Introduction

  • Presenters: Max and Taylor, discussing the role of physical and occupational therapists, and collaboration with speech-language pathologists (SLPs).

Background of Presenters

  • Maxwell McKinney (Physical Therapist)
      - Graduated from OSU in 2015 with a Bachelor’s in Health Sciences.
      - Completed a Doctorate of Physical Therapy in 2018 at OSU.
      - Three-year program combining didactic coursework with 42 weeks of clinical training.
      - Experience in five outpatient clinics, OSU Wexner Medical Center, and skilled nursing facilities.
      - Works in acute care focusing on orthopedic and transplant populations, has started working with ICU patients.

  • Taylor Cockrell (Occupational Therapist)
      - Graduated from OSU in 2015 with a Bachelor’s in Health Sciences.
      - Obtained a Master’s in Occupational Therapy in 2017 from OSU.
      - Experience in outpatient pediatrics, skilled nursing facilities, and acute care (brain and spine hospital, orthopedic trauma, neuro patients, and NICU).

Learning Objectives of the Lecture

  • Understand the roles of physical and occupational therapists in various settings.

  • Identify similarities and differences between physical therapy (PT), occupational therapy (OT), and speech therapy (SLP).

  • Understand proper posture and its effects on swallowing.

  • Review case studies and discuss interdisciplinary approaches to patient treatment.

Overview of Coursework Differences

  • A slide showcasing differences and similarities in PT, OT, and SLP coursework presented in a Venn diagram format, encouraging review before discussion.

Role and Responsibilities of Physical Therapists

  • Definition: Physical therapists are movement experts who improve quality of life through prescribed exercise, hands-on care, and patient education (Source: American Physical Therapy Association, APTA).

  • Main Focus Areas:
      - Improving patient mobility.
      - Pain management (chronic, acute, post-surgery).
      - Restoring function for daily tasks.
      - Preventing deterioration and disability (especially in aging and inactive populations).
      - Maintenance Therapy: Preserving strength and mobility for at-risk patients.

  • Methods to Accomplish Goals:
      - Prescribing exercises for strength and range of motion.
      - Transfer training (standing/movement in bed).
      - Gait training (walking/stair climbing).
      - Endurance and balance training.
      - Manual therapy (e.g., massage).
      - Utilizing modalities such as ultrasound, traction, and electrical stimulation (e-stim).
      - Fitting and creating orthotics and braces.

Patient Demographics for Physical Therapy

  • Physical therapists work with a diverse population ranging from newborns to geriatrics, including various conditions such as:
      - Premature infants.
      - Teen athletes (e.g., ACL tears).
      - Adults post-COVID-19.
      - Post-surgery patients (e.g., back surgery).
      - Older adults with neurological disorders (e.g., Parkinson’s disease).

Overview of Occupational Therapy

  • Definition: Occupational therapists enable participation in desired activities (occupations) through therapeutic use of everyday tasks.

  • Holistic Approach: Client-centered and occupation-based interventions.

Categories of Occupations

  • Activities of Daily Living (ADLs): Basic self-care tasks (e.g., eating, bathing, grooming, dressing).

  • Instrumental Activities of Daily Living (IADLs): More complex tasks (e.g., medication management, grocery shopping, meal preparation).

  • Rest and Sleep: Hygiene and sleep routines.

  • Education: Learning and information processing tasks.

  • Work: Job duties and responsibilities.

  • Play: Recreational activities.

  • Leisure: Enjoyable and fulfilling activities.

  • Social Participation: Interactions and connections with others.

Unique Contributions of Occupational Therapists

  • Assessment of Interaction Between Areas: Occupational therapists evaluate how various areas (ADLs, IADLs, etc.) interact within a client’s environment to promote wellness and life balance.

  • Categories of Intervention Areas:
      - Occupations and Activities: ADL/IADL training (self-care tasks).
      - Preparatory Methods/Tasks: Modalities, assistive technology, coordination programs.
      - Education and Training: Empowering clients, occupational justice.
      - Advocacy: Supporting reasonable accommodations in the community.
      - Groups: Fostering social interaction and group therapy.

