Intro-History

PHT 1201: Introduction to PTA

  • Instructor: Beatriz Melendez, DPT, MSPT, ACCE

Definition of Physical Therapy

  • Physical Therapy: Begins with an examination to:

    • Determine the nature and status of the condition.

    • Establish a diagnosis, prognosis, and plan of care.

  • Provided by or under the direction of a physical therapist.

Physical Therapy as a Profession

  • Hierarchy in the Profession:

    1. Lifetime Commitment: Dedication required.

    2. Representative Organization: Standards and structure provided by the APTA.

    3. Specialized Education: Ensures competency.

    4. Service to Clients: Direct benefit to society.

    5. Autonomy: Independent and accurate judgment expected.

Historical Development

  • Polio Epidemic: Left many children paralyzed, highlighting the need for PT.

  • World War I: Surgeons went to England and France to learn PT techniques for veterans.

Continued Historical Development

  • Development of an organization to train Reconstruction Aides post-WWI.

  • Creation of the American Women's Physical Therapist Association after WWI,

    • Mary McMillan elected first president in 1921, first PT in the US.

Post-WWI Progress

  • Journal of PT Review introduced.

  • In 1922, the AWCPTA changed names to American Physiotherapy Association (APA), admitting male members.

  • Journal re-titled to Physiotherapy Review.

Educational Developments Post-WWI

  • 1928: APA suggested a 9-month curriculum.

  • 1930: Approved 11 educational programs.

Post-WWII Period

  • Army recognized the need for organized PT training for military personnel.

  • APA renamed to American Physical Therapy Association.

  • 1962: Publication known as Journal of Physical Therapy.

1960-1980s Developments

  • 1960: Policy statements for PTAs established.

  • 1971: APTA headquarters relocated to Washington D.C.

  • Minimum Requirement for PTs raised to a baccalaureate degree in 1960; mandatory BS degree by 1970.

APTA Recognition and Specialization

  • 1977: APTA recognized as an accrediting agency.

  • 1978: American Board of Physical Therapy Specialist created for specialization and certifications.

  • 1980: All programs must award a post-baccalaureate (MS) degree by 1990.

Changes in Accreditation

  • 1983: APTA became the sole agency for accrediting PT and PTA programs.

  • 1984: APTA adopted policy on diagnosis in PT.

  • 1988: Direct access to PTs became legal in 20 states.

Challenges in the 1990s

  • New reimbursement issues from managed care limited practice environments.

  • Creation of a separate body for PTAs, Representative Body of the National Assembly.

  • 2020: Included provisions for services by Doctors of Physical Therapy.

Role of Physical Therapist Assistant (PTA)

  • Defined as a health care provider assisting PTs in delivering PT services.

  • Must graduate from an accredited PTA associate degree program.

  • PTA's function includes compliance with federal and state regulations.

Responsibilities of the PTA

  • PTA cannot initiate/change treatment without PT's assessment and approval.

  • Inpatient care requires the PT to be physically available.

  • For non-inpatients, PT must be accessible by telecommunications.

  • PTA reports patient responses and inquiries about prognosis to PT.

PT Responsibilities

  • Interpretation of Referrals.

  • Initial patient assessment and treatment plan development.

  • Documentation and identification of special precautions.

  • Regular reassessment and modification of treatment plans.

Components of the Initial Assessment

  • Informed Consent: Clear description of interventions, expected benefits, risks, and alternatives.

  • Examination: Gathering information including patient medical history.

  • Initial Assessment: All measurements recorded.

  • Diagnosis: Defined from examination findings.

  • Prognosis: Prediction of improvement and necessary timeline.

  • Plan of Care: Incorporates patient expectations.

  • Goals: Should be measurable.

  • Treatment Interventions: Procedures to achieve desired outcomes.

Documentation Formats

  • SOAP Notes: Framework for documenting patient interactions.

    • S: Subjective data, information from the patient or caregivers.

    • O: Objective data, measurable and reproducible findings.

    • A: Assessment, summarizing subjective and objective data.

    • P: Plan, outlining what will happen next in treatment.