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Physiotherapy Trends

As in many other areas of medicine, two important trends are evident in Physiotherapy:

  1. Stratification

    Physiotherapy is no longer a single tiered nursing specialty. Skills, education and qualifications now range from diploma qualified PT Assistants to post-graduate licensed physicians.

  2. Specialization

    The American Board of Physical Therapy Specialties currently certifies 8 specialities. This is a moving feast, as existing specialties continue to subdivide, and new technologies and techniques evolve creating entirely new specialist areas of therapy. Below are some with brief explanations of some current specialties.

  1. Cardiovascular & Pulmonary

    Cardiovascular rehab and pulmonary respiratory practitioners treat patients with cardiopulmonary disorders or having undergone cardiac or pulmonary surgery. Primary goals of this specialty include increasing endurance and functional independence. Manual therapy is used to clear lung secretions experienced with cystic fibrosis. Cardio work includes rehab after heart attacks, or coronary bypass surgery. Pulmonary conditions treated include chronic obstructive pulmonary disease, and pulmonary fibrosis.

  2. Clinical Electrophysiology

    This specialty area encompasses electrotherapy/physical agents, electrophysiological evaluation (EMG/NCV), physical agents, and wound management.

  3. Geriatric

    Geriatrics is medicine for the elderly. Geriatric physical therapy does cover issues arising from normal adult aging but is more usually focused on disorders associated with advanced age. Such conditions include - arthritis, osteoporosis, cancer, Alzheimer's disease, Parkinson's disease, hip and joint replacement, balance disorders, incontinence. Geriatric physical therapists specialize in treating older adults.

  4. Integumentary

    Integumentary (treatment of conditions involving the skin and related organs). Common conditions managed include wounds and burns. Physical therapists utilize surgical instruments, mechanical lavage, dressings and topical agents to debride necrotic tissue and promote tissue healing. Other commonly used interventions include exercise, oedema control, splinting, and compression garments.

  5. Neurological

    Neurological physical therapy is a field focused on working with individuals who have a neurological disorder or disease. These include Alzheimer's disease, Charcot-Marie-Tooth disease (CMT), ALS, brain injury, cerebral palsy, multiple sclerosis, Parkinson's disease, spinal cord injury, and stroke. Common difficulties experienced from neurologic conditions include impairments of vision, balance, ambulation, activities of daily living, movement, muscle strength and loss of functional independence. Physiotherapy can help with many of these impairments by restoring and maintaining function, slowing disease progression, and improving quality of life.

  6. Orthopedic

    Orthopedic physical therapists diagnose, manage, and treat disorders and injuries of the musculoskeletal system including rehab after orthopaedic surgery. Orthopedic therapists are concerned with rehab following orthopedic surgery, fractures, acute sports injuries, arthritis, sprains, strains, back and neck pain, spinal conditions, and amputations.

    Joint and spine mobilization/manipulation, dry needling (not universally available due to licensing restrictions), therapeutic exercise, neuromuscular re-education, hot/cold packs, and electrical muscle stimulation (e.g., cryotherapy, iontophoresis, electrotherapy) are treatments used to assist orthopedic recovery. Sonography is increasingly employed for diagnosis and to guide treatments such as muscle retraining. In summary, patients suffering injury or disease involving the muscles, bones, ligaments, or tendons will benefit from assessment by a orthopedic PT specialist.

  7. Pediatric

    Pediatrics is medicine for children. Pediatric physical therapy objectives include early detection of health problems and the treatment conditions affecting infants, children, and adolescents. These conditions comprise congenital, developmental, neuromuscular, skeletal, or acquired disorders/diseases. Treatments focus on improving motor skills, balance and coordination, strength and endurance as well as cognitive and sensory function. Pediatric physical therapists treat children with developmental delays, cerebral palsy, spina bifida, or torticollis, and Down Syndrome.

  8. Sports Medicine

    Physiotherapists are involved in the care of athletes from recreational to professional and Olympians. This area of practice includes athletic injury management, including acute care, treatment and rehabilitation, prevention, and education. Physical therapists are also active in sports medicine programs. Physical therapists who work for professional sport teams often have this specialized certification.

  9. Women's Health

    Women's health physical therapy addresses issues related to child birth, and post partum. These conditions include lymphedema, osteoporosis, pelvic pain, prenatal and post partum periods, and urinary incontinence. PT may also assist with menopausal issues including rehabilitation after prolapse of uterus or bladder.

  10. Pain Management

    Some conditions feature continuing problems of pain experienced by patients. As a complement to reliance on analgesic medication, Physiotherapists offer a range of therapies to control and reduce chronic pain. This is a significant quality of life issue for many patients. Physiotherapists also have an important educational role in teaching patients how to self-manage their pain.

  11. Public Health / Health Promotion

    This application concerns education and encouragement to foster more healthy lifestyles including regular excercise. A particular focus is encouraging young people to engage in sports. Governments are belatedly recognising that disease prevention is way cheaper than cure.

  12. Multi-disciplinary Care Groups

    Apart from their own functional specialties, Physiotherapists are now routinely called upon by other medical professionals to form multi-disciplinary groups focussing on a specific group of patients or conditions. Examples include recovery from heart attacks and strokes; helping cancer patients to cope with disease progression or the side effects of treatment; special programs for children with Down Syndrome; mobility and independence of older people; rehabilitation of amputees and military casualties.

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Pediatric Disorders

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