All About PT
Entry Level Education
Doctor of Physical Therapy Degree
3 year program (CAPTE)
Bachelor’s degree with prereqs required
Combined classroom and clinical education
At VCU
~2 years of classroom education
Four 8-week clinical experiences in 3rd year
Post Entry Level Education Options
Clinical Residency
Clinical Fellowship
Specialty Certifications
Cardiovascular and Pulmonary
Clinical Electrophysiology
Geriatrics
Neurology
Orthopaedics
Pediatrics
Areas of specialty/niche practice
Below is a list of some of the new niches in physical therapy
practice:
Performing Arts: help dancers, figure skaters, and other performers by
educating them on injury prevention, facilitating recovery from injuries, and
supervising training.
Obesity Management: guide their patients in their efforts to lose weight
and live a healthier lifestyle.
Animal Therapy:work with with veterinarians and trainers in animal
rehabilitation. Most of those animals are horses and dogs.
Scope of practice
Purpose: sets forth the range of responsibilities and procedural
guidelines for practicing physical therapists to embody the standards
and values of the dynamic and evolving profession
Professional Role: restore, maintain and promote optimal physical
function to individuals of all ages who currently have or may
develop illnesses or injuries to the various systems
(cardiovascular, pulmonary, musculoskeletal, neuromuscular
and integumentary) based on personal or environmental
factors to prevent, minimize, or eliminate impairments, activity
limitations, and participation restrictions.
Health Care Role: recognized as an essential member to the team
in providing optimal care for rehabilitation, habilitation,
performance enhancement, risk-reduction, and prevention in
cost-effective manner.
SCOPE OF PRACTICE
3 Components
Professional
Jurisdictional
(legal)
Domains
Actions allowed
(see resource docs for full list)
-Examination
-Alleviation
-Prevention
-Engagement
Examine: to diagnose, prognose, and intervene via tests and measures
to gait, pain, nerve integrity, orthotic/protective/and supportive devices,
posture, ventilation and muscle/motor function, etc.
Alleviation: by designing, implementing and modifying tx interventions for
coordination, prescription of devices and exercise, integumentary
repair/prevention, etc.
Prevention: to promote and maintain health, wellness, fitness and quality
of life (ALL ages), etc
Engagement: to consult, educate, and research
APTA Policies & Bylaws (examples)
-Sharp Debridement
-Supervision of PTA
-Diagnosis based on PT needs
-Pharmacology: knowledge,
management and prescription
-PT for Older Adults
-Practice in Educational Settings
Model State Practice Act
Federation of State Boards of
Physical Therapy
http://www.apta.org/uploadedFiles/
APTAorg/About_Us/Policies/Practi
ce/ScopePractice.pdf
http://guidetoptpractice.apta.org
http://www.apta.org/Policies/Practi
ce/
http://www.apta.org/uploadedFiles/
APTAorg/About_Us/Policies/Educ
ation/MinimumRequiredSkillsPTGr
ads.pdf
-Licensure
(National and
State)
-Practice acts
Licensure: Annually in all 50 states, most requiring continuing education
for renewal
●
Graduate from accredited program
●
Passed NPTE
-APTA guidelines of minimal required
skills document
-NPTE: licensure exam (national)
-CAPTE: accrediting agency for PT
programs
-Board of Physical Therapy (state):
guidelines, standards of care
-Organizational Policies and procedures
http://www.apta.org/Licensure/
-Code of Ethics
-Guide for Physical Therapy Conduct
-APTA learning center
http://www.apta.org/uploadedFiles/
APTAorg/About_Us/Policies/Judici
al_Legal/ProfessionalismCoreValu
es.pdf
Practice Acts: set forth scope of practice for physical therapist practicing
on a national level and a state level
●
State: Direct Access and Dry Needling (VA)
●
National: HIPPA (prohibiting disclosure of patient information)
Personal
-Ethics
Professionali
sm
Perform and practice only within your own knowledge and skill set
Embody the core values: altruism, excellence, caring, ethics, respect,
communication and accountability
Actions guided and regulated by...
Resource Documents
http://law.lis.virginia.gov/vacode
http://www.fsbpt.org/Portals/0/doc
uments/freeresources/MPA_5thEdition2011.pd
f
http://www.apta.org/Ethics/Core/
Access To Services
Direct Access:
Access to a physical therapist without the need of a physician’s referral
All states and the District of Columbia allow for an evaluation and some form of
treatment without a physician’s referral. Restrictions on certain patient populations or
diagnoses, the number of visits, and specific interventions such as needle EMG still
exist from state to state. These restrictions continue to limit and delay the treatment
of individuals in need of physical therapy services.
State specifications:
http://www.apta.org/uploadedFiles/APTAorg/Advocacy/State/Issues/Direct_Access/LevelsofPatientAccesstoPTinth
eStates2016.pdf
Practice settings
Outpatient clinics
Hospitals
Inpatient rehabilitation
Schools
Military
Nursing Homes
Role of PT
Generally, physical therapists help patients improve their mobility and function.
This can include:
- Therapeutic exercise and modalities
- Pain management
- Postural correction
- Training with assistive devices or orthotics/prosthetics
- Caretaker and patient education
Examples of common patient profiles (diagnoses,
age, impairments, etc)
25yo runner (condensed outpatient evaluation)
Pt. stepped on a tree root while running on the Buttermilk Trail. CC “pain on outside of foot.”
Impairments: dec’d active + passive plantar flexion and inversion 2/2 pain. Point tenderness on lateral
aspect of r. foot. Visible swelling and discoloration of r. foot.
Special Tests: (+) Inversion stress test.
Palpation: No pain at base of 5th metatarsal or lateral malleolus. No pain to palpation of fibularis
longus/brevis muscle belly.
PT Diagnosis: Sprained anterior talofibular ligament
Examples of common patient profiles (diagnoses, age,
impairments, etc)
68yo retired factory worker, former smoker 1ppd (condensed inpatient evaluation)
Reason for visit: Asthma/COPD exacerbation
Clinical Display: O2 as req’d to maintain sats >89%
Mobility:
Supine->sit: min assist
Sit<->stand: min assist
Gait: ambulates 50’ x 2 CG assist. Pt. takes seated break to maintain O2 sat >89%. Pt. demonstrates dec’d step
length and frequency, forward trunk flexion.
Assessment: Pt. presents to acute PT s/p asthma/COPD exacerbation with orders to eval/treat. Pt. has 24/7 supervision
from wife. Pt. demonstrates dec’d endurance + LE strength. Pt. would benefit from acute PT to increase exercise tolerance
and functional independence. Disc’d HHPT safety eval with pt. upon d/c.