A man once said to me, 'Science is always changing, and will never stop changing throughout the course of this lifetime.' Physical therapy, also referred to as physiotherapy, is a branch of medical science that has to do with the treatment of injury and/or disorder by using physical methods. It is performed under the guidance of a physical therapist (PT). During a therapy session, a therapist may use heat, cold, exercise, and electricity. Like other medical fields, physical therapy has evolved tremendously. Physical therapy is a broad field of rehabilitation medicine, able to help patients in a variety of settings and with a mass of injuries achieves a higher level of function. Physical therapists are found in critical care hospitals, rehabilitation hospitals, outpatient care centers, wound care clinics, holistic health centers, hospital urgent care clinics, schools and on staff with many athletic organizations (like my father, who is a certified athletic trainer, or ATC.) Physical therapists help people who have injuries or illnesses improve their movement and control and get rid of their pain. They are often an important part of rehabilitation and treatment of patients with chronic conditions or injuries. They treat everyone from infants to senior citizens and will continue to be a very important part to the medical field for many years to come. Physical therapy has been practiced since 460 B.C. and its technology is continuing to grow and evolve every year.
To become a physical therapist, one must complete a graduate degree program in physical therapy. These degree programs teach you about anatomy, biology, biomechanics, pathology, physiology and pharmacology as well as provide you with clinical hands-on physical therapy experience. Physical Therapy is a continuing education and in order to stay licensed, classes must be taken yearly because science is always changing and on the move.
There are a few different types of physical therapy, for instance, Orthopedic, Geriatric, Neurological, Cardiovascular and Pulmonary Rehabilitation, and Pediatric Physical Therapy. Orthopedic physical therapists diagnose, and treat disorders and injuries of the muscle and skeletal systems. They also help people recover from surgery. This specialty of physical therapy is mainly found in the out-patient clinical setting. Orthopedic therapists are trained in the treatment of post-operative joints, sports injuries, arthritis and amputations, among other injuries and conditions. Joint mobilizations, strength training, hot packs and cold packs, and electrical stimulation are often used to speed recovery in the orthopedic setting. Those who have suffered injury or disease affecting the muscles, bones, ligaments or tendons of the body may benefit from help from a physical therapist specialized in orthopedics.
Geriatric physical therapy covers many issues concerning people as they go through normal adult aging. These include arthritis, osteoporosis, cancer, Alzheimer's disease, hip and joint replacement, balance disorders and incontinence. Geriatric physical therapists make special programs for the injured to help restore mobility, reduce pain and increase fitness.
Neurological physical therapists work with individuals who have a neurological disorder or disease. These include Alzheimer's disease, ALS, brain injury, cerebral palsy, multiple sclerosis, Parkinson's disease, spinal cord injury and stroke. The majority of problems of patients with neurological disorders include paralysis, vision impairment, poor balance, difficulty walking and loss of independence. Therapists work with patients to improve these damaged areas.
Cardiovascular and pulmonary rehabilitation physical therapists treat a wide variety of people with cardiopulmonary disorders and people who have had cardiac or pulmonary surgery. Primary goals of this specialty include increasing patient endurance and independence.
Pediatric physical therapy helps in early findings of health problems as well as the diagnosis, treatment, and management of infants, children, and adolescents with a variety of injuries, disorders and diseases that affect the muscles, bones, and joints. Treatments emphasize on improving fine motor skills, balance and coordination, strength and endurance as well as cognitive and sensory processing and integration. Children with developmental delays, cerebral palsy, spina bifida and torticollis are a few of the patients treated by pediatric physical therapists.
There are many different kinds of treatment in physical therapy. A few are Electrotherapy, Virtual Rehabilitation, Hot Packs, and Cold Packs. There are quite a few kinds of electrotherapy which are used in the current age. TENS (Trans-Cutaneous Electrical Nerve Stimulation), IFC or interferential current, which is a Russian stimulator for strengthening of damaged muscles and usage of micro currents to use small intensity currents to return damaged tissues, are some of the methods. Galvanic Stimulation or Iontophoresis is another form of electrotherapy. TENS is one of the more dominant methods, which blocks slow spread nerve fibers that carry pain signals from the brain. It is perfect for physical therapy to relieve chronic and severe pain. Each of these methods uses changing combinations of voltage and current to vary the physical therapy for relieving different forms of pain being made from various sources.
Virtual rehabilitation is one of the latest kinds of physical therapy, which can be seen as a way of stimulating the brain through virtual reality. In this form of therapy, the patient is made to interact with characters on-screen as well as objects in a wide selection of sporting and adventure activities. These are designed as part of an exercise treatment that is designed by the clinician keeping the patient's handicaps in mind. Immersive Therapy Solutions keep track of the hand-eye coordination, movement and repair of the patient. There are various stages for this form of physical therapy as the patient continues to be rehabilitated. This form of therapy is pretty popular for those with mental impairment, traumatic brain injuries, autism, cerebral palsy or strokes in the past. Mobility and motor movement are greatly improved with this technology.
