Allied Health: Rehabilitative & Habilitative Options

Allied Health: Rehabilitative & Habilitative Options

• Allied health: the health professions that are distinct from medicine and nursing; basically, any career related to healthcare outside of being a doctor or nurse.

• Allied Health Professionals: health professionals who use scientific principles and evidence-based practice for the diagnosis, evaluation, and treatment of acute and chronic diseases; promote disease prevention and wellness for optimum health; and apply administration and management skills to support health care systems in a variety of settings.

Examples of Allied Health Professionals

• Physical Therapist (PT)

• Physical Therapist Assistant (PTA)

• Occupational Therapist Assistant (OTA)

• Researchers

• Administrators

• Dietitians

• Technicians

Where can you find allied health professionals?

• Inpatient Facilities

• Outpatient Facilities

• Sports Settings

• Private Practice

• Most allied health professionals work in the same locations as medical professionals

Allied Health Work Locations (expanded)

• Inpatient Facilities: goal to get maximum functional level

• Outpatient Facilities: wide range of patients and equipment

• Sports Teams: expansive facilities to meet range of needs

• Private Practice: expensive and require strong patient base
  
  These roles often require coordination to address diverse patient bases and settings

What do Allied Health Professionals do with rehabilitative and habilitative care?

• Both rehabilitative and habilitative care are forms of therapeutic exercise.

• Rehabilitative vs. habilitative care:

  • Rehabilitative: processes and treatments that restore skills and functions lost from injury; specialists also consider the psychological and social effects of injury.

  • Habilitative: interventions lead to skill acquisition of normal skills or functions typical for age and status; physical state must be considered.
    
    Both rehabilitative and habilitative exercise can be preventative
    

Proverb and Philosophy in Practice

• Quote: "An ounce of prevention is worth a pound of cure." (prevention emphasis)

• Both rehabilitative and habilitative professionals focus on developing the body's systems so that injury or disease is less likely in the future.

Restoring physical function involves both passive and active interventions.

• Habilitative Therapeutic Exercise

Rehabilitative Therapeutic Exercise

• Passive interventions (done to the individual or afflicted area): heat, cold, manual therapy, electrical stimulation, and others.

• Active interventions (used and stepped through; done to the person): exercises used to improve strength, range of motion, and balance.

Exercise Therapy for Rehabilitation

• Musculoskeletal Injuries:

• Injury may affect neuromuscular function and cardiovascular endurance.

• Goal: restore symptom-free movement and function of the cardio system.

• Settings: outpatient physical therapy clinics, hospitals, and athletic training clinics.
  

• Athletic Injuries:

• Rehab begins almost immediately following injury.

• Sport-specific functional progress is important to reintegrate into athletic activity.

• Sports medicine is exclusively dedicated to therapeutic exercise with athletic injuries.

Prehabilitation and Sports Medicine

• Prehabilitation: after injury but before surgery to gain strength and range of motion (ROM) as much as possible; occurs after an injury and before a surgical intervention

• Sports medicine: a generic term referring to the practice of medicine, the art of rehabilitation, and the sciences related to preventing, treating, and rehabilitating athletic injuries.

Postsurgical Trauma and Cardiopulmonary Rehabilitation

• Exercise therapists work closely with physicians.

• Important to know certain conditions that can cause more harm

  • Due to the disease, physician supervision is common in cardiopulmonary rehabilitation programs.

• Older Populations: aim to minimize age-related loss of strength, flexibility, and cardiovascular condition; minimize chronic disease conditions and pain.

• Exercise can reduce stress and emotional disorders; can improve sleep; exercise triggers "feel good" chemicals like endorphins and serotonin.

Habilitative Therapeutic Exercise

• Specialized Habilitation:

  • Goal: reach established fitness standards for the person’s age and demographic.

• Many health and fitness professions provide habilitative therapeutic exercise (e.g., PT, OT, ATC, speech pathology, etc.).

• There is confusion and related factors around weight loss.

  • specialists cooperate to address nutritional and exercise counseling.

• Overweight and Obese Populations: management often involves both diet and exercise strategies.

• Many of these patients (children with developmental challenges) require help adapting or compensating for anatomical and physiological deficits.

• Social and cognitive development present unique challenges

• The population is more sedentary due to screens and lifestyle; technology is both helpful and harmful.

