Debating the Practices of Physical Therapy
What is there to debate? Several sources repeatedly convey similar information on the care that a physical
therapist provides. The Handbook of Physical Therapy, written by Robert Shestack, Current Physical
Therapy, a book by Malcolm Peat, and “A Future in Physical Therapy,” an internet publication by The American
Physical Therapy Association, have notably parallel information within them. However, small variations can be
found in their writings. Physical therapy is defined as the treatment of patients’ disabilities from disease
and injury to the loss of a body part with therapeutic exercise, heat, cold, water, light, electricity, ultrasound, or
massage (Shestack 3). Through extensive direct contact with patients and other health care personnel, physical
therapists have the opportunity to positively make a difference in a person’s life (The American Physical
Therapy Association 1-2). Specific education requirements are necessary to fulfill in order to become a licensed
physical therapist. When the education requirements are met, physical therapists have specific jobs in treating
various conditions such as arthritis and asthma.
When entering into a physical therapy program, certain educational requirements must be met. All colleges and
universities insist upon students wishing to enter into the pre-professional part of the physical therapy program be
high school graduates (Shestack 4-5). According to The American Physical Therapy Association (APTA), the
pre-professional part of schooling includes psychology, biology, physics, statistics, chemistry, english,
professional writing, and humanities (5). Shestack combines the entire program to include applied science,
anatomy, physiology, neuroanatomy, kinesiology, pathology, psychology, physics, neurology, orthopedics,
pediatrics, surgery, electrotherapy, massage, physical rehabilitation, and physical therapy as applied to medicine
(4-5). The APTA states the professional part of the physical therapy program includes basic and clinical medical
science courses and emphasizes the theory through extensive clinical education and a variety of practice settings
(5). The requirements as proposed by both authors are similar, yet not exact, implying that the requirements are
probably quite similar, but vary most likely from state to state and school to school within those states.
Both sources agree that colleges and universities around the United States are currently changing their programs
from a bachelor’s degree program to a master’s degree program (APTA 5, Shestack 5).
Obviously this fact is true and schools are in progress in reforming their programs.
Arthritis is a commonly treated illness by physical therapists. Arthritis is an inflammation of a joint in which a
person goes through three stages of severity. These stages are the acute stage, the subacute stage, and the
chronic stage. Physical therapy should begin at the onset of problems. The therapist should assess the history of
the disease, a joint examination, morning stiffness, grip strength measurement, and a timed fifty-foot walk (Peat
103). During the acute stage, Peat advises rest, patient education, ice packs, splinting, and range of motion
exercises (104). Shestack, however, prescribes moist heat for thirty minutes two to three times a day (94). The
difference in techniques is most likely due to the fact that all patients have different severities of this disease. Not
only one technique could possibly be the only techniques used on all patients.
For the subacute stage, Peat and Shestack agree that maintaining range of motion in the affected joint is the task
of this stage. To do this, specific exercises are taught to the patient by the therapist according to the particular
joint with a problem (Peat 104, Shestack 94). Their agreeance clearly proves that maintaining range of motion is
the most important treatment to give in the subacute stage of arthritis.
Finally, in the chronic stage, Peat recommends to decrease pain in the joint, increase range of motion for the
joint, increase muscle strength, and improve functional capacity (105). However, Shestack simply advises to
apply a triad of heat, massage, and exercise daily (94). Again, similar to the first stage, because of differences in
patients, there must also be differences in treating them. Some of Peat’s tasks in treating a client with
arthritis could possibly be carried through by using the triad that Shestack recommends.
Asthma sufferers often seek help from a physical therapist to treat their condition. Asthma is a respiratory
disorder characterized by wheezing, difficulty in expiration, and a feeling of constriction in the chest. Physical
therapy can provide comfort and help for a patient inflicted with an airway limitation, such as asthma (Peat 12).
A physical therapist can offer breathing exercises to help improve breathing by strengthening the diaphragm,
chest, and back muscles (Shestack 169). Both sources believe the therapists objective when treating a patient
with asthma is to assist the patient with breathing more comfortably, efficiently, and with less effort. This can be
done by mobilizing the trunk of the body, encouraging coughing, and when breathing forcing the tongue to stick
to the roof of the patient’s mouth (Peat 13, Shestack 169). This treatment is logical. The treatment for
asthma by a physical therapist is obviously black and white. There is no gray in between.
Physical therapists have the ability to truly help people and make a positive influence in a patient’s life. In
several ways, physical therapists can change the lives of the patients they treat. These ways can vary from
therapist to therapist and from patient to patient according to specific needs a particular patient may require.
There are several educational requirements to meet before becoming a physical therapist. However, when they
are completed, physical therapists can work with people of all ages everywhere treating various conditions.
The American Physical Therapy Association. “A Future in Physical Therapy.” 15 July 1998: Online.
Microsoft Internet Explorer. 18 February 1999.
Peat, Malcolm. Current Physical Therapy. Philadelphia: B.C. Decker Inc., 1988.
Shestack, Robert. Handbook of Physical Therapy. New York: Springer Publishing