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Because the body of knowledge of physical therapy is extremely large, PTs usually specialize in a specific clinical area. While there are many different types of physical therapy,[33] the American Board of Physical Therapy Specialties list eight specialist certifications. Most Physical Therapists practicing under a specialism will have undergone further training. Cardiovascular & pulmonary__ Cardiovascular and pulmonary rehabilitation respiratory practitioners and physical therapists treat a wide variety of cardiopulmonary disorders or pre and post cardiac or pulmonary surgery. An example of cardiac surgery is cabg. Primary goals of this specialty include increasing endurance and functional independence. Manual therapy is used in this field to assist in clearing lung secretions experienced with cystic fibrosis. Disorders, including heart attacks, post coronary bypass surgery, chronic obstructive pulmonary disease, and pulmonary fibrosis, treatments can benefit[citation needed] from cardiovascular and pulmonary specialized physical therapists.[34][verification needed] Clinical electrophysiology__ This specialty area encompasses electrotherapy/physical agents, electrophysiological evaluation (EMG/NCV), physical agents, and wound management. Geriatric__ Geriatric physical therapy covers a wide area of issues concerning people as they go through normal adult aging but is usually focused on the older adult. There are many conditions that affect many people as they grow older and include but are not limited to the following: arthritis, osteoporosis, cancer, Alzheimer's disease, hip and joint replacement, balance disorders, incontinence, etc. Geriatric physical therapists specialize in treating conditions in older adults. Integumentary__ Integumentary (treatment of conditions involving the skin and all its related organs). Common conditions managed include wounds and burns. Physical therapists may utilize surgical instruments, mechanical lavage, dressings and topical agents to debride necrotic tissue and promote tissue healing. Other commonly used interventions include exercise, edema control, splinting, and compression garments. Neurological__ Neurological physical therapy is a field focused on working with individuals who have a neurological disorder or disease. These can include stroke, chronic back pain, Alzheimer's disease, Charcot-Marie-Tooth disease (CMT), ALS, brain injury, cerebral palsy,l.g.b.syndrome, multiple sclerosis, Parkinson's disease, facial palsy and spinal cord injury. Common impairments associated with neurologic conditions include impairments of vision, balance, ambulation, activities of daily living, movement, muscle strength and loss of functional independence.[34] Physiotherapy can address many of these impairments and aid in restoring and maintaining function, slowing disease progression, and improving quality of life. The techniques involve in neurological physical therapy are wide ranging and often require specialized training. Neurological physiotherapy is also called neurophysiotherapy or neurological rehabilitation. Orthopedic__ Orthopedic physical therapists diagnose, manage, and treat disorders and injuries of the musculoskeletal system including rehabilitation after orthopedic surgery. This specialty of physical therapy is most often found in the out-patient clinical setting. Orthopedic therapists are trained in the treatment of post-operative orthopedic procedures, fractures, acute sports injuries, arthritis, sprains, strains, back and neck pain, spinal conditions, and amputations. Joint and spine mobilization/manipulation, dry needling, therapeutic exercise, neuromuscular techniques, muscle reeducation, hot/cold packs, and electrical muscle stimulation (e.g., cryotherapy, iontophoresis, electrotherapy) are modalities often used to expedite recovery in the orthopedic setting.[35][verification needed] Additionally, an emerging adjunct to diagnosis and treatment is the use of sonography for diagnosis and to guide treatments such as muscle retraining.[36][37][38] Those who have suffered injury or disease affecting the muscles, bones, ligaments, or tendons will benefit from assessment by a physical therapist specialized in orthopedics. Pediatric__ Pediatric physical therapy assists in early detection of health problems and uses a wide variety of modalities to treat disorders in the pediatric population. These therapists are specialized in the diagnosis, treatment, and management of infants, children, and adolescents with a variety of congenital, developmental, neuromuscular, skeletal, or acquired disorders/diseases. Treatments focus on improving gross and fine motor skills, balance and coordination, strength and endurance as well as cognitive and sensory processing/integration. Children with developmental delays, cerebral palsy, spina bifida, or torticollis may be treated[citation needed] by pediatric physical therapists.[34][verification needed] Sports__ Physical therapists can be involved in the care and wellbeing of athletes including recreational, semi-professional (paid) and professional (full-time employment) participants. This area of practice encompasses complete athletic injury management under 6 main categories: acute care - assessment and diagnosis of an initial injury; treatment - application of specialist advice and techniques to encourage healing; rehabilitation - progressive management for full return to sport; prevention - identification and address of deficiencies known to directly result in, or act as precursors to injury education - sharing of specialist knowledge to individual athletes, teams or clubs to assist in prevention or management of injury Physical therapists who work for professional sport teams often have a specialized sports certification issued through their national registering organisation. Most Physical therapists who practise in a sporting environment are also active in sports medicine programs too. Women's health__ Women's health physical therapy addresses women's issues related to the female reproductive system, child birth, and post-partum. These conditions include lymphedema, osteoporosis, pelvic pain, prenatal and post partum periods, and urinary incontinence. It also addresses incontinence, pelvic pain, and other disorders associated with pelvic floor dysfunction.[39] Palliative care__ Physiotherapy in the field of Oncology and Palliative care is a continuously evolving and developing specialty, both in Malignant and non-malignant diseases. Rehabilitation for both groups of patients is now recognized as an essential part of the clinical pathway, as early diagnoses and new treatments are enabling patients to live longer. it is generally accepted that patients should have access to an appropriate level of rehabilitation, so that they can function at a minimum level of dependency and optimize their quality of life, regardless of their life expectancy. |
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