physical therapists to evaluate worksites, develop exercise programs, and teach safe work habits to employees in the hope of reducing injuries.

Physical therapist assistants and aides

Employment for physical therapist assistants and aides is expected to increase by at least 36% through the year 2008. As with the future outlook for physical therapists, the demand for physical therapist assistants and aides will continue to rise to keep pace with the increase in the number of individuals with disabilities and the rapidly growing elderly population, many of whom are particularly vulnerable to chronic and debilitating conditions that require therapeutic services. These patients often need additional assistance in their treatment, making the roles of assistants and aides vital. As the large baby-boom generation reaches the prime age for heart attacks and strokes, the demand for cardiac and physical rehabilitation will also increase. In addition, future medical developments should permit an increased percentage of trauma victims to survive, creating an additional demand for therapy services.

In 1998, physical therapist assistants and aides earned a median annual income of $21,870. The lowest 10% earned less than $13,760 while the highest 10% earned more than $39,730 a year. The middle 50% earned between $16,700 and $31,260 a year. In 1997, the median annual income earned by physical therapist assistants and aides working in the industries employing the largest number of physical therapist assistants and aides included hospitals, $21,200; health care practitioners offices, $20,700; and nursing and personal care facilities, $19,200.

Resources

BOOKS

American Physical Therapy Association. Guide to Physical Therapist Practice, 2nd Edition. American Physical Therapy Association, 2001.

Carr, Janet, and Shepherd, Roberta. Movement Science: Foundations for Physical Therapy in Rehabilitation, 2nd Edition. Aspen Publishers, Inc. 2000.

Krumshansl, Bernice. Opportunities in Physical Therapy Careers. VGM Career Horizons, 1999.

U.S. Department of Labor. Occupational Outlook Handbook 2000-2001 Edition. Bureau of Labor Statistics.

ORGANIZATIONS

The American Physical Therapy Association, 1111 North Fairfax Street, Alexandria, VA 22314-1488. <http://www.apta.org>.

Bill Asenjo, MS, CRC

Cite this article
Pick a style below, and copy the text for your bibliography.

  • MLA
  • Chicago
  • APA

"Physical Therapy." Gale Encyclopedia of Nursing and Allied Health. . Encyclopedia.com. 21 Sep. 2018 <http://www.encyclopedia.com>.

"Physical Therapy." Gale Encyclopedia of Nursing and Allied Health. . Encyclopedia.com. (September 21, 2018). http://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-maps/physical-therapy

"Physical Therapy." Gale Encyclopedia of Nursing and Allied Health. . Retrieved September 21, 2018 from Encyclopedia.com: http://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-maps/physical-therapy

Learn more about citation styles

Citation styles

Encyclopedia.com gives you the ability to cite reference entries and articles according to common styles from the Modern Language Association (MLA), The Chicago Manual of Style, and the American Psychological Association (APA).

Within the “Cite this article” tool, pick a style to see how all available information looks when formatted according to that style. Then, copy and paste the text into your bibliography or works cited list.

Because each style has its own formatting nuances that evolve over time and not all information is available for every reference entry or article, Encyclopedia.com cannot guarantee each citation it generates. Therefore, it’s best to use Encyclopedia.com citations as a starting point before checking the style against your school or publication’s requirements and the most-recent information available at these sites:

Modern Language Association

http://www.mla.org/style

The Chicago Manual of Style

http://www.chicagomanualofstyle.org/tools_citationguide.html

American Psychological Association

http://apastyle.apa.org/

Notes:
  • Most online reference entries and articles do not have page numbers. Therefore, that information is unavailable for most Encyclopedia.com content. However, the date of retrieval is often important. Refer to each style’s convention regarding the best way to format page numbers and retrieval dates.
  • In addition to the MLA, Chicago, and APA styles, your school, university, publication, or institution may have its own requirements for citations. Therefore, be sure to refer to those guidelines when editing your bibliography or works cited list.

Physical Therapy

Physical therapy

Physical therapy is a medical specialty that provides treatment using various devices or the hands to strengthen muscles and supply flexibility to a part of the body that is subnormal. The need for physical therapy can be the result of a genetic condition, disease , surgery , or a trauma such as a burn or automobile accident. The goal of physical therapy is not necessarily to restore normality but to allow the patient to return to a comfortable and productive life even if the problem persists.

