Types of Physical Therapy

There are many specialty areas in the field of physical therapy. Although these areas are well known throughout the profession, it is often overlooked by the general public. Here is a brief description of the most common specialty areas in physical therapy and find out which is most appropriate for you or your family member.

Orthopedic physical therapy

It is the diagnosis, management, and treatment for disorders and injuries of the musculoskeletal system as well as rehabilitation of patients’ post-orthopedic surgery. This specialty is most often found in the out-patient clinical setting. Orthopedic therapists are trainied in the treatment of post-operative joints, acute sports injuries, arthritis, and amputations just to name a few.

Common modalities used to expedite recovery are joint mobilization, strength training, hot and cold packs, and electrical stimulation. Those who have suffered injury or disease affecting the muscles, bones, ligaments, or tendons of the body would benefit from assessment by a physical therapist specialized in orthopedics.

Geriatric physical therapy

This area covers a wide area of issues concerning people as they go through normal adult aging, but is usually focused on the older adult. There are many conditions that affect people as they grow older and that includes (but not limited to) arthritis, osteoporosis, cancer, Alzheimer’s disease, hip and join replacement, balance disorders, and incontinence.

Geriatric physical therapy helps those affected with such problems in developing a specialized program to help restore mobility, reduce pain, increase fitness levels, and more.

Neurological physical therapy

This is a discipline focused on working with individuals who have a neurological disorder or disease. These include Alzheimer’s disease, ALS, brain injury, cerebral palsy, multiple sclerosis, Parkinson’s disease, spinal cord injury, and stroke.

Common problems of patients with such disorders include paralysis, vision impairment, poor balance, inability to ambulate, and loss of functional independence. Therapists work with patients to improve these areas of dysfunction.

Cardiovascular and pulmonary rehabilitation

CPR therapists treat a wide variety of patients with cardio-pulmonary disorders or those who have had cardiac or pulmonary surgery. Primary goals of this specialty include increasing patient endurance and functional independence.

Manual therapy is utilized in this field to assist in clearing lung secretions experienced in patients with cystic fibrosis. Patients with disorders including heart attacks, post-coronary bypass surgery, chronic obstructive pulmonary disease, and pulmonary fibrosis are only a few examples of those who would benefit from this.

Pediatric physical therapy

It is the assistance in early detection of health problems and uses a wide variety of modalities to treat disorders in the pediatric population. These therapists are specialized in the diagnosis, treatment, and management of infants, children, and adolescents with a variety of congenital, developmental, neuromuscular, skeletal, or acquired disorders or diseases.

Treatments focus on improving gross and fine motor skills, balance and coordination, strength, and endurance as well as cognitive and sensory processing/ integration. Patients include children with developmental delays, cerebral palsy, spina bifida, and torticollis.

How Physical Therapy Work

Physical therapy is one of the less known medical practice in the US, but its responsibility and popularity around the world is unquestionable. It is a health care specialty concerned with treating musculoskeletal disorders and its interaction with physical movement.

Physical therapists are licensed professionals who hold a masters, doctorate, or bachelors degree in physical therapy. They work in a wide variety of setting including hospitals, rehabilitation centers, out-patient facilities, schools, nursing homes, and gymnasiums.

What is physical therapy?

It is a health care specialty involved with evaluating, diagnosing, and treating disorders of man’s muscles and bones. The ultimate goal of this practice is to restore maximum functional independence to each individual patient and in order to achieve it, exercise, heat, cold, electricity, and massage are utilized. Physical therapy is ordered by a physician when it is felt that such treatment would be beneficial. It is offered to a wide variety of patients including newborn babies, children, adults, and the elderly.

Physical therapy is useful in treating many different medical disorders and injuries, neurological and muscular illness, as well as cardiopulmonary diseases. Through patient and therapist interaction, physical therapy can help restore movement and function helping patients returns to their prior level of independence.

What physical therapist do?

Physical therapists are licensed professionals who work with people that have sustained disabilities, impairments or limitations in their overall physical function. These deviations can be the result of disease, injury, or pathological processes. They work to restore function, improve mobility, and decrease pain with the goal of re-establishing a patient’s prior functional level.

Physical therapists focus on the evaluation of strength, balance, range of motion, coordination, endurance, and posture of each individual patient. It is through the results of this examination they then develop a treatment plan geared towards reaching specific rehabilitation goals. However, they would also help in determining realistic goals through their knowledge of pathology and prognosis.

Over the course of the rehabilitation period, they document progress, re-evaluate physical findings, and modify treatment strategies as appropriate. They often work as a team with a variety of other professionals including physicians, speech pathologists, occupational therapists, and recreational therapists.

