定義 

Physical therapy, also termed physiotherapy, is referred to the application of physical activities and exercises to restore strength, movement, and conditioning of muscles. Physical therapy is a useful therapeutic modality for restoring the movements of the shoulder and arm. This is also beneficial for restoring the strength of back muscles following breast cancer surgery. [1]

用途

The primary aim and objective of physical therapy are used to alleviate pain and restore the strength of weakened muscles. Physical therapy involves the use of exercises, massages, and physical stimuli such as ultrasound, heat, cold, and electrical currents. Exercises are considered as active movements that the patient performs, while, massage is referred to as passive movements that are performed by the physician or physical therapist and involve the application of pressure. Physical therapy is not confined to a hospital or other clinical setups. This can be performed at home by the affected individual after receiving adequate guidance. Physical therapy encourages individuals to follow measures that can improve their health.

Physical therapy techniques are used for the treatment of both acute and chronic conditions. Physical therapy also serves as a preventive measure for future health ailments. Physical therapy serves as an effective rehabilitation modality to improve the health of individuals who have undergone surgery, injuries, or other long-term medical conditions.

Physical therapy is generally used for the treatment of the following conditions. [2]

1. Developmental abnormalities in children that affect their bones and/or muscles
2. 背痛
3. 骨關節炎 
4. 類風濕關節炎 
5. Pathologies of the pelvic floor such as pain and/or urinary incontinence
6. Pathologies associated with the injuries or wear-and-tear of the muscles, tendons, and/or joints
7. Cardiovascular disorders
8. Disorders of the respiratory system
9. Neurologic conditions including multiple sclerosis, stroke, or Parkinson’s disease
10. Prevention of falls and associated injuries 
11. Strengthen weakened muscles
12. Assistance is required to perform tasks in a sequential manner 

The aims of physical therapy include restoration of the normal body function, improved circulation and metabolism of the body, alleviation of pain, improved strength and coordination of movements, compensation for the body for physical disabilities, and prevention of chronic problems in the future. Physical therapy is offered in both inpatient and outpatient settings. These include hospitals, nursing homes, and rehabilitative care centers. The treatment is administered by adequately qualified and trained physical therapists or physiotherapists. Massages, electrotherapy, and heat therapy can also be administered by other healthcare professionals. Hydrotherapists or people who use water for the treatment of health conditions can also administer these treatments. [2]

Qualification Required To Become Physical Therapist 

In order to become a physical therapist and continue with the clinical practice in the US, one must complete a degree in doctor of physical therapy (DPT). The degree shall be obtained from an accredited physical therapist education program via Accreditation in Physical Therapy Education. After obtaining the degree, one must clear the state licensure exam to begin with clinical practice. A professional DPT program is usually three years long. 80% of the curriculum in the DPT programs comprises classroom and lab study. On the contrary, 20% of the curriculum is attributed to the clinical education of the students with the students spending approximately 27.5 weeks during the final clinical experience. Primary content taught in DPT programs encompasses anatomy, histology, physiology, neuroscience, exercise physiology, kinesiology, pathology, pharmacology, biomechanics, behavioral sciences, clinical reasoning, musculoskeletal, cardiovascular, pulmonary, and other associated fields. 

In order to enter into the professional DPT program, an individual must obtain a bachelor’s degree in most DPT programs. However, other DPT programs have a 3+3 curriculum format, offering three years of undergraduate (pre-physical therapy) courses before the students progress to the professional training program. Some other programs recruit students as they graduate their high school. [3]

Physical Therapy Theory 

The motor control theory refers to the regulation of mechanisms attributed to the movement. Motor control theories also include the traditional hierarchical theory. This theory describes motor control as a rigid process with the central nervous system serving as the command center including the motor cortex which inhibits the lower centers and regulates movement. On the contrary, dynamic system, ecological, and systems theory focus on motor control as a function of the interaction between multiple factors. The integrated systems-based theory describes that the execution of a motor task is determined by task attributes and environmental attributes. While administering physical therapy, the physical therapists shall also focus on the constraints to the movement that include cognition, action, and perception. [4] 

Physical Therapy Subspecialties 

The subspecialties of physical therapy are listed down below. [5]

1. Pediatric Physical Therapy

This subspecialty caters to the needs of the pediatric age group (adolescents, children, toddlers, and infants). Pediatric physical therapy is required when an individual is suffering from head trauma, orthopedic disabilities, birth defects, limb deficiencies, and acute injury. 

2. Neurological Physical Therapy 

This subspecialty caters to the neurologic conditions including brain injury, Parkinson’s disease, Alzheimer’s disease, multiple sclerosis, cerebral palsy, stroke, and spinal cord injury. The physical therapists help the patients adapt to the impairments and live independently. 

3. Cardiopulmonary Physical Therapy 

This subspecialty caters to the treatment of cardiopulmonary disorders including chronic obstructive pulmonary disease, pulmonary fibrosis, and heart attacks. This subspecialty aims to enhance the functional independence and endurance of an individual. 

4. Orthopedic Physical Therapy 

This subspecialty caters to musculoskeletal disorders that may involve muscles, bones, joints, ligaments, and tendons. Orthopedic physical therapy includes endurance exercises, ultrasound, strength training, electrical muscle stimulation, and the use of hot and cold packs. 

5. Geriatric Physical Therapy 

This subspecialty caters to the needs of elderly patients suffering from cancer, arthritis, osteoporosis, and balance disorders. Geriatric physical therapy improves mobility, alleviates pain, and promotes fitness in older patients. 

Physical Therapy Treatment 

Each physical therapy lasts for approximately 30-90 minutes and may continue for up to 8-12 weeks. Treatment beyond this period occurs when objective improvement is observed. If objective clinical improvement is not identified within the provided duration, the physical therapy techniques shall be reconsidered. Exercise, manual or passive therapy, and massage therapy are involved in the treatment of different health conditions. [6]

結論

Physical therapists used different exercises, massage techniques, and physical stimuli to treat multiple health ailments. Physical therapy is beneficial for restoring muscle strength and joint mobilization as well as improvement in the quality of life of individuals suffering from chronic conditions. 

參考 

1. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/physical-therapy
2. https://www.ncbi.nlm.nih.gov/books/NBK561514/  
3. https://www.apta.org/your-career/careers-in-physical-therapy/becoming-a-pt 
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3157995/ 
5. https://www.oleanpt.com/library/4299/FiveTypesofPhysicalTherapy.html
6. https://www.ncbi.nlm.nih.gov/books/NBK409578/