OT Approaches to Intervention

  • Health Promotion: Initiatives for all clients, regardless of disability. (e.g., fall prevention programs for seniors).

  • Establish and Restore: Changing or restoring client variables; promoting skills (e.g., upper extremity movement for dressing).

  • Maintenance: Supporting performance capabilities to preserve independence (e.g., modified tools for arthritis).

  • Modification: Revising activity demands for current performance level (e.g., simplifying tasks for cognitive impairments).

  • Prevention: Preventing occupational performance problems (e.g., social isolation activities).

Clinical Settings for OT and PT

  • Acute Care: Hospitals, promoting mobility to prevent deconditioning during hospitalization.

  • Skilled Nursing Facilities: Long-term supervision, rehabilitation services following hospital discharge.

  • Inpatient Rehabilitation Facilities: More intensive therapy for patients with higher needs.

  • Home Health Care: Therapy provided at the patient's residence.

  • Outpatient Clinics: Patients visit clinics for scheduled therapy sessions.

Acute Care Settings

  • Role in Acute Care: Promote mobility; prevent complications (bedsores, blood clots, pneumonia) through education and motivation.

  • Evaluations:
      - Initial chart reviews and subjective history collection.
      - Assessment of range of motion, strength, balance, and transfer abilities.

Physical and Occupational Therapy Interventions in Acute Care

  • PT Interventions:
      - Focus on mobility training, accommodations for specific surgical precautions, discharge barriers identification.

  • OT Interventions:
      - Improvement in cognitive function, basic self-care tasks, providing caregiver education.

Interventions in Skilled Nursing Facilities and Inpatient Rehabs

  • PT Focus: Range of motion, strength, endurance, balance, gait, stair training.

  • OT Focus: ADLs/IADLs, occupational profiles, patient-centered goals, adaptive equipment recommendations.

Home Health Therapy

  • Involves subjective history taking and physical assessments focusing on mobility within the patient’s home that helps identify outdoor/indoor obstacles.

  • PT Focus: Navigation training, family education.

  • OT Focus: ADL routines, home modifications, chronic condition management, and medication reminders.

Outpatient Clinics

  • Patients attend clinics for specialized therapy. Evaluations include extensive history, assessments, and goal-setting.

  • PT Interventions: Focus on specific impairments (range of motion, strength).

  • OT Interventions: Could be more varied based on specialization (e.g., neuro rehab, driving skill rehabilitation, pediatric clinics).

The Relationship between PT, OT, and SLP

  • Cognition Training: Overlaps significantly between OT and SLP, especially regarding cognitive deficits that affect daily function. Example: completion of ADLs and cognition assessments for ADL tasks.

  • Importance of interdisciplinary collaboration for effective treatment outcomes.

Postural Considerations in Therapy

  • Posture affects movement and swallowing ability. Two pivotal studies show improved swallowing in upright posture as measured by subjective difficulties and muscle recruitment.

  • Practical Application: Address posture in therapy to aid swallowing and overall functional performance in patients.

Case Studies

  • Case Study 1: 72-year-old male post-stroke with right-sided weakness and dysphagia.
      - PT Focus: Transfer training, gait pattern improvement, strength and range of motion exercises.
      - OT Focus: Fine motor and gross coordination tasks, ADL performance strategies, education on impairments.
      - SLP Focus: Swallow evaluations, diet recommendations, cognitive assessments.

  • Case Study 2: 81-year-old female with Parkinson’s disease exhibiting a forward posture and tremors.
      - PT Focus: Postural education, gait training, balance exercises.
      - OT Focus: Adaptive equipment, fatigue management, transfers.
      - SLP Focus: Communication techniques and evaluations.

Conclusion

  • The integration of PT, OT, and SLP ensures a holistic approach to patient care that acknowledges the interconnectedness of movement, daily activities, and communication.

  • Attendees encouraged to reach out with further questions.

Contact Information

  • Email addresses of Max and Taylor provided for follow-up questions.