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Chapter 13: Therapy and Rehabilitation

Chapter 13: Therapy and Rehabilitation. Physical Therapists. History of the Profession Began during WWI w. rehabilitation of wounded soldiers 1917: Army training program for reconstruction aides 1921: reconstruction aides form association (APTA)

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Chapter 13: Therapy and Rehabilitation

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  1. Chapter 13: Therapy and Rehabilitation

  2. Physical Therapists • History of the Profession • Began during WWI w. rehabilitation of wounded soldiers • 1917: Army training program for reconstruction aides • 1921: reconstruction aides form association (APTA) • 1940s & 1950s: demand for therapists due to WWII & polio • 1950s: state licensing increased • 1954: APTA developed competency exam • 1960s: therapists began treating other conditions • 1968: PT services authorized for Medicare program

  3. Physical Therapists (cont’d) • Education • Master’s degree programs • Minimum requirement • 19 accredited programs • Take 2 to 2 ½ years • Doctoral degree programs • Are becoming the entry-level requirement • 203 accredited programs • Take 3 years • More content & longer clinical rotations than master’s

  4. Physical Therapists (cont’d) • Course Work • Anatomy • Cellular biology • Physiology • Exercise physiology • Neuroscience • Pharmacology • Applied psychology • Applied sociology • Communication • Clinical reasoning • Applied statistics

  5. Physical Therapists (cont’d) • Licensure • Required in all states • Requires: • Graduation from accredited program • Passing exam • Other state requirements • Specialist Certification • Offered by American Board of Physical Therapy Specialties • For licensed PTs in practice for at least 10 years • Available for 7 specialties • Requires 2,000 hours of direct patient care in area

  6. Physical Therapists (cont’d) • Work Responsibilities • Do a systems review • Take patients’ medical history • Conduct motor function tests • Develop treatment plans • Perform gait & locomotion training • Assess patients’ progress • Educate patients about expected outcomes • Coordinate with home care agencies

  7. Physical Therapists (cont’d) • Personal Characteristics • Care • Compassion • Positive attitude • Ability to work well with others • Good observation skills • Good problem-solving skills

  8. Physical Therapists (cont’d) • Employment Opportunities and Trends • 30% growth from 2008 to 2018 • Growth due to: • Easing of service restrictions by insurers • Rising population of older adults • Increased survival of trauma victims & infants w. birth defects • Increase in treatment of previously untreatable conditions • Influence of Individuals with Disabilities Education Act • About 35% of jobs in practitioners’ offices • About 30% of jobs in hospitals

  9. Physical Therapists (cont’d) • Professional Organization: APTA • 72,000 members • Goal: help advance PT practice, research, & education • Monitors legislation & advocates for profession • Conducts research on profession • Certifies specialists • Credentials residency & fellowship programs • Offers many member benefits

  10. Physical Therapist Assistants • History of the Profession • Developed after WWII w. greater need for PT treatments • 1950s: first assistants appeared, informally trained • 1967: first two PTA education programs approved • CAPTE set program accreditation standards • APTA developed guidelines for tasks • 1970s to 1990s: PTA training programs grew rapidly

  11. Physical Therapist Assistants (cont’d) • Education • Associate’s degree programs (most) • 252 accredited programs • 2 years long • Includes general education & technical education classes • Includes 520 to 720 hours of clinical experience

  12. Physical Therapist Assistants (cont’d) • Course Work: General & Technical • Basic sciences • Applied physical therapy science • Physical therapy interventions • Communication • Behavior & conduct • Data collection

  13. Physical Therapist Assistants (cont’d) • Licensure, Registration, or Certification • Required in most states • Requires • Associate’s degree from accredited PTA program • Passing NPTE exam • Passing state exam (in some states) • Continuing education for license renewal • PTA Recognition Program provides distinction for PTAs with advanced proficiency

  14. Physical Therapist Assistants (cont’d) • Work Responsibilities • Measure height, weight, length, & girth • Use hip & knee flexion techniques • Use static stretching techniques • Conduct gait training • Collect patient data • Massage tissues to ease swelling • Teach a patient to use a walker • Update progress notes after a session

  15. Physical Therapist Assistants (cont’d) • Personal Characteristics • Empathy • Good people skills • Good communication skills • Good organizational skills • Attention to detail • Good teamwork skills

  16. Physical Therapist Assistants (cont’d) • Employment Opportunities and Trends • Rapid growth: 33% between 2008 & 2018 • Setting distribution • 72% in hospitals or offices of health practitioners • Remainder in: • Nursing care • Home health care • Outpatient care

