History of physical therapy from past to present it continues to be an expansive area in medical field. Historically, during 460 BC primitive physical therapy techniques were employed and applied in diagnosing, treatment and management of the patients. The traditional primitive techniques applied involved massage and hydrotherapy in treating patients, which was advocated by physicians like hector and Hippocrates (Basmajian, 2000). It is therefore, from this primitive interventional approach in treating individuals with physical injuries that today techniques developed.
America in 1924 witnessed a new dawn by formation of Physical Therapy Association organized by Mary MacMillan that today is popularly known as APTA (America Physical Therapy Association). This body (APTA) is vital organ in physical therapy related issues and development. In these historical periods, the commonly practiced areas of intervention to patients were in exercise, traction and message. The practice environment for therapists was only based on in – patient, but today has extended to out-patient accounting to over 63 percent (Basmajian, 2000, p. 10).
However, with time therapists moved to out-patent orthopedic clinics, schools, rehabilitation centers and genetriatic settings as opposed to hospital settings. This marked new beginning in expansion of the physical therapy area of operation and services diversity. According to ABPT (American Board of physical therapy), lists several fields that falls under physical therapy, but emphasize on six major ones that are universally accepted worldwide.
These areas are: orthopedic that therapists diagnose marriage and treat injuries and disorders involving the musculoskeletal systems and rehabilitation after surgery practiced especially in outpatients. Secondly, cardiopulmonary therapies that treats and manages patients after surgery or patients without undergoing surgery in cardiopulmonary disorders (Worthingham, 2002). Thirdly, neurological therapies focus on treating and managing after diagnosing patients affected with neurological disorders. Fourthly, pediatric therapies aim at early detection of health problems and treat disorders.
Fifth, geriatric therapies focuses on the treatment and management of health issues related to aging old age like osteoporosis cancer and Alzheimer’s diseases. And lastly, the therapies of integument focus on the treatment of the conditions that involves or relate to skin health problems like would treatment. However, the areas of concern for physical therapists are not limited to the mentioned six but do extend to other relevant emerging special fields like clinical electrophysiology and sports injuries (Worthingham, 2002)
Advancements in physical therapy A part for tradition practices in the field of physical therapy; the past decades there have been various developments that have facilitated change. For instance, in defined physical therapy as treatment by use of exercises and massaging to keep muscles stretched. I have no objection with this definition as it was appropriate and served the purpose at time, in fact to help to come up with a better definition.
As effect with need for expansion and growing, needs to be accommodating in physical therapy, (Wyke, 2008), come up with physical therapy as diagnosis, treatment of disorders and injuries through physical means. This new devised therapy practices, but it also indicate the expanded view and perception and description of physical therapy in today’s world. Thus, the latest advancement in physical therapy was optimal treatment outcome to the patients by adaptation of psychological approach.
The approach visualize optimal treatment outcome as a function of both clinical professional factors associated with therapist and the psychological factors associated with the patient. In order to achieve this, various advancements has been achieved geared towards making patient health care efficient. Introduction of sports, recreation and manipulation The introduction and use of sports, recreation and manipulation is one of the advancement witnessed in physical therapy that has really improved patient care.
For instance, the cases of shoulder impingement syndrome are managed with a multimodal approach. Such patients no wards undergo a multimodal protocol intervention hat encompasses photospheres, rotator cuff and shoulder girdle muscle exercises, diversified manipulation and soft tissue, and finally return to normal daily sporting activities and work. The resultant outcome reports mo re than 68% effectiveness at the end of treatment protocol with follow-up of 4 to 12 weeks (Worthingham 239).
In sum total, the use of soft tissue techniques like frictional and ischemic compression electrons electro modalities-technique like ultrasound, rehabilitation by are of exercises and manipulation is proved to be useful in improving outcome of the patient care, since it is more interactive and centralize patient centered care. Advancement interventions In diagnosis and treatment of muscular-skeletal systems like weakness pain and altered joint properties there has been major advancement in the area of approach.
One of the main advancements reached include active assistance of joint range of motion, active assistance of soft tissue morality, passive joint range of motion, functioning multi – plane self graded strengthens, kinematic chain biomechanics and lastly PNF (Proprioceptive Neuro-motor Re-education) (Wyke, 2008) these aspects have been designed to achieve patient friendliness, encouragement of positive carry over between treatments in home based programs, improved patients ability to reduce pain by themselves by use of current end ranges of motions and lastly restoration of correct neuro-motor biochemical (Moore, 2007, p. 51) through use of AAROM (Active Assisted Range of Motions) The results to patient out some proves to be more than 73% effective with follow up of about 5 – 13 weeks. Whereas in neurology such therapies like constraint – induced movement therapy CCI) proves to be efficient in restoring functions in the upper extremities of patients with stroke. Advanced administration and management Physical the rapists in order to deliver best patient care, they need to utilize knowledge and skill in administration or business management to be guiding framework for their work.
Historically, administration has evolved since the 1999 LAMP document guiding on physical therapists administration. LAMP (leadership administration and management preparation) documented by APTA’s (Moore, 2007) can no longer be efficient to function in this era of technology and paradigm shift in administration skills. The basic six areas contained in the document include: examinations evaluations, intervention, diagnosis, prognosis and outcome needed to be integrated with business and technological domains in order to advance the field of physical therapy (Basmajian, 2000).
For instance, many practioners find it necessary to use management software to standardize practice and facilitate outcome comparison. One such useful gad gets is the PTCMR (physical therapy computerized medical record). This system gather all the incoming information about the patients treatment and evaluation additionally, the system is for clinical research with incorporation of DCDC (Duke cardiovascular database) and ARAMIS (American Rheumatism Association of medical information database) that gives PTCMR with vital information through networks for research.
Such aspects of standard physical therapy measures of important like pain, range of motion and strength are also inclusive in the system (effectiveness of the system refer to table 1). The system proves efficient by resultant of about 32% reduction of pain in patient with TENS (Transcutaneous Electrical Nerve Stimulation) which was tested. Additionally, there noted decreased ambulation as a result of management enhanced by PTCMR system (Moore, 2007).
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