Chapter 2

Roles and Characteristics of

Physical Therapists

Copyright 2012, 2007, 2001, 1996 by Mosby, Inc., an affiliate of Elsevier Inc.
Standards and Practice for Physical
Therapy
Core document approved by HOD of APTA
Sections of the Standards:
I. Ethical/Legal Considerations
II. Administration of the Physical Therapy Service
III. Patient/Client Management
IV. Education
V. Research
VI. Community Responsibility

Copyright 2012, 2007, 2001, 1996 by Mosby, Inc., an affiliate of Elsevier Inc. 2
 Primary, Secondary, and Tertiary
Care
Primary Care
Usually the first health care provider contacted
May be PT if direct access is available
Health care system responsible for the majority of health
needs of the individual
Secondary Care
After individual receives care from his or her primary care
provider he or she may be referred to a secondary care
provider
PT is most often secondary or tertiary care
Tertiary Care
Service provided by specialist
E.g., care in a burn care center

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 Team Approach
Collaborate with other health care
professionals
Physicians, nurses, OTs, dentists, social workers,
speech-language pathologists, and
orthotists/prosthetists
Collaborate with other practitioners
Podiatrists, chiropractors, massage therapists,
acupuncturists, and osteopaths
Collaborate with other individuals
Educators and insurers

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Prevention and Health Promotion
Prevention and limitation of dysfunction leads
to:
More positive work experience
More positive recreation experience
Less cost of health care
PTs are well qualified to provide services to
prevent or limit dysfunction
Screening
Prevention
Includes ergonomics, work-conditioning, and work-
hardening

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 Patient/Client Management Model

Figure 2-1 The patient/client management model describes the sequence of events by which a
physical therapist perform the process of examination and intervention for individuals who receive
care. (Modified from American Physical Therapy Association [APTA]: Guide to physical therapist
practice, rev ed 2, Alexandria, Va, 2003, APTA.)
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 Patient/Client Management Model
(contd)
Examination
History
Systems review
Tests and measures
Evaluation
PT reviews data from examination
PT makes a clinical judgement based on the data
May include consultation with other health care
providers, family, patient, etc.

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 Patient/Client Management Model
(contd)
Diagnosis
Established based on the evaluation
PT is responsible in this step to refer patient/client to other
practitioners when warranted
Prognosis
PT predicts how long and to what level the individual is likely to
improve
Plan of care is developed that includes short-term and long-term
goals, outcomes, patient/client related instruction, interventions,
and discharge criteria
Intervention
The major interaction between therapist/therapist assistant and the
patient/client
PTA is involved at this point in the patient/client management model
Discharge or discontinuation is determined

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 Examination

Figure 2-3 Manual techniques such as manual muscle testing are critical in physical examination Here
the therapist is performing a muscle test on the patients shoulder musculature. (Courtesy Dewey Neild.)

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 Procedural Interventions Used in
Physical Therapy

(Data from American Physical Therapy Association [APTA]: Guide to physical therapist practice, rev ed 2, Alexandria, Va, 2003, APTA.)

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 Intervention

Figure 2-8. The physical therapist corrects cervical posture with manual techniques and
instruction. (Courtesy Dewey Neild.)

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 Intervention (contd)

Figure 2-11 Hot packs applied to the shoulder region provide an effective form if superficial
heat. (Courtesy Dewey Neild.)

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 Other Professional Roles
Consultation
Patient-centered consultation
PT makes recommendations on current or proposed PT
plan of care
Usually involves examination but not intervention
Client-centered consultation
Expert opinion or advise
Examples: court testimony, architectural barrier
recommendations, academic and clinical program
evaluation, and suggestions for health care policies
Education
Critical Inquiry
Administration
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 Demographics
Gender
Age
Education
Employment facility

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 Education Statistics

Figure 2-15. Highest earned degree achieved by physical therapists who are members of the American Physical
Therapy Association. (Data from American Physical Therapy Association [APTA]: Physical therapist member
demographic profile 1999-2008, Alexandria, Va, APTA. Available at: www.apta.org/AM/Template.cfm?
Section=Workforce_Salaries_and_Stats&Template=/CM/HTMLDisplay.cfm&ContentID=71497. Accessed
September 13, 2010. )

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