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Physical Therapy Assistants

The Job

Physical therapy personnel work to prevent, diagnose, and rehabilitate, to restore physical function, prevent permanent disability as much as possible, and help people achieve their maximum attainable performance. For many patients, this objective involves daily living skills, such as eating, grooming, dressing, bathing, and other basic movements that unimpaired people do automatically without thinking.

Physical therapy may alleviate conditions such as muscular pain, spasm, and weakness, joint pain and stiffness, and neuromuscular incoordination. These conditions may be caused by any number of disorders, including fractures, burns, amputations, arthritis, nerve or muscular injuries, trauma, birth defects, stroke, multiple sclerosis, and cerebral palsy. Patients of all ages receive physical therapy services; they may be severely disabled or they may need only minimal therapeutic intervention.

Physical therapy assistants always work under the direction of a qualified physical therapist. Other members of the health team may be a physician or surgeon, nurse, occupational therapist, psychologist, or vocational counselor. Each of these practitioners helps establish and achieve realistic goals consistent with the patient's individual needs. Physical therapy assistants help perform tests to evaluate disabilities and determine the most suitable treatment for the patient; then, as the treatment progresses, they routinely report the patient's condition to the physical therapist. If they observe a patient having serious problems during treatment, the assistants notify the therapist as soon as possible. Physical therapy assistants generally perform complicated therapeutic procedures decided by the physical therapist; however, assistants may initiate routine procedures independently.

These procedures may include physical exercises, which are the most varied and widely used physical treatments. Exercises may be simple or complicated, easy or strenuous, active or passive. Active motions are performed by the patient alone and strengthen or train muscles. Passive exercises involve the assistant moving the body part through the motion, which improves mobility of the joint but does not strengthen muscle. For example, for a patient with a fractured arm, both active and passive exercise may be appropriate. The passive exercises may be designed to maintain or increase the range of motion in the shoulder, elbow, wrist, and finger joints, while active resistive exercises strengthen muscles weakened by disuse. An elderly patient who has suffered a stroke may need guided exercises aimed at keeping the joints mobile, regaining the function of a limb, walking, or climbing stairs. A child with cerebral palsy who would otherwise never walk may be helped to learn coordination exercises that enable crawling, sitting balance, standing balance, and, finally, walking.

Patients sometimes perform exercises in bed or immersed in warm water. Besides its usefulness in alleviating stiffness or paralysis, exercise also helps to improve circulation, relax tense muscles, correct posture, and aid the breathing of patients with lung problems.

Other treatments that physical therapy assistants may administer include massages, traction for patients with neck or back pain, ultrasound and various kinds of heat treatment for diseases such as arthritis that inflame joints or nerves, cold applications to reduce swelling, pain, or hemorrhaging, and ultraviolet light.

Physical therapy assistants train patients to manage devices and equipment that they either need temporarily or permanently. For example, they instruct patients how to walk with canes or crutches using proper gait and maneuver well in a wheelchair. They also teach patients how to apply, remove, care for, and cope with splints, braces, and artificial body parts.

Physical therapy personnel must often work on improving the emotional state of patients, preparing them psychologically for treatments. The overwhelming sense of hopelessness and lack of confidence that afflict many disabled patients can reduce the patients' success in achieving improved functioning. The health team must be attuned to both the physical and nonphysical aspects of patients to assure that treatments are most beneficial. Sometimes physical therapy personnel work with patients' families to educate them on how to provide simple physical treatments and psychological support at home.

In addition, physical therapy assistants may perform office duties: They schedule patients, keep records, handle inventory, and order supplies. Physical therapy aides may also handle these duties.

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