The Role of Therapy
Physical therapists, occupational therapists, speech-language pathologists, respiratory therapists and therapy assistants make small miracles happen each and every day. Through skilled interventions, they restore patients to their highest level of function. Read more about the three rehab disciplines:
The American Physical Therapy Association (APTA) defines physical therapists as trusted health care professionals with extensive clinical experience who examine, diagnose, and then prevent or treat conditions that limit the body’s ability to move and function in daily life. They provide services that help restore function, improve mobility, relieve pain, and prevent or limit permanent physical disabilities of patients suffering from injuries or disease. They restore, maintain, and promote overall fitness and health. Their patients include accident victims and individuals with disabling conditions such as low-back pain, arthritis, heart disease, fractures, head injuries, and cerebral palsy.
Physical therapists provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes.
Physical therapists examine patients’ medical histories and then test and measure the patients’ strength, range of motion, balance and coordination, posture, muscle performance, respiration, and motor function. Next, physical therapists develop plans describing a treatment strategy and its anticipated outcome.
Treatment often includes exercise, especially for patients who have been immobilized or who lack flexibility, strength, or endurance. Physical therapists encourage patients to use their muscles to increase their flexibility and range of motion. More advanced exercises focus on improving strength, balance, coordination, and endurance. The goal is to improve how an individual functions at work and at home.
Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2008-09 Edition, Physical Therapists, on the Internet at http://www.bls.gov/oco/ocos080.htm (visited February 20, 2009).
Occupational therapists help patients improve their ability to perform tasks in living and working environments. They work with individuals who suffer from a mentally, physically, developmentally, or emotionally disabling condition. Occupational therapists use treatments to develop, recover, or maintain the daily living and work skills of their patients. The therapist helps clients not only to improve their basic motor functions and reasoning abilities, but also to compensate for permanent loss of function. The goal is to help clients have independent, productive, and satisfying lives.
Occupational therapists help clients to perform all types of activities, from using a computer to caring for daily needs such as dressing, cooking, and eating. Physical exercises may be used to increase strength and dexterity, while other activities may be chosen to improve visual acuity or the ability to discern patterns. For example, a client with short-term memory loss might be encouraged to make lists to aid recall, and a person with coordination problems might be assigned exercises to improve hand-eye coordination. Occupational therapists also use computer programs to help clients improve decision-making, abstract-reasoning, problem-solving, and perceptual skills, as well as memory, sequencing, and coordination—all of which are important for independent living.
Patients with permanent disabilities, such as spinal cord injuries, cerebral palsy, or muscular dystrophy, often need special instruction to master certain daily tasks. For these individuals, therapists demonstrate the use of adaptive equipment, including wheelchairs, orthoses, eating aids, and dressing aids. They also design or build special equipment needed at home or at work, including computer-aided adaptive equipment. They teach clients how to use the equipment to improve communication and control various situations in their environment.
Many occupational therapists work with elderly patients. These therapists help the elderly lead more productive, active, and independent lives through a variety of methods. Therapists with specialized training in driver rehabilitation assess an individual’s ability to drive using both clinical and on-the-road tests. The evaluations allow the therapist to make recommendations for adaptive equipment, training to prolong driving independence, and alternative transportation options. Occupational therapists also work with clients to assess their homes for hazards and to identify environmental factors that contribute to falls.
Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2008-09 Edition, Occupational Therapists, on the Internet at http://www.bls.gov/oco/ocos078.htm (visited February 20, 2009).
Speech-language pathologists, sometimes called speech therapists, assess, diagnose, treat, and help to prevent disorders related to speech, language, cognitive-communication, voice, swallowing, and fluency.
Speech-language pathologists work with people who cannot produce speech sounds or cannot produce them clearly; those with speech rhythm and fluency problems, such as stuttering; people with voice disorders, such as inappropriate pitch or harsh voice; those with problems understanding and producing language; those who wish to improve their communication skills by modifying an accent; and those with cognitive communication impairments, such as attention, memory, and problem solving disorders. They also work with people who have swallowing difficulties.
