Comprehensive Physical Therapy Practice and Patient Care Frameworks

Role of the Physical Therapist

Provide direct patient care, evaluate patients, create plans of care, provide interventions, educate patients, and collaborate with healthcare professionals.

Standards of Practice for Physical Therapy

APTA guidelines describing essential conditions for high-quality physical therapy practice.

Why has demand for PTs/PTAs increased?

Aging population, healthcare for children in public schools, increased public interest in fitness, and healthcare reimbursement changes.

Primary Care

Healthcare provided by a primary care provider responsible for most health needs (family doctor/PCP).

Secondary Care

Healthcare provided by specialists after referral from a primary care provider; most PT services occur here.

Tertiary Care

Specialized care for complex or long-term conditions such as burns, neurology, oncology, or cardiology.

Can PTs practice at all three levels of care?

Yes.

Direct Access

Patients can seek physical therapy services without a physician referral.

Interprofessional Approach

Healthcare providers from multiple disciplines work together to improve patient outcomes.

PTs commonly collaborate with

Physicians, nurses, PTAs, occupational therapists, speech-language pathologists, social workers, orthotists/prosthetists, podiatrists, chiropractors, massage therapists.

Why are PTs involved in prevention and wellness?

They help prevent injury, reduce dysfunction, promote healthy lifestyles, and lower healthcare costs.

Screen

Determines whether additional healthcare services are needed.

Prevention

Services designed to prevent pain, injury, or dysfunction before or after they occur.

Health Promotion Programs

Programs that prevent injury and disease while improving productivity and reducing healthcare costs.

Ergonomic Evaluation

Assessment of workplace setup to reduce injury risk.

Functional Capacity Evaluation (FCE)

Test that measures a person's ability to perform work-related tasks safely.

Work Conditioning

Program that restores physical capacity needed to return to work.

Work Hardening

Intensive work-specific rehabilitation simulating actual job tasks.

Patient/Client Management Model

Framework PTs use to examine, evaluate, diagnose, determine prognosis, intervene, and assess outcomes.

Informed Consent

Patient agrees to treatment after understanding risks, benefits, alternatives, and expected outcomes.

Examination

Process of gathering history, performing systems review, tests, and measurements.

Systems Review

General assessment of musculoskeletal, neuromuscular, cardiovascular/pulmonary, and integumentary systems.

Evaluation

Clinical judgment based on examination findings.

Diagnosis

Process of categorizing patient problems based on examination findings.

Prognosis

Prediction of expected improvement and time needed to achieve goals.

Plan of Care (POC)

Overall treatment plan developed to achieve patient goals.

Intervention

Treatment procedures performed by the PT and PTA.

Outcome

Results of interventions and the entire plan of care.

Purpose of Communication and Documentation

Ensure everyone involved in patient care is updated on patient status.

Documentation Requirements

Must be clear, concise, accurate, and meet legal and insurance requirements.

SOAP Note

Documentation format: Subjective, Objective, Assessment, Plan.

Problem-Oriented Medical Record (POMR)

System from which SOAP notes originated.

Patient Education

Teaching patients and families about treatment, home exercise programs, and health management.

Direct Intervention

Therapeutic interaction between PT/PTA and patient.

Examples of Direct Interventions

Therapeutic exercise, manual therapy, functional training, patient education, airway clearance, assistive technology.

Therapeutic Exercise

Exercises used to improve strength, flexibility, endurance, and function.

Manual Therapy

Hands-on techniques to improve movement and reduce pain.

Motor Function Training

Activities that improve movement patterns and coordination.

Functional Training

Practice of everyday activities such as walking, self-care, and work tasks.

Assistive Technology

Devices prescribed or modified to improve patient function.

Airway Clearance Techniques

Methods used to remove secretions from the lungs.

Consultation

PT provides examination or expert advice without ongoing treatment.

Patient-Centered Consultation

Examination without intervention.

Client-Centered Consultation

Expert advice regarding ergonomics, architecture, legal cases, academic programs, or healthcare policy.

Education Role of PT

Educating patients, families, students, and other healthcare professionals.

Critical Inquiry

Questioning why treatments work and seeking evidence to improve practice.

Evidence-Based Practice

Using the best available research, clinical expertise, and patient preferences in decision-making.

Administration Role of PT

Planning, budgeting, supervising, delegating, communicating, and managing healthcare services.

Case Manager

Coordinates patient care across multiple healthcare providers and services.

Employment Trend for PT/PTA

Demand remains strong even though reimbursement has decreased.

Median Age of PT (2021)

41.2 years.

Median Age of PTA (2021)

37.8 years.

Approximate Number of PTAs (2024)

104,000.

Average PTA Salary (2024)

About $59,640 per year or $28.67/hour.

Average PTA Salary (2024)

About $64,080 per year.

PTA Gender Distribution

Female: 68%; Male: 32%.

Highest Degree for Most PTs

Doctor of Physical Therapy (DPT).

Most Common PTA Degree

Associate degree.

Other Degrees Held by PTAs

Bachelor's, Master's, PhD, or equivalent.

Most Common Employment Setting for PTs/PTAs

Private outpatient practice.

Other Employment Settings

Acute care hospitals, home health, skilled nursing facilities, inpatient rehab, schools, academic institutions, health systems.

Mission of the Standards of Practice

Promote ethical, legal, effective, and high-quality physical therapy care.