Questions and Answers
What role does the physician commonly fulfill in the PM & R team?
Which team member specializes in helping patients with cognitive impairments related to communication?
What level of education is required for a Physical Therapist?
Which task can be performed by a Physical Therapist Assistant within their legal limitations?
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Who is considered the most important member of the PM & R team according to the stated content?
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Which intervention is specifically used to decrease edema?
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What is the purpose of the Oswestry Disability Index?
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Which outcome measure would be most appropriate for assessing balance?
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Which physical therapy intervention uses heat to promote healing?
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What does the 'Timed Up and Go' assessment primarily evaluate?
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Which type of electrical stimulation is used to reduce muscle spasms?
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Which of the following is NOT a self-report questionnaire?
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What is the role of ultrasound in physical therapy?
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What is the primary purpose of biofeedback?
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Which manual therapy technique involves moving joint surfaces on one another?
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What does therapeutic exercise aim to improve?
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Which technique uses tools to break up scar tissue?
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Gait training primarily focuses on which aspect of movement?
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What differentiates functional training from other training types?
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What is the purpose of aquatic therapy?
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What role does job site analysis or ergonomic assessment serve?
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Who was the first Reconstruction Aide and Physical Therapist in the US?
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What was the purpose of the Division of Special Hospitals and Physical Reconstruction (DSH&PR)?
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What significant event in the history of physical therapy occurred in 1921?
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What type of therapy uses dolphins to treat cognitive and physical impairments?
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What was one reason for the development of physical therapy in the US?
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What was the original name of the American Physiotherapy Association?
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What was one of the five purposes of the AWPTA?
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What therapy involves the use of horses to alter muscle tone?
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Which of the following patients would most likely require hospitalization for acute care?
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What type of care is primarily provided in skilled nursing and extended care facilities?
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In which setting are orthopedic conditions most commonly treated?
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Which patient group is typically served by home health care?
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Which condition is associated with early intervention services in schools and playgrounds?
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What type of facility provides care specifically for mental health and cognitive impairments?
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Which of the following is NOT a typical focus of outpatient clinics?
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What type of patients would athletic teams typically include?
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Study Notes
PM & R Team Composition
- Physician, often a physiatrist, oversees medical rehabilitation for neurological and chronic pain patients.
- Physical Therapists (PT) and Physical Therapist Assistants (PTA) provide rehabilitation services.
- Occupational Therapists (OT) and Certified Occupational Therapy Assistants (COTA) focus on basic and instrumental activities of daily living (BADLs, IADLs) and cognitive impairments.
- Speech Language Pathologists (SLP) assist with speech and swallowing difficulties.
- Recreational Therapists (RT) help patients resume hobbies and leisure activities.
- Nursing staff, dieticians, psychologists, and Licensed Clinical Social Workers (LCSW) play supportive roles in restoration and coordination of care.
- Patients and their families are essential members of the team, actively involved in goal setting.
Differences Between PT and PTA
- Physical Therapists hold an entry-level Doctorate in Physical Therapy (DPT), requiring 3 years of post-bachelor education.
- PTs conduct initial evaluations, establish plans of care (POC), and document progress.
- More complex interventions are managed by PTs, while PTAs perform tasks under PT supervision.
- Controversial aspects include the performance of joint mobilizations by PTAs limited to Grades 1 and 2.
Common Outcome Measures
- Patient self-report questionnaires:
- Oswestry Disability Index (OSW) for low back pain.
- Neck Disability Index (NDI).
- Quick DASH for arm, shoulder, and hand disabilities.
- Lower Extremity Functional Scale (LEFS).
- Shoulder Pain and Disability Index (SPADI).
- Balance assessments include:
- Berg Balance Scale (BBS).
- Dynamic Gait Index (DGI).
- Timed Up and Go (TUG) with motor and cognitive variations.
Physical Therapy Interventions
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Thermal Agents:
- Superficial heat (hot packs, paraffin) and deep heat (ultrasound, diathermy) to reduce pain and muscle spasms.
- Cryotherapy (ice packs) for inflammation and edema.
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Hydrotherapy:
- Water-based treatments for pain relief and healing.
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Electrical Stimulation:
- Various modalities (e.g., TENS, NMES) to manage pain and muscle function.
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Manual Therapy:
- Techniques like joint mobilization, muscle energy techniques, myofascial release, and craniosacral therapy.
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Therapeutic Exercise:
- Focus on increasing strength, flexibility, and coordination.
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Functional Training:
- Engaging patients in activities of daily living and mobility.
History of Physical Therapy
- PT roots trace back to approximately 400 BC in Europe with practices involving hydrotherapy and manual techniques.
- Growth of PT in the U.S. linked to industrialization, polio epidemics, and the aftermath of WWI and WWII.
- Formation of the Division of Special Hospitals and Physical Reconstruction (DSH&PR) in 1917 to address increased disability rates.
- Mary McMillan recognized as the first physical therapist in the U.S.
Professional Organizations
- The American Women's Physical Therapeutic Association established in 1921 by Mary McMillan, evolving into the American Physiotherapy Association (APA) in 1922.
- Five goals of the AWPTA: establish professional standards, encourage advanced study, disseminate information, and support effective practices in physical therapeutics.
Different Settings for Physical Therapy Interventions
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Hospitals:
- Care for acute conditions such as neurologic disorders, fractures, burns, and post-surgical recovery.
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Skilled Nursing Facilities:
- Focus on rehabilitation for fractures, open wounds, and general weakness.
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Outpatient Clinics:
- Deal predominantly with orthopedic and neurological cases.
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Home Health Services:
- Provide therapy mainly for geriatric patients in their residences.
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Educational Institutions:
- Address developmental disabilities and conditions like cerebral palsy and muscular dystrophy in children.
Additional Therapeutic Approaches
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Aquatic Therapy:
- Utilizes water-based exercise for joint relief.
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Animal Facilitated Therapy:
- Involves using trained animals, like dolphins, to assist patients with cognitive and physical impairments.
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Description
Explore the diverse roles within the Physical Medicine and Rehabilitation (PM & R) team, including the responsibilities of physiatrists, physical therapists, occupational therapists, and other healthcare professionals. Understand how each role contributes to patient care and recovery, highlighting the importance of collaboration among all team members.
