June 10th - Professional Behavior Lesson 1 Part 2

Key Aspects of Physical Therapy History (1914-2024)

Introduction

  • The lecture covers a 100-year history of physical therapy (PT), emphasizing its evolution in healing, rehabilitation, and prevention of physical problems.
  • The profession's strength and durability reflect both its power and beauty.
  • The presenter expresses a deep love for the PT profession despite initial plans for a career in Wall Street.

Framework: The Diamond Approach

  • The historical overview is structured around a diamond framework, with each point representing a key aspect of the profession. These four points form a quadrilateral around the history:
    • Practice
    • Research
    • Education
    • Association
1914-1926: Early Years
Global History
  • The United States was involved in World War I, leading to over 200,000 wounded Americans.
  • Automobile production reached 4,000,000, symbolizing affluence and necessity.
  • The US Army completed its first around-the-world flight in 15 days and 11 hours, with 175 days of actual flying time.
  • The 19th Amendment granted women the right to vote.
Education History
  • Programs were developed to train individuals as "reconstruction aids" to treat war wounds.
  • Initial programs were at Walter Reed Hospital and Reed College.
  • Graduates were often nurses or physical education instructors.
  • These reconstruction aids laid the foundation for modern physical therapy.
Key Figures: Mary McMillan
  • Mary McMillan, a significant leader in the profession, was born in the US but raised in England.
  • She earned a degree in physical culture and corrective exercise, later studying neuroanatomy, neurology, and psychology.
  • She helped set up the program at Walter Reed Hospital and trained emergency PTs at Reed College.
Practice History
  • Focused on techniques to treat war wounds.
  • Drs. Frank Granger and Joel Goldsway were sent to Europe to study war wound treatments.
  • Mary McMillan and Marguerite Sanderson headed the Walter Reed program, establishing two groups of reconstruction aids:
    • Physical therapists
    • Occupational therapists (initially working in "insane asylums")
  • In 1918, Marguerite Sanderson led a group of reconstruction aids to Europe to implement programs in US Army hospitals.
Uniforms and Modalities
  • PTs wore short-sleeved uniforms, while OTs wore long-sleeved uniforms, due to the modalities used, such as water tanks.
  • Early treatments included self-massage and restrictive exercises.
Poliomyelitis Epidemics
  • Polio epidemics significantly influenced the profession.
  • Physical therapists worked with physicians to treat polio patients.
  • Pool therapy was used at Boston Children's Hospital.
  • In 1924, Georgia Warm Springs was founded as a treatment center for polio.
Research History
  • The PT Review, the precursor to the PT journal, was first published in March 1921.
Association History
  • Local associations predated the American Women's Physiotherapeutic Association.
  • On January 15, 1921, the association was conceived at Keane's Chop House in New York City.
  • On March 24, 1921, Mary McMillan was elected president, with 274 members.
Purposes of the Association (1921)
  • Establish and maintain professional and scientific standards.
  • Increase efficiency among members through advanced study.
  • Disseminate information via medical literature.
  • Assist in securing positions for members.
  • Make available efficiently trained women to the medical profession.
  • Sustain social fellowship.
Membership Categories
  • Charter membership: reconstruction aides with at least one year of military experience.
  • Active members: graduates of recognized physiotherapy programs.
  • Requirements included training in massage and Therex, knowledge of electro or hydrotherapy, and suitable character.
1927-1936: The Great Depression
Global History
  • The US experienced the Wall Street crash in 1929 and the Great Depression.
  • Franklin Delano Roosevelt was elected and implemented the New Deal.
  • The WPA, Civilian Conservation Corps, and TVA were established to relieve unemployment.
  • The Social Security Act was passed in 1934.
President Roosevelt's Polio
  • President Roosevelt had polio and was severely disabled, often using a wheelchair.
  • His condition was largely hidden from the public.
  • The Roosevelt Monument in Washington DC includes subtle depictions of his braces.
Education History
  • Development of accreditation standards for PT education programs in 1928.
  • In 1933, the American Physiotherapy Association sought assistance from the American Medical Association for accreditation.
Practice History
  • Adoption of a code of ethics and discipline.
  • The American Congress of Physical Medicine created the American Registry for registered physical therapists (RPT).
  • Continued polio epidemics.
Research History
  • Limited research activity during this period.
Association History
  • Active members required graduation from approved nursing schools or completion of courses in physical education and nursing.
  • The association hired paid staff, and membership grew to 710 individuals.
1937-1946: World War II
Global History
  • The US was involved in World War II, leading to more advanced technology and warfare tactics.
  • 16,000,000 Americans engaged in battlefields, returning with major disabilities.
  • The war resulted in the Holocaust and the dropping of atomic bombs in Hiroshima and Nagasaki.
