Physical Therapy: What You Should Know

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THE FITNESS PRIORITY BY KRISTIN MCNEALUS, PT, DPT

Feel free to get second opinions. Physical therapists treat many different diagnoses, again at many different stages.

Exceptional Parents often are well versed in many avenues of care for themselves and their children, including all of the rehabilitation professionals. Do you know what each auxillary profession is knowledgeable about? As a physical therapist, I am going to present some information that I think may be useful to you to find the best provider for you and/or your child.

Per the American Physical Therapy Association, Physical therapists (PTs) are “highly-educated, licensed health care professionals who can help patients reduce pain and improve or restore mobility—in many cases without expensive surgery and often reducing the need for long-term use of prescription medications and their side effects.” Physical therapists are now graduating with a Doctorate degree, which requires three years of graduate school after a four-year Bachelor degree is completed.

The graduate education focuses on how the body moves, and why it moves the way it does. After learning anatomy and physiology, PT students learn all the various pathologies that can impact mobility and how to address them. After three years of this study, physical therapists are truly the experts in mobility!

Physical therapy students are required to do internships to get hands-on guidance on how to apply the education to the evaluation and treatment of patients in various settings. Physical therapy treats at all levels of care, from the ICU to the community gym! After these internships are completed, graduates then take licensing exams by the state in which they practice. Most states require ongoing education to keep a therapist up to date with the latest treatment research and practices.
• How do you know that your child is getting the best physical therapist for his needs? Well, talk to her. Discuss the goals that you want to achieve with physical therapy, and ask what the plan is to get there.
• Ask about the milestones that will be measured along the way.
• Ask about what modalities may be used and why.
• Don’t be shy.

Another thing to discuss is how the treatment plan may be impacted by insurance coverage. There may be  treatments that would be beneficial that are not covered by your insurance, and are therefore never presented. But understanding what treatments exist may be helpful, and knowing how much it may cost out-of-pocket is a decision that you may wish to make, rather than having your health care providers making it for you. This is not always a conversation that is initiated by a healthcare provider. It also may be important to know if there are treatments that you should be advocating with your health plan for coverage.

Feel free to get second opinions. Physical therapists treat many different diagnoses, again at many different stages. One PT may simply have more experience with people similar to you or your child and therefore have a different view of what may be the best plan of care. Another PT may approach the goal in a different way, drawing from experience from a variety of patients. Every therapist should be able to explain their reasoning and you can decide what may be the better path to try. Do not be afraid to question your therapist.

If you would like to take an additional step, you can visit www.apta.org and go to “Find a PT.” This is a list of members of the professional organization (not all therapists are members) and it will provide any specializations. You can search what type of therapy you are looking for (i.e. pediatric, neurologic, etc.) When you see the credentials next to a therapist’s name, the people with letters like NCS or OCS, this is a certified “Clinical Specialist.” This is an exam that a person chooses to register to take, and study for hours to prepare. It requires these therapists to study specific diagnoses and research in that area, and is given only once per year. The certification lasts for 10 years. PCS is a pediatric clinical specialist, and may be a great resource for your child.

Why do therapists always assign exercises to be done at home? Because they want to use your session for the hands-on skills that they can provide, especially because the time is limited. Also, doing work between sessions will help you or your child make greater gains and achieve those goals. Additionally, it will prevent decline. While these routines can be tedious, preventing an issue is always preferable to treating one. For example, range of motion exercises to prevent contractures is much better for a body than accommodating seating systems and transfer techniques to a joint that has lost range. Put this home exercise program into the regular routine just like bathing.

I hope that helps you to be more appreciative and discerning of your physical therapist. •

THE FITNESS PRIORITY
1Kristin McNealus, PT, DPT, ATP received her Masters in Physical Therapy from Boston University then went on to earn her Doctorate in Physical Therapy from MGH Institute of Health Professions. She has been a staff physical therapist on inpatient rehabilitation for people with spinal cord injuries at a number of hospitals in Southern California, as well as Director of a community adaptive gym for people with neurological injuries. She is a member of the International Network Spinal Cord Injury Physiotherapists, and has contributed to the APTA Guidelines for Exercising with a SCI. She has completed 3 marathons, and 25 triathlons, including the Ironman! SCI Total Fitness is designed to promote health and wellness for people with physical disabilities.