Physical therapists wrap moist hot packs in several layers of towels and place them on the area that needs treatment. The heat provided by the hot packs has several important benefits. It relaxes tight muscles causing tissues to relax. This decreases pain caused by muscle tension or spasms. It also causes vasodilatation of the blood vessels which increases circulation to the area. Patients with muscle strains, spasms, or arthritis often get better from treatment with moist hot packs.
Cold packs are a frozen gel substance used by physical therapists to treat areas of pain and inflammation. The cold packs are wrapped in wet towel and applied directly to the area in need of treatment. The cold transferred to the patient's skin, muscle, and tissue has several beneficial effects. The cold temperature causes constriction of the blood vessels in the area. This decreases the inflammation in the area. By decreasing inflammation, pain and swelling are decreased.
A long time ago, one would find that the interventions used by physical therapists today have been used throughout the ages. The first real evidence of physical therapy dates back all the way to 460 BC. Ancient peoples like the Greeks, Romans and Chinese used massage, sunlight and water for healing the wounded. Exercise was used in almost all cultures and across time as a way to improve health. In 1921, Mary McMillan (the first physical therapy aide) founded the American Women's Physical Therapeutic Association, which was later changed to the American Physical Therapy Association (APTA). She contributed a lot to the rebuilding advisor services and came to be known as "The Mother of Physical Therapy". It was in the same year, that the first research paper on physical therapy was published in the US. The year 1921, was regarded as a milestone, in the field of physical therapy, as physiotherapy programs were introduced.
Physical therapy was mainly provided at critical care hospitals or special rehabilitation centers until the 1950s when patient clinics, schools and skilled nursing facilities all began to hire their own therapy staff. Rehabilitation was now becoming common and accessible to the whole population.
The passing of the Civil Rights Act of 1964 did more than to reduce racism, it also allowed for those with disabilities to access the world in a way they had not been able to before. This was now an opportunity for physical therapists to help patients in a different way no longer just helping with rehabilitation from an injury or illness but in helping them fit back into society, something therapists continue to do today. Treatment up through the 1940's mostly consisted of exercise, massage, and traction of muscles. Manipulative techniques to the spine and joints began to be practiced, especially in the British countries, in the early 1950's. Up until this point, there was no known practice of a combination of exercise and manipulative therapy in existence.
In the 1950's, Physical Therapists started to move beyond hospital based practice. The majority continued to practice in hospitals through the 1960's. Physical Therapists now practice in a wide variety of settings, including outpatient orthopedic clinics, public schools, college/universities, geriatric settings (skilled nursing facilities), rehabilitation centers, hospitals and medical centers. With the development of computer and technology in the 1980s, more advancement was observed in the field of physiotherapy techniques. For example, electrical stimulators were introduced for practicing physiotherapy.
Technology has come a long way in the field of medicine, and for Physical Therapy. Technology and machines, such as the Ultrasound machine, the TENS machine, and the Electrical Stimulator are frequently used.
Ultrasound machines are a treatment modality used by physical therapists that utilize high or low frequency sound waves. These sound waves are conducted to the surrounding tissue. They enter the muscles to cause deep tissue/muscle warming. This helps tissue relaxation and is useful in treating muscle tightness and spasms. The warming effect of the sound waves also causes vessel vasodilatation and increase movement of blood to the area that needs healing. The physical therapist can also adjust the frequency on the machine to use waves that will decrease inflammation in the injured area.
A TENS unit stands for Transcutaneous Electrical Nerve Stimulation. It is a small battery operated machine that uses electrical transmission to decrease pain. Electrodes are applied to the affected area. The machine is turned on and an electrical current is sent through the electrodes. A tingling sensation is felt in the underlying skin and muscle. This signal disrupts the pain signal that is being sent from the affected area to the surrounding nerves. By breaking this signal, the patient experiences less pain.
Electrical stimulation uses an electrical current to cause a single muscle or a group of muscles to contract. By placing electrodes on the skin in various locations the physical therapist can access the appropriate muscle fibers. Contracting the muscle through electrical stimulation helps strengthen the affected muscle. The physical therapist can change the current setting to allow for a forceful or gentle muscle contraction. Along with increasing muscle strength, the contraction of the muscle also helps blood supply to the area that assists in healing.
The practice of physical therapy in the United States has come a long way from its beginnings serving those with poliomyelitis (disease affecting the brain and the spinal cord) and war wounds. This practice is one with a rich history of almost 90 years of healing the generations; of nursing those with disease, disability, and pain, and of preventing physical problems challenging so many people. The strength of the profession throughout the most trying times are the qualities that have made this profession what it has been and what it will continue to be. This practice throughout history has been and will always be shaped by scientific and technological improvements in health. But at the same time, the profession will also be continuously shaped by the qualities of spirit, skill, and incredible dedication of those professionals whose main goal is to improve the lives of those we serve for now and for years to come. Chris Trytten, ATC, said to me, 'Science is always changing, and will never stop changing throughout the course of this lifetime.'
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