  • In 1946, 46 countries signed the United Nations declaration.
  • The dawn of television emerged.
Education History
  • School section meetings increased movement from certificate programs to university-based programs.
  • The US received funding from the National Foundation for Infantile Paralysis.
Practice History
  • Dominated by treating individuals wounded in World War II.
  • Federal legislation recognized women physical therapists as members of the army medical department.
  • Continued polio epidemics caused severe paralysis.
Research History
  • Influenced by the National Foundation's contributions.
  • The foundation promoted the science of PT and scientific research.
Association History
  • The National Foundation influenced the association's purposes.
  • A prescription was required for treatment.
  • The charter member category was dropped, and a life member category was added.
  • The American Physiotherapy Association established a permanent office in Chicago in 1938.
  • The first house of delegates began in 1944.
  • In 1946, the association changed its name to the American Physical Therapy Association.
1947-1956: Post-War Era
Global History
  • Recovery from World War II led to technological advancements.
  • Assembly line production increased consumer goods.
  • The Korean War broke out in 1950, with over 1,600,000 US troops committed.
  • Sir Edmund Hillary conquered Mount Everest on June 2, 1953.
  • The civil rights movement was ushered in with Brown versus Board of Education.
Education History
  • The Allied Health Professions Training Act was passed in 1953.
  • A baccalaureate degree became the minimum requirement for entry-level PT education.
Practice History
  • Treatment of individuals returning from the Korean War.
  • The Salk vaccine was introduced in 1955, leading to the near eradication of polio.
  • The role of the physical therapist progressed from technician to professional practitioner.
  • Private practice expanded.
  • The precursor of the national licensure exam was a seven-hour competency exam in conjunction with the professional examination service.
  • PNF (proprioceptive neuromuscular facilitation) emerged.
Research History
  • The association cooperated with Salk vaccine trials.
  • The physical therapy review expanded from six to 12 issues per year.
Association History
  • A student member category was added to the bylaws.
  • In 1956, the association hosted the second World Confederation for Physical Therapy in New York City.
1957-1966: The Space Race and Civil Rights
Global History
  • The Russians put Sputnik in space in 1957, initiating the space race.
  • Eisenhower sent troops to Little Rock to enforce compliance with desegregation.
  • John Glenn orbited the Earth in 1962.
  • President John F. Kennedy was assassinated in 1963.
  • The 1964 Civil Rights Act was signed.
  • The Vietnam War began, leading to the countercultural revolution.
  • Johnson's Great Society programs were started.
Education History
  • In 1960, a two-year graduate program was developed at Case Western Reserve University.
  • The Health Professions Education Act paved the way for assistant-level personnel.
Practice History
  • Physical therapists went to Vietnam.
  • Enactment of the first state licensure laws for PTs.
  • Services were recognized in the Medicare program.
Research History
  • The section on research was established in 1965.
Association History
  • The House of Delegates established the public health section.
  • The Macmillan Scholarship Fund was established.
1967-1976: Vietnam War Era
Global History
  • Rising inflation and the Vietnam War.
  • Severe racial rioting.
  • Lou Fuller Junior Vietnam Veteran Physical Therapy presentation.
  • First step on the moon.
  • Roe versus Wade decision.
  • Nixon resigned.
  • Fall of Saigon.
Education History
  • Foundation for education of the physical therapist assistant.
  • Howard University established a PT program
  • Entry-level was the clinical doctoral degree for physical therapy education.
  • Brenstrom's text on hemiplegia charted new avenues.
1977-1986: Economic Growth and High Tech
Global History
  • Incredible economic growth despite escalating budget deficits.
  • Sandra Day O'Connor appointed to the Supreme Court.
  • Explosion on take-off of the space shuttle challenger, seven astronauts died.
  • Genetically engineered recombinant DNA method utilized primarily to establish important medically devised drugs.
  • Researchers and PT began to be challenged by AIDS.
Education History
  • Historical recognition of ATPA by the council on post secondary education as an independent accrediting agency.
1987-1996: End of the Cold War
Global History
  • End of the Cold War and the fall of the Berlin Wall.
  • Americans with Disabilities Act (ADA) was signed into law.
  • The establishment of the National Center for Medical Rehabilitation Research
  • We’re re-introduced and challenged. practitioners through the World.
Education History
  • PT professional doctoral education at 4 institutions.
1997-2006: Health Care Reform
Global History
  • The passing of the much talked about Health Care Reform, came with an array of complexities that affected consumers/ Patients everywhere.
  • Terrorism in the US reached extreme, we will all bore witness to tragic events at the World Trade Center.
Education History
  • Implementation of Clinical education with CAPP. Limited Baccalaureate applicants
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