  17. Physical Therapist Assistants (cont’d) • Professional Organization: APTA • American Physical Therapy Association (APTA) • Represents both PTs & PTAs • Has organization just for PTAs, National Assembly • Offers: • Continuing education • Special interest groups • Awards • Online career center

  18. Occupational Therapists • History of the Profession • Moral treatment: 18th & 19th century approach to mental illness • Provided patients w. activities, exercise, & pleasant surroundings • Late 19th & early 20th centuries: OT expanded to disabilities • 1917: Barton forms professional association (AOTA) • WWI: reconstruction aids provided OT for soldiers • 1935: AMA joined AOTA in accrediting OT programs • WWII: rapid growth, shift in focus to physical rehabilitation • 1960s: call for return to occupation-centered roots • 2002: AOTA adopted new practice framework

  19. Occupational Therapists (cont’d) • Education • Master’s degree at minimum • 151 accredited master’s degree programs • 4 accredited doctoral programs • Undergraduate degree can be from variety of majors • Programs include: • Core & professional courses • 24 weeks of supervised fieldwork • Doctoral programs offer additional instruction in many subjects

  20. Occupational Therapists (cont’d) • Course Work • General intro to OT • Skills in screening, evaluating, & referring clients • Development of an intervention plan • Interventions • Accommodation to different work settings • Management of OT services • Research • Professional ethics, values, & responsibilities

  21. Occupational Therapists (cont’d) • Licensure and Certification • Licensure • Required in all states • Requires graduation from accredited program & passing exam • Certification • AOTA offers board certification in various areas • Requirements: • Professional degree • Set # of years in practice • Set # of hours of OT practice

  22. Occupational Therapists (cont’d) • Work Responsibilities • Screen for learning disabilities • Perform muscle testing • Test visual acuity • Evaluate home environment • Develop intervention plans • Select assistive technology • Teach patients to dress • Instruct in reading strategies • Modify classroom equipment

  23. Occupational Therapists (cont’d) • Professional Characteristics • Good interpersonal skills • Empathy • Patience • Good observation skills • Creativity • Strong organizational skills • Attention to detail • Good communication skills

  24. Occupational Therapists (cont’d) • Employment Opportunities and Trends • Growth of 26% between 2008 & 2018 • Increased opportunities due to: • Needs of increasing older population • Medical advances allowing patients w. conditions to survive • Setting distribution • 29% in offices of health practitioners • 28% in hospitals • 13% in educational services • 10% in nursing residential care

  25. Occupational Therapists (cont’d) • Professional Organization: AOTA • 36,000 members • Goals • Represent interests of members • Improve quality of OT services • Monitors legislation & regulations affecting profession • Advocates for profession • Offers board & specialty certifications • Provides many benefits to members

  26. Occupational Therapy Assistants • History of the Profession • 1950s: shortage of OTs after WWII • 1958: AOTA began approving ed. programs for assistants • Early programs were 3 months long & in hospitals • Later moved to community colleges & technical schools, longer time • Moved from hospitals to other practice settings

  27. Occupational Therapy Assistants (cont’d) • Education • 2-year associate’s degree is standard • 145 accredited programs • Includes: • Course work • At least 16 hours of supervised fieldwork

  28. Occupational Therapy Assistants (cont’d) • Course Work • General intro. to OT • Skills in screening & evaluation • Assistance in development of intervention plan • OT skills • Accommodation to different work settings • Assistance in management of OT services • Use of professional literature • Professional ethics, values, & responsibilities

  29. Occupational Therapy Assistants (cont’d) • Licensure, Registration, or Certification • Required in 40 states • Optional certification via NBCOT exam: COTA • Taking exam requires graduation from accredited program • Renewal required every 3 years • Specialty certifications available from AOTA

  30. Occupational Therapy Assistants (cont’d) • Work Responsibilities • Screen for visual perception • Test touch awareness • Evaluate client data • Select therapy activities to fit client’s needs • Develop energy-saving strategies for a client with MS • Write progress notes

  31. Occupational Therapy Assistants (cont’d) • Personal Characteristics • Good people skills • Empathy • Patience • Responsibility • Willingness to take direction • Good teamwork skills

  32. Occupational Therapy Assistants (cont’d) • Employment Opportunities and Trends • Growth: 30% between 2008 & 2018 • Factors prompting growth • Cost-control measure • Growing school-age population • Federal laws requiring funding for ed. for those w. disabilities • Setting distribution • ¾ in hospitals, practitioner offices, & nursing care facilities • Remainder in community care & home health care

  33. Occupational Therapy Assistants (cont’d) • Professional Organization: AOTA • Represents OTs & OTAs • Offers: • Specialty certifications • Continuing education • Online resources