  • People in general have become less active as work and life require less of them

  
  
  
  
  
  

Allied Health Takeaways

• Skills needed: communication, business acumen, problem-solving, compassion, soft skills, and empathy.

• The allied health field is growing, including geriatric populations and preventative care.

Professions and Their Settings (Overview)

• Athletic Trainer (ATC)

• Clinical Exercise Physiologist (CEP/RCEP)

• Occupational Therapist (OT)

• Physical Therapist (PT)

• Therapeutic Recreation Specialist

• Orthotists and Prosthetists

Athletic Trainer (ATC)

• Responsible for the prevention, evaluation, management, treatment, and rehabilitation of athletic injuries

• Works under the direction of an MD or DO

• Employment settings: athletic or clinical

• See the injury happen, and have an idea of the client’s history

• Education and credentials:

  • Accredited undergraduate athletic training program

  • Master of Science (MS) required in 2022

  • Certification required

Clinical Exercise Physiologist (CEP / RCEP)

• Exercise treatment and testing for cardiac, pulmonary, and metabolic diseases

• Duties include: monitoring vital signs, patient education and counseling

• RCEP develops and directs clinical program and works with physician to structure exercise program

• Employment settings: hospitals, specialty clinics, urgent care centers (clinical settings); health and fitness centers (prevention programs)

  • work with preventative care

• Education and credentials: undergraduate or graduate degree in related field recommended; clinical rotations; Certifications: ACSM-ES, ACSM-CEP

How CEPs and ATCs Differ

• Both work with patients before, during, and after injury to regain prior ability

• CEPs typically require a master’s degree; may focus more on prevention and clinical populations including older adults; live on the preventative side

• ATCs focus on prevention and management of sports injuries; work within athletic settings and clinics; not doing wound care

Physical and Occupational Therapy Roles

• Clinical Exercise Physiologist vs Certified Athletic Trainer (PT vs ATC differences summarized)

• Occupational Therapist (OT) and OTA (Occupational Therapy Assistant):

  • OT focuses on independence at home and work; OTA may be supervised; settings include hospitals, clinics, outpatient clinics, schools (secondary schools or colleges); look at everything overall; developmental/ cognitive side of things

  • Education: Master’s degree for OT; OTA typically an Associate degree; state licensure for OT/PT; Certification options exist

Physical Therapist (PT)

• Functions: rehab exercises for a diverse patient population with various injuries, illnesses, and diseases; have to have doctors sign off on what they are doing: limited; fewer activities of daily living

• Oversees Physical Therapy Assistant (PTA); collaborates with other healthcare professionals

• May combine diagnostic tests with interventions; some tasks shifted to PTA due to reimbursement

• Employment settings: specialized or general clinics, hospitals, nursing facilities, health and wellness centers, school systems, colleges, universities

• Education and credentials:

  • Accredited entry-level master’s degree (as of 2020, PhD required in many programs)

  • PTA: accredited two-year program

  • State licensure for PT or PTA

How Do PTs Specialize?

• Age Groups: Pediatric, Adult, Geriatric

• Patient Status: Athletes, Disabilities, Existing Health

• Conditions/Need: Cardiac Patients, Surgical Patients

Therapeutic Recreation Specialist

• Functions: Use exercise and leisure activities to help people with disabilities restore function or reduce effects to develop independence and social integration; work with other professionals; use exercise and leisure activities to connect with their patients

• Employment Settings: Inpatient and outpatient facilities (hospitals and nursing facilities), community recreation programs, substance abuse centers, residential facilities, camps, and public schools

• Education and credentials: Bachelor’s degree required; Certification available

• How they differ from PT/OT: focus on recreation and leisure-based goals alongside physical function; rely on play

Orthotists and Prosthetists

• Responsibilities: Develop, build, and fit braces and artificial limbs

• Education: Master’s degree level, followed by a one-year residency with an accredited program

• Certification: Board certification

• Dual role: Occasionally MD or DO may also work as an Orthotist or Prosthetist if already working as an Orthopedist
  
  

Allied Health Take-Aways

• People are living longer: this means the need for allied health professionals specializing in geriatric populations is growing

• People are more sedentary than ever: the need for healthy lifestyle coaching and interventions is growing

• Barriers to care are changing: technology is helping and hurting; financial barriers are greater than before

• Skills needed: communication skills, business acumen, problem-solving, compassion, emphasis on soft skills