OSU Pre-PT Club. Northern Therapy and Rehabilitation. Physical Therapy. Ken Schaecher, DPT, OCS.

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1 OSU Pre-PT Club Northern Therapy and Rehabilitation Physical Therapy Ken Schaecher, DPT, OCS

2 Evolution and History AWPTA started in 1921 (reconstruction aides from WWI) American Physiotherapy Assoc in 1930 s (men admitted) Expanded after polio and WWII 1940 s changed name to APTA Education programs grew from 16 to 52 in the 1960 s Evolved into Physical Therapy

3 Vision 2020 By 2020, physical therapy (PT) will be provided by physical therapists (PTs) who are doctors of PT, recognized by consumers and other health care professionals as the practitioners of choice to whom consumers have direct access for the diagnosis of, interventions for, and prevention of impairments, activity limitations, participation restrictions, and environmental barriers related to movement, function, and health. Source

4 Education Currently 213 PT programs 309 PTA programs Associate degree program Only 2 PT schools in OK (OU and Langston) Progressed education from BS, to MS or MPT Now DPT

5 Pre-PT Degree All programs in the US are DPT now Any Undergraduate degree will work as long as you have the pre-requisite courses Each program has specific prerequisites OU has OKC and Tulsa campus Texas has 12 programs for PT Kansas has 2, Arkansas has 3

6 Admissions Process Research programs find best fit Complete prerequisites Obtain observation hours (experience) Best to have different settings Take GRE 6 weeks before application deadline Get references (if needed) Official transcripts Submit application prior to deadline date

7 Sample Prerequisites Anatomy and Physiology I & II Biology I & II Advanced Biology Chemistry I & II Physics I & II Psychology & Advanced Psychology Statistics English Composition Almost every program is different

8 OK School Websites OT, PT, DSc, PhD

9 Curriculum Usually full-time, concurrent programs 3 year programs 80% didactic and lab 20% clinical education Rankings APTA does not rank programs Outside ranking agencies

10 Licensure Graduate from an accredited PT program Pass a state administered national exam (boards) Practice Act (each state) Some requirements like jurisprudence or ethics exam Pay fees Maintain a license in OK Continuing education (40 hours/ 2 years) Ethics

11 Work Settings Inpatient (Acute care) Rehab / Subacute Post-Acute care (SNF, Nursing Home) Outpatient Home Health Schools Wellness/ Prevention/ Sports/ Fitness Hospice Industrial, workplace, Occupational Local, state, federal government Research Center

12 Specialist Areas Board Certification Cardiovascular and Pulmonary Clinical Electrophysiology Geriatrics Neurology Orthopaedics Pediatrics Sports Women s Health

13 Job Satisfaction Rated 1 of The ten Happiest Jobs - Forbes PTs ranked 2 nd to clergy and the only health care professionals in the top 5 of a Washington post study

14 Job Outlook US News and World Report and CNNMoney.com PT is consistently in the top 100 jobs Top 10 fastest growing jobs Bureau of Labor Statistics Expected 36% growth from Unemployment rates are very low US aging population = increased demand

15 Salaries Median salary $85,000/ year Salaries vary depending on position, years of experience, degree of education, geographic location, and practice setting. Secondary income possibilities Owning all or a piece of your practice Fitness and prevention programs Direct access

16 Furthering Education Clinical Residency Narrowed scope of practice Leads to Specialty Certification Exam Clinical Fellowship Further narrowed scope and expertise Teaching Continuing Education Live courses Category A Online Category B (can do ½ of the required hours)

17 Outpatient PT I work in an outpatient setting Different patient populations of all ages (11 and older) Many different diagnoses Neck and back complaints Post-surgical (ACL, RTC, Total joints, etc) Extremities All payers WC, MVA, MC, Insurance

18 Direct Access 49 th State to pass direct access Don t need a physician referral Limited to 30 days Most insurances recognize and cover Prevention ACL prevention (female athletes) Fall prevention (baby boomers) Fitness (stretch U)

19 What do physicians need to know? When to refer a patient to physical therapy Musculoskeletal issue Red flags cleared Earlier the better (Lateral Shift) Why refer a patient to physical therapy PTs spend about hours, 2-3 times per week with the patient We evaluate and treat as a process each visit We refer back to the physician if anything seems odd Red flags or outside scope of practice Research supports manual therapy and exercise over many other methods of treatment Risk vs Benefit ratio

20 PT vs NSAIDS

21 NSAIDs Conservative calculations estimate that approximately 107,000 patients are hospitalized annually for nonsteroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) complications and at least 16,500 NSAID-related deaths occur each year among arthritis patients alone. The figures of all NSAID users would be overwhelming, yet the scope of this problem is generally under-appreciated. Other studies also indicate that the risk of Congestive Heart Failure (CHF) while using NSAIDs is also quite substantial. One author suggested that the number of deaths could be similar to those that are being seen with gastrointestinal bleeding. If so, the numbers of deaths attributed to NSAIDs would increase dramatically from the already large figure of 16,500.

22 PT vs Surgery Surgery has inherent risks Infection Anesthesia Complications Many times therapy can fix the problem or help function Herniated disc in neck or back Adhesive capsulitis Pre-surgery strengthening can shorten post-op rehab

23 PT vs Chiropractic PT is education and science based Traditional medical model PT has done more research on manipulation benefits No Chiro school is on a University campus Bill Kinsinger Anesthesiologist in OKC OU website

24 PT Process Examination / Assessment Differential Diagnosis Candidate for PT (direct access) Different methods of treatment / Intervention Modalities (used sparingly) Manual therapy Thrust and non-thrust mobilization/ manipulation Joint PROM, mobilizations MFR, Massage, stretching Exercise (very specific and detailed) Documentation

25 CPR Examination Cervical radiculopathy (2/3 tests) Spurling, Distraction, ULTTa Patellar stability Repeated motion testing (McKenzie) Intervention success Lumbar HVLA for LBP Sx<16 days, no sx below knee, L hypomobility, Hip IR>35, FABQ Thoracic HVLA for neck pain Cervical HVLA for neck pain Patellar taping patellar tilt test Many more

26 Q & A Any Questions?

27 Sample Cervical Manipulation

28 ULT Thoracic Manipulation Can get very specific

29 CPR lumbar

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