This exacting science has evolved from centuries of using natural therapeutic methods such as sunlight, warm springs, and warm mud to treat injuries. The modern form of physical therapy bloomed after World War I when wounded soldiers were in great need of such services. Further incentive was provided by World War II, and the epidemic of poliomyelitis in the mid-1950s again brought on great numbers of patients in need of therapy. The development of antibiotics and other modern therapeutic measures preserved the lives of those who earlier would have died. These wounded, limbless, or diseased individuals needed a means to regain their independence and ability to earn a living.

Modern physical therapists use heat and cold, electricity , massage, and various types of machines designed to assist flexibility or restore strength to a given body part. Efforts must go far beyond the simple exercising or heating of an injured limb, however. Most physical therapy is carried out by a team headed by a physiatrist, a physician who specializes in the application of various means of physical therapy. The physical therapist, a technician who is schooled in the muscles and joints and how to exercise them, carries out the exercise program with the patient. Devices that apply pressure in certain directions and on which resistance can be adjusted are employed in the exercise program, as is simpler methodology such as walking or running. An engineer can build special equipment as needed or alter existing machinery to better suit the patient's needs. The rehabilitation nurse provides basic medical care and tracks the patient's progress. If needed, a psychologist is brought in to help the patient adjust to a new, less-comfortable lifestyle. An occupational therapist can assess the patient's needs and provide instruction on how to move about his home, use prosthetic devices, and specially constructed assist devices such as doorknobs or fork handles that allow someone with a paralyzed hand to open doors or feed himself.


The modalities of physical therapy

Four basic modalities are employed in physical therapy, each applied where and when it will do the most good. Not all of the modalities are used in every case.


Cold therapy

Cold therapy or cryotherapy is an effective means of reducing inflammation following an accident or injury. Cold therapy is applied in the form of ice packs, sometimes combined with massage, cold water bath of the injured area, and other methods. The reduced temperature will quell the firing of the nerve-muscle units and reduce muscle spasms, and that along with the anesthetic effect of the cold temperature will ease pain . Also, the cold reduces blood flow into the injury and reduces any bleeding that may be present and reduces oxygen demands of the injured tissue , thus preserving the muscle cells. An ice pack often is applied with a compression wrap to reduce swelling, and with elevation of the injured extremity above heart level for maximal reduction in swelling.


Heat therapy

Heat or thermotherapy may be employed only after the active swelling of the injury has abated, 24-48 hours following the injury. Heat is conveyed into the injured area by the use of moist heat packs, hot paraffin, hot air or hot water as in a whirlpool bath, by infrared lamp, and by conversion. Conversion is the development of heat brought about by the passage of sound waves or electric current through tissue. Diathermy is an example of electrical waves directed into tissue and converted into heat. Ultrasound, very high-frequency sound waves, bring about the vibration of the tissues, which increases the temperature within them. A form of application of sound waves called phonophoresis consists of application of a medication to the injured area followed by ultrasound to drive the medication deep into the tissues.

Heat increases blood flow to an area, so should not be used when internal bleeding accompanies an injury. However, like cryotherapy, heat reduces muscle spasms by increasing the blood flow to an area, which helps to wash out metabolic waste products and increase the amount of oxygen reaching the tissues.


Electrical stimulation

Application of electrical stimulation can restore muscle tone by stimulating muscles to contract rhythmically. This method is used often when an injured person has been confined to bed for a long period of time . Over time, muscles will atrophy and the patient will require long, arduous periods of exercise once he is mobile. The use of electrical stimulation can prevent muscle atrophy and reduce the necessary physical therapy regimen required later. Electricity is also used to drive molecules of medication through the skin into the tissues. This is called iontophoresis. A special machine called a TENS machine (transcutaneous electrical nerve stimulation) beams electric current through the skin (transcutaneously) into the injured area specifically to stop pain. Why TENS has this ability to assuage pain remains open to question, but it is thought that it prevents pain perception by the sensory nerves in the injured area. That is, the nerves that normally would detect pain and carry the impulse to the spinal cord do not sense pain. The electrical signal from the TENS machine can be adjusted for frequency and strength to achieve its effect without patient discomfort. All electrical stimulation is delivered by placing pads on or around the injured area to conduct the electrical current.


Mechanical manipulation

The use of massage, manipulation of the injured limb, traction, and weight lifting are part of the mechanical form of physical therapy. Massage is the rubbing, tapping, or kneading of an injured area to increase blood circulation and relieve pain. Manipulation consists of putting an injured joint through its movements from one extreme to the other. This is designed to restore full range of motion to the joint and eliminate pain from movement. Traction is the application of weight to stretch muscles or to help increase the space between vertebrae and relieve nerve compression. Manipulation may be carried out by a trained technician or by using a machine especially constructed to exercise the injured joint. Resistance can be altered in the machine to make joint extension or flexing more difficult, thus helping to build the muscles that control the joint movement.