Speech, language, and swallowing difficulties can result from a variety of causes including stroke, brain injury or deterioration, developmental delays or disorders, learning disabilities, cerebral palsy, cleft palate, voice pathology, mental retardation, hearing loss, or emotional problems. Problems can be congenital, developmental, or acquired. Speech-language pathologists use special instruments and qualitative and quantitative assessment methods, including standardized tests, to analyze and diagnose the nature and extent of impairments.
Speech-language pathologists develop an individualized plan of care, tailored to each patient’s needs. For individuals with little or no speech capability, speech-language pathologists may select augmentative or alternative communication methods, including automated devices and sign language, and teach their use. They teach patients how to make sounds, improve their voices, or increase their oral or written language skills to communicate more effectively. They also teach individuals how to strengthen muscles or use compensatory strategies to swallow without choking or inhaling food or liquid. Speech-language pathologists help patients develop, or recover, reliable communication and swallowing skills so patients can fulfill their educational, vocational, and social roles.
Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2008-09 Edition, Speech-Language Pathologists, on the Internet at http://www.bls.gov/oco/ocos099.htm (visited February 20, 2009).
Respiratory therapists—also known as respiratory care practitioners—evaluate, treat, and care for patients with breathing or other cardiopulmonary disorders. Practicing under the direction of a physician, respiratory therapists assume primary responsibility for all respiratory care therapeutic treatments and diagnostic procedures, including the supervision of respiratory therapy technicians. They consult with physicians and other healthcare staff to help develop and modify patient care plans. Therapists also provide complex therapy requiring considerable independent judgment, such as caring for patients on life support in intensive-care units of hospitals.
Respiratory therapists evaluate and treat all types of patients, ranging from premature infants whose lungs are not fully developed to elderly people whose lungs are diseased. They provide temporary relief to patients with chronic asthma or emphysema and give emergency care to patients who are victims of a heart attack, stroke, drowning, or shock.
Respiratory therapists interview patients, perform limited physical examinations, and conduct diagnostic tests. For example, respiratory therapists test a patient's breathing capacity and determine the concentration of oxygen and other gases in a patient's blood. They also measure a patient's pH, which indicates the acidity or alkalinity of the blood. To evaluate a patient's lung capacity, respiratory therapists have the patient breathe into an instrument that measures the volume and flow of oxygen during inhalation and exhalation. By comparing the reading with the norm for the patient's age, height, weight, and sex, respiratory therapists can provide information that helps determine whether the patient has any lung deficiencies. To analyze oxygen, carbon dioxide, and blood pH levels, therapists draw an arterial blood sample, place it in a blood gas analyzer, and relay the results to a physician, who then makes treatment decisions.
To treat patients, respiratory therapists use oxygen or oxygen mixtures, chest physiotherapy, and aerosol medications—liquid medications suspended in a gas that forms a mist which is inhaled. They teach patients how to inhale the aerosol properly to ensure its effectiveness. When a patient has difficulty getting enough oxygen into his or her blood, therapists increase the patient's concentration of oxygen by placing an oxygen mask or nasal cannula on the patient and setting the oxygen flow at the level prescribed by a physician. Therapists also connect patients who cannot breathe on their own to ventilators that deliver pressurized oxygen into the lungs. The therapists insert a tube into the patient's trachea, or windpipe; connect the tube to the ventilator; and set the rate, volume, and oxygen concentration of the oxygen mixture entering the patient's lungs.
Therapists perform regular assessments of patients and equipment. If a patient appears to be having difficulty breathing or if the oxygen, carbon dioxide, or pH level of the blood is abnormal, therapists change the ventilator setting according to the doctor's orders or check the equipment for mechanical problems.
Respiratory therapists perform chest physiotherapy on patients to remove mucus from their lungs and make it easier for them to breathe. Therapists place patients in positions that help drain mucus, and then vibrate the patients' rib cages, often by tapping on the chest, and tell the patients to cough. Chest physiotherapy may be needed after surgery, for example, because anesthesia depresses respiration. As a result, physiotherapy may be prescribed to help get the patient's lungs back to normal and to prevent congestion. Chest physiotherapy also helps patients suffering from lung diseases, such as cystic fibrosis, that cause mucus to collect in the lungs.
Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2010-11 Edition, Respiratory Therapists, on the Internet at http://www.bls.gov/oco/ocos321.htm (visited February 04, 2010).