  34. Respiratory Therapists • History of the Profession • Tech developments in 20th century led to oxygen therapy • Nurses initially administered oxygen therapy • Post-WWII • Equipment became more complex • Oxygen orderlies took over • 1946: professional organization of oxygen orderlies established • 1962: school guidelines approved by AMA • 2009: most recent revision of school guidelines

  35. Respiratory Therapists (cont’d) • Education • Associate’s degree at minimum • Bachelor’s or master’s degree may help advancement • Programs: • Offered at: • Colleges & universities • Medical schools • Vocational-technical institutes & military • 378 advanced-level & 27 entry-level accredited programs

  36. Respiratory Therapists (cont’d) • Course Work • Communication • Social & behavioral sciences • Math • Computer science • Cardiopulmonary A&P • Chemistry • Microbiology • Pharmacology • Assessment of cardiopulmonary status • Airway management • Lung inflation therapy • Alternate site care

  37. Respiratory Therapists (cont’d) • Licensure • Required in all states except Alaska & Hawaii • Must be renewed every 3 years, requiring continuing ed.

  38. Respiratory Therapists (cont’d) • Credentials Awarded by NBRC • Certified Registered Therapist (CRT) • Registered Respiratory Therapist (RRT) • Neonatal/Pediatric Specialist (CRT-NPS or RRT-NPS) • Sleep Disorders Testing and Therapeutic Intervention Respiratory Care Specialist (CRT-SDS or RRT-SDS)

  39. Respiratory Therapists (cont’d) • Work Responsibilities • Do pulmonary function tests • Set up mechanical ventilators • Monitor arterial blood gases • Insert airway tubes • Obtain & analyze oxygenation level of arterial blood • Administer aerosol medications • Perform chest physiotherapy • Check lung sounds

  40. Respiratory Therapists (cont’d) • Personal Characteristics • Calm, reassuring manner • Sensitivity to patients’ needs • Good communication skills • Good teamwork skills • Flexibility • Willingness to learn

  41. Respiratory Therapists (cont’d) • Employment Opportunities and Trends • Growth: 21% between 2008 & 2018 • Factors prompting growth • Increasing # of middle-aged & older adults • Enhancements in respiratory medications & treatments • Movement of respiratory therapists into case management • Setting distribution • 81% in hospitals • Remainder in physicians’ offices & other locations

  42. Respiratory Therapists (cont’d) • Professional Organization: AARC • Founded in 1947 • Dedicated to professional development & lung health • Advocates for profession on legislative & regulatory issues • Accredits continuing education programs • Offers many member benefits

  43. Massage Therapists • History of the Profession • Practiced in ancient China, India, Egypt, & other societies • Performed on athletes competing in ancient Greek Olympics • Per Henrik Ling: developed Swedish massage • Mid-1800s: Taylor promoted Swedish massage in U.S. • Early 20th century: massage declined in U.S. • 1927: first professional massage organization in U.S. • 1960s & 1970s: resurgence of massage in U.S.

  44. Massage Therapists (cont’d) • Education • Most complete formal training program • Programs: • Combination of course work & hands-on practice • May focus on particular modalities • Approved by state board & sometimes accredited • Take 500 hours or more to complete • Require HS diploma or equivalent

  45. Massage Therapists (cont’d) • Course Work • Anatomy • Physiology • Kinesiology • Pathology • Massage theory & application • Business • Ethics • Various modalities

  46. Massage Therapists (cont’d) • Licensure or Certification • Required by almost all states • Requires: • Completion of state-approved program • Passing an exam • Two certification exams administered by NCBTMB • Certification renewal requires: • 48 hours of continuing education • 200 hours of work experience

  47. Massage Therapists (cont’d) • Work Responsibilities • Schedule client sessions • Do client assessments • Prepare initial treatment plans • Position clients’ body • Apply appropriate massage strokes • Use various modalities • Use proper body mechanics • Maintain client records

  48. Massage Therapists (cont’d) • Personal Characteristics • Sociability • Empathy • Good communicationskills

  49. Massage Therapists (cont’d) • Employment Opportunities and Trends • Growth: 19% between 2008 & 2018 • Factors prompting growth • Increased awareness of the benefits of massage • Formation of more spas & massage clinic franchises • Companies adopting seated massage as a work benefit • Increased demands for massage among older & young adults • 57% are self-employed • Settings: salons, spas, physicians’ & chiropractors’ offices, fitness centers, hotels

  50. Massage Therapists (cont’d) • Professional Organizations • American Massage Therapy Association (AMTA) • Founded in 1943 • >58,000 members • Associated Bodywork & Massage Professionals (ABMP) • Founded in 1987 • >70,000 members

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