Many forms of physical therapy can be carried out at home, but the exercises must first be carefully explained by a trained therapist. Incorrect application of a physical therapy modality can be as harmful as any traumatic injury. Most modalities are applied two or three times daily over a period of time to help restore movement, flexibility, or strength to an injured area.


Physical therapy and the aging adult

Aging is a normal process. Some age-related bodily changes may be misunderstood and unnecessarily limit daily activities. Normal aging need not result in pain and decrease in physical mobility. A physical therapist is a source of information to understand these changes and offer assistance for regaining lost abilities or develop new ones. A physical therapist working with older adults understands the anatomical and physiological changes that occur with normal aging. The physical therapist will evaluate and develop a specially designed therapeutic exercise program. Physical therapy intervention may prevent life long disability and restore the highest level of functioning.

Through the use of tests, evaluations, exercises, treatments with modalities, screening programs, as well as educational information, physical therapists:

  • increase, restore or maintain range of motion, physical strength, flexibility, coordination, balance and endurance
  • recommend adaptations to make the home accessible and safe
  • teach positioning, transfers, and walking skills to promote maximum function and independence within an individual's capability
  • increase overall fitness through exercise programs
  • prevent further decline in functional abilities through education, energy conservation techniques, joint protection, and use of assistive devices to promote independence
  • improve sensation, joint proprioception and reduce pain

Common Conditions

A vast number of conditions are treated effectively with physical therapy intervention. Examples of specific diseases and conditions that may be improved with physical therapy include:

  • arthritis
  • sports/orthopedic injuries
  • joint replacements
  • cerebral vascular accident (stroke)
  • coordination and balance disorders
  • Alzheimer disease

See also Syndrome.


Resources

books

Larson, David E., ed. Mayo Clinic Family Health Book. New York: William Morrow, 1996.

Pisetsky, David S., and Susan F. Trien. The Duke UniversityMedical Center Book of Arthritis. New York: Fawcett Columbine, 1992.


Larry Blaser

KEY TERMS

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cryo

—A prefix meaning cold.

Modality

—Any of the forms into which physical therapy is divided.

Thermo

—A prefix meaning heat.

Transcutaneous

—A term meaning through the skin.

Cite this article
Pick a style below, and copy the text for your bibliography.

  • MLA
  • Chicago
  • APA

"Physical Therapy." The Gale Encyclopedia of Science. . Encyclopedia.com. 21 Sep. 2018 <http://www.encyclopedia.com>.

"Physical Therapy." The Gale Encyclopedia of Science. . Encyclopedia.com. (September 21, 2018). http://www.encyclopedia.com/science/encyclopedias-almanacs-transcripts-and-maps/physical-therapy-0

"Physical Therapy." The Gale Encyclopedia of Science. . Retrieved September 21, 2018 from Encyclopedia.com: http://www.encyclopedia.com/science/encyclopedias-almanacs-transcripts-and-maps/physical-therapy-0

Learn more about citation styles

Citation styles

Encyclopedia.com gives you the ability to cite reference entries and articles according to common styles from the Modern Language Association (MLA), The Chicago Manual of Style, and the American Psychological Association (APA).

Within the “Cite this article” tool, pick a style to see how all available information looks when formatted according to that style. Then, copy and paste the text into your bibliography or works cited list.

Because each style has its own formatting nuances that evolve over time and not all information is available for every reference entry or article, Encyclopedia.com cannot guarantee each citation it generates. Therefore, it’s best to use Encyclopedia.com citations as a starting point before checking the style against your school or publication’s requirements and the most-recent information available at these sites:

Modern Language Association

http://www.mla.org/style

The Chicago Manual of Style

http://www.chicagomanualofstyle.org/tools_citationguide.html

American Psychological Association

http://apastyle.apa.org/

Notes:
  • Most online reference entries and articles do not have page numbers. Therefore, that information is unavailable for most Encyclopedia.com content. However, the date of retrieval is often important. Refer to each style’s convention regarding the best way to format page numbers and retrieval dates.
  • In addition to the MLA, Chicago, and APA styles, your school, university, publication, or institution may have its own requirements for citations. Therefore, be sure to refer to those guidelines when editing your bibliography or works cited list.