Physical Therapy Patients
By an allied health world contributing writer
Published: February 5th, 2010
What types of patients can physical therapists see?
There is a wide spectrum of patients physical therapists are trained to rehabilitate. The types of patients generally differ based on the setting they are receiving rehabilitation from. For instance, in the hospital acute care setting, physical therapists see patients
who have had total joint replacement (including hip and knee), cardiac rehab patients (such as those who have survived heart attacks), stroke patients, and those with diabetic ulcers and others with wound problems. In outpatient settings PTs see a variety of types of patients such as those with sports-related injuries including ACL reconstruction, rotator cuff repairs, frozen shoulders, total knee and total hip replacements. Outpatient PTs also see patients with neck and back strains. Low back pain could arguably be the most common issue for patients who see outpatient physical therapists. After neurological patients, such as stroke survivors, are well enough to be released from acute care hospital settings, they are sent to outpatient clinics to continue with their therapy. Other outpatients include those with vertigo, dizziness or balance problems. Also, individuals who have had amputations and need prosthetic training typically see PTs in outpatient settings.
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How often and for what duration does a patient typically see a PT?
The duration of physical therapy is determined based on each patient’s injury or diagnosis. Oftentimes insurance coverage is a determining factor in the length of care as well. The physical therapy prescription is written by the referring physician. One of the most common prescriptions physical therapists receive for patients is for therapy three times a week for four weeks. It is the PT’s responsibility to contact the referring physician if they have a prescription that doesn’t match the duration they feel is needed to effectively improve the patient’s condition. Per Medicaid rules, every month physical therapists must reevaluate the treatment to determine if it is still effective or if the patient is no longer progressing. Based on that information, physical therapists develop an updated plan of care. As a general rule, surgery rehabilitations take more physical therapy visits than an issue like low back pain.
What criteria does a PT use to determine when it appropriate to “release” the patient from care?
While physician approval is necessary for a patient to be released from physical therapy, the PT also has a great deal of influence on the discharge timeline. Physical therapists develop an objective measure for each patient that is goal based. Typically both short and long-term goals are developed early into the treatment, and measured periodically. Objective measurements include a patient’s range of motion, strength, balance, flexibility, and ability to complete specific tasks. It is important for the goals to be realistic. For instance, someone with knee replacement surgery should not have the goal of the knee that was operated on having equal strength to the non-effected knee. A more realistic goal may be to get the knee with the prosthetic implant to a range of 100-120 degrees of flexion so they are able to better bend it. Patients who no longer need the one-on-one care may be discharged to complete an exercise program at home.
