Situation and Audience: The audience is prospective physical therapy patients with minor to moderate bone, joint, or muscle injuries (i.e., musculoskeletal injuries) who are looking for alternatives to medication or surgery, a supplement for medication or surgery, or a general way to improve range of motion and pain. This oral report is part of a seminar on alternative forms of treatment for prospective patients. I am a practicing physical therapist who has just completed a technical report, Physical Therapy: A Guide for Prospective Patients, and am presenting an overview of the report to you, the prospective patients.
So what is physical therapy? It is the field of medical care that uses physical agents such as heat, light, water, and massage coupled with exercise to treat certain physical disabilities, according to The Manual of Physical Therapy Practice. Among its objectives are the relief of pain caused by surgery or by medical problems, the improvement of muscle strength and mobility, and the improvement of such basic functions as standing, walking, and grasping.
The field is relatively new, entering into the medical scene during World War I in military hospitals. The American Physical Therapy Association, the national organization that monitors therapists and their practice, estimates that there are 70,000 active physical therapists in the United States today, and the profession is growing at such a rapid rate that the demand for therapists far exceeds the supply.
Many individuals want to know what treatment they can expect when they visit a physical therapist. During the first visit, a patient will usually undergo an initial evaluation in which the therapist may inquire about the patient's medical background, how the illness or injury occurred, and how long the patient has had the problem. The physical therapist will also perform different tests to diagnose the patient's condition. After the therapist completes the patient assessment, he or she will form a treatment plan and therapy will then begin. The physical therapist can perform a variety of techniques used in conjunction with different equipment to treat the patient. A few common techniques include the use of heat, massage, and manipulation. There are many other forms of treatment that your physical therapist will decide to use specifically for your condition.
Although there are different forms of equipment used, one of the most important ones for work or home use that I recommend is an ergonomic device. Ergonomic devices are chairs, tables, mouse pointers, or anything designed to align the body correctly and support it. Many injuries and accidents can be prevented with the correct use of ergonomic devices and I strongly urge you to incorporate the use of them into your daily lives. I have free literature on how to find and use ergonomic devices which will be available after the report.
Patients can also expect to be assigned exercises to perform during office visits and at home. They may include breathing, strengthening, or stretching exercises. Exercise is probably the single most important thing in maintaining and improving a patient's condition. It is imperative that a patient performs the exercises regularly and correctly for benefits to be effective and long-lasting.
Now that you have an idea of the treatment involved, why is physical therapy a good idea for you? From this transparency, you can see that the primary benefits of therapy include reduced pain, increased range of motion, and a decreased need for alternatives. Next to these benefits, I have also listed the disadvantages of treatment which I will discuss later.
The number one reason you have probably attended this seminar is for the relief of your pain. Although this is a main goal for the therapist, we also realize that if you, as patients, are limited in daily activities of living because of pain, it is unlikely that you will make much progress in regaining control over range of motion, use of assistive devices, or completing exercises until the pain has been reduced or relieved. Physical therapy is commonly used to relieve pain caused by surgery or other procedures that "fix" a person's injury or disease, but may not reduce pain or may even increase it. Treatment can also provide reduction of discomfort for individuals who have chronic pain due to an old injury or illness that is not debilitating, but distressing nevertheless.
Although pain is an important factor in undergoing therapy, patients are also interested in increasing their range of motion in order to improve their daily functioning abilities. Range of motion is how much movement a given joint or muscle has in the three different anatomical planes illustrated here on this diagram [visual 1]. As you can see, your body is divided into three different planes so that range of motion can be measured in degrees from the original axis in each plane. Physical therapy is one of the main treatments used to provide long-lasting increased range of motion for patients with dysfunctional joints or muscles.
Finally one of the main advantages and benefits of physical therapy is the decreased need for alternatives, such as surgery or medication. Although some physical therapy patients still require surgery after treatment, many do recover without this alternative or have a decreased need for it. Today, in an environment of health awareness, people are also beginning to shy away from dependence on medication and turn toward treatment that addresses the actual cause of the problem, not the symptoms.
Patients must be willing to compare the benefits I just talked about to the disadvantages of treatment to decide if physical therapy is right for them. From the transparency [visual 2], you can see that the major disadvantages of physical therapy are high patient involvement and ineffective physical therapy treatment programs. Patients must be willing to allocate a significant amount of time for office visits and home care, and expend considerable effort to maintain and continue improvement of their condition. Patients must almost be aware that ineffective physical therapy programs can occur. Inappropriate treatment plans or mistreatment by therapy assistants or therapists can lead to ineffective therapy and may even worsen the injury or disease. It is important for patients to ask questions concerning their diagnosis, their treatment plan, and the actual therapy performed on them.
As you have heard from this report today, physical therapy treatment includes a wide range of techniques used in conjunction with the appropriate equipment and exercise to decrease pain, increase range of motion, and contribute to helping an individual learn or re-learn functions of daily living. In order to decide if physical therapy is appropriate for you, you must weigh the benefits and disadvantages of treatment.
Physical therapy is quickly becoming a dominant field in the rehabilitation of patients with minor to moderate musculoskeletal injuries who are looking for alternatives or supplements to medication and surgery, or a general way to improve range of motion and pain. I hope this report provided helpful background and information concerning physical therapy practice and treatment in order for you as prospective patients to decide if physical therapy is right for you. For more detailed information on physical therapy and the topics I just talked about, please pick up a copy of my recent technical report, Physical Therapy: A Guide for Prospective Patients. Thank you for your time and attention.
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