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The Profession
What is Physical Therapy?
DESCRIPTION OF PHYSICAL THERAPY*
The nature of physical therapy
Physical therapy provides services to individuals and populations to develop, maintain and restore maximum movement and functional ability throughout the lifespan. This includes providing services in circumstances where movement and function are threatened by ageing, injury, disease or environmental factors. Functional movement is central to what it means to be healthy.
Physical therapy is concerned with identifying and maximising quality of life and movement potential within the spheres of promotion, prevention, treatment/intervention, habilitation and rehabilitation. This encompasses physical, psychological, emotional, and social well being. Physical therapy involves the interaction between physical therapist, patients/clients, other health professionals, families, care givers, and communities in a process where movement potential is assessed and goals are agreed upon, using knowledge and skills unique to physical therapists.
Physical therapists are qualified and professionally required to:
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Undertake a comprehensive examination/assessment/evaluation of the patient/client or needs of a client group;
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Formulate a diagnosis, prognosis, and plan;
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Provide consultation within their expertise and determine when patients/clients need to be referred to another healthcare professional;
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Implement a physical therapist intervention/treatment programme;
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Determine the outcomes of any interventions/treatments; and
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Make recommendations for self management.
The physical therapist’s extensive knowledge of the body and its movement needs and potential is central to determining strategies for diagnosis and intervention. The practice settings will vary according to whether the physical therapy is concerned with health promotion, prevention, treatment/intervention, habilitation or rehabilitation.
Physical therapists operate as independent practitioners, as well as members of health service provider teams, and are subject to the ethical principles of WCPT. They are able to act as first contact practitioners, and patients/clients may seek direct services without referral from another health care professional.
Physical therapy is an established and regulated profession, with specific professional aspects of clinical practice and education, indicative of diversity in social, economic, cultural, and political contexts. But it is clearly a single profession, and the first professional qualification, obtained in any country, represents the completion of a curriculum that qualifies the physical therapist to use the professional title and to practice as an independent professional.
The nature of the physical therapy process
Physical therapy is the service provided only by, or under the direction and supervision of, a physical therapist. It includes examination/assessment, evaluation, diagnosis, prognosis, plan of care/intervention and re-examination.
Assessment includes:
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the examination of individuals or groups with actual or potential impairments, activity limitations, participation restrictions or abilities/disabilities by history taking, screening and the use of specific tests and measures; and
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the evaluation of the results of the examination of individuals/groups and/or the environment through analysis and synthesis within a process of clinical reasoning to determine the facilitators and barriers to optimal human functioning.
Diagnosis and prognosis arise from the examination and evaluation and represent the outcome of the process of clinical reasoning and the incorporation of additional information from other professionals as needed. This may be expressed in terms of movement dysfunction or may encompass categories of impairments, activity limitations, participatory restrictions, environmental influences or abilities/disabilities.
Prognosis (including plan of care/intervention) begins with determining the need for care/intervention and normally leads to the development of a plan of care/intervention, including measurable outcome goals negotiated in collaboration with the patient/client, family or care giver. Alternatively it may lead to referral to another agency or health professional in cases which are inappropriate for physical therapy.
Intervention/treatment is implemented and modified in order to reach agreed goals and may include manual handling; movement enhancement; physical, electro-therapeutic and mechanical agents; functional training; provision of assistive technologies; patient related instruction and counselling; documentation and co-ordination, and communication. Intervention/treatment may also be aimed at prevention of impairments, activity limitations, participatory restrictions, disability and injury including the promotion and maintenance of health, quality of life, workability and fitness in all ages and populations.
Re-examination necessitates determining the outcomes.
Practitioner – the term practitioner encompasses all roles that a physical therapist may assume such as patient/client care, management, research, policy maker, educator and consultant.