Cognitive Restructuring for Stress Relief

Stress management involves different ways on how to handle stress. One of them is the use of cognitive restructuring for relieving stress. Cognitive restructuring has actually been developed as a form of therapy used for treating conditions such as severe stress, anxiety disorders as well as depression.

What is cognitive restructuring?

Cognitive restructuring as a form of therapy was developed in the belief that situations and circumstances that seem to bring or cause stress is borne out of a person’s way of thinking. This can be explained better at how different people may look at spending some of their vacant time.

Some people may see it as an opportunity to feel relaxed and get lost in the moment. Others may think of it as time wasted with nothing productive to do and may even feel distressed or get bored. A person’s way of thinking can determine the resultant action or behavior to a given situation.

The theory behind cognitive restructuring states that a person’s own unrealistic beliefs can be directly responsible for bringing out certain dysfunctional emotions and feelings that further lead to behavior and attitudes resulting from it such as depression, stress or anxiety.

By trying to get rid of such emotions and feelings, stress and other similar conditions can be prevented. But in order to get rid of them, there would be a need to restructure or change certain unrealistic beliefs or faulty thinking that may be giving them life.

Faulty thinking

In cognitive restructuring, faulty thinking or beliefs is referred to as cognitive distortions. Cognitive restructuring is the process of identifying, challenging and then changing the cognitive distortions and negative and unrealistic thinking patterns with more accurate and beneficial ones.

When it comes to stress management, cognitive restructuring can help change certain unrealistic beliefs and thought patterns that usually lead to negative behavior as well as stress. Self-talk usually have a big impact as to how this way of thinking is gradually ingrained into a person’s subconscious mind.

Self-talk

Self-talk can either make life better or worse for a person. It is the internal dialogue that a person makes that initially tries to interpret, explain and judge every situation encountered. The way a person process the internal dialogue based on certain beliefs can lead to different resulting behavior or actions.

If the internal dialogue is based on cognitive distortions are faulty thinking, then it would most likely lead to negative behavior and thought patterns, many of which lead further to stress, anxiety and depression up to a certain period.

The "I Must Be Loved" thinking

The "I Must Be Loved" way of thinking can be considered as one of those cognitive distortions and unrealistic views that can lead to negative results in terms of behavior and attitude. It is unrealistic in a way that it is impossible for all people to experience being loved by everybody.

If a person is led to believe as such, this can result to failure, false hopes and unfulfillment. Cognitive restructuring works to try and recognize and change these faulty beliefs and way of thinking into something positive and reachable. As people undergo a restructured thinking and beliefs, they begin to see things differently little by little.

Concealing Medication in Food and Drink

When we were kids, our parents used to conceal medication in our food and drink when we were sick. It is admissible when there is no other way to give a drug. Covert administration of drugs for adults is an entirely different matter, even for mentally ill patients who will not or cannot take their medicine.

Is it ethical to conceal medication in food and drink? Should drug concealment be medically sanctioned and recorded? How common is it?

The extent of concealing medication

Studies about the extent of covert drug concealment are patchy but suggestive. A 2000 study revealed that medications were administered covertly at some point in 24 of 34 nursing, inpatient and residential units in southeast England. In Norway, a recent study of caregivers for patients with dementia in nursing home and special care units showed that 11%-17% of 1,362 patients were given drugs mixed in food or drink at least once every week.

The Norway study also found that only 40% of the nursing documents recorded the concealment of medication in food or drink. When a doctor authorized the concealment, it was found that medical records were more likely to have written confirmation of the practice, 57% as opposed to 23%.

According to former American Psychological Association (APA) President Paul Appelbaum, concealing medication is rare in inpatient settings in the United States. Overall, there is little information about the extent of this questionable practice in the country.

Support for the practice

Concealing medications in food and drink of patients has supporters. Try talking to a professional caregiver and he or she can often cite good examples of times when covert drug administration seemed logical and sensible.

Caregivers and physicians might consider concealing medications in food and drink to avoid delays in treatment. Delays in treatment could result in self-destructive behavior or means increased morbidity, prolong the patient’s agony, or worsen outcomes.

Criticisms of the practice

Critics of the practice argue that it is a violation of trust by the physician or the caregiver or by members of the family who administer the medications. Many patients are upset and refuse treatment when they learn that their doctor or family betrayed their trust. This in turn breeds paranoia.

It is illegal and unethical in the United States to perform this practice without the consent of a competent and responsible person. According to Spencer Eth, APA Ethics Committee Chair, "Can you treat someone without his or her consent? Not without violating the patient’s autonomy and the core ethical principle of consent. It is a paternalistic attitude that is an anachronism in psychiatric practice. You can’t justify it in the name of ‘the patient’s best interests.’"