Physical Therapy: How We Transform Society Through Movement

NAP Physical Therapy Academy
Beth Davis, PT, DPT, MBA, FNAP and Robert Wellmon, PT, DPT, PhD, FNAP

published in the NAP Times on October 17, 2022

Physical therapists are movement experts who improve quality of life through prescribed exercise, manual care, and patient/client education. Physical therapists diagnose and treat individuals of all ages, using clinical decision-making skills for examination and treatment to improve movement, reduce or manage pain, restore function, and prevent disability.

Physical therapists practice in a wide variety of settings and specialty areas. Physical therapists who demonstrate advanced clinical knowledge and skills in certain physical therapy specialty areas can obtain board-certification through the American Board of Physical Therapy Specialties.

Acute Care

• Evaluate and treat patients/clients with a focus on activities of daily living such as bed mobility, moving to and from a chair, ambulation, and gait training which includes the proper instruction, fitting, and safe use of equipment such as canes, crutches, or walkers.
• Provide expert recommendations for safe discharge planning and continued rehabilitation to prevent readmission and facilitate continue recovery after hospitalization.
• Provide recommendations for home modifications, medical equipment, or other adaptations to allow safe and successful discharge.
• Educate family and/or caregivers regarding how to assist the patient/client with moving and walking.

Cardiopulmonary Rehabilitation

• Evaluate and treat patients/clients to address all impairments related to the cardiovascular and pulmonary system across the lifespan.
• Evaluate and treat patients/clients with impaired aerobic capacity, impaired airway clearance, impaired posture impacting the respiratory system, impaired strength, impaired endurance, etc.
• Cardiopulmonary Clinical Specialist Board Certification can be earned.
• Provide direct care in acute care, long term, rehabilitation, home health, or outpatient settings.

Clinical Electrophysiology

• Practice in areas that use electricity to monitor, measure, or produce physiologic responses in the evaluation, treatment, and prevention of human dysfunction.
• Skilled in planning and administering special electrodiagnostic and electrotherapeutic clinical procedures, interpreting electrophysiologic responses, and proposing recommendations for subsequent management or intervention.
• Clinical Electrophysiology Specialist Board Certification can be earned.

Concussion Prevention and Rehabilitation

• Provide baseline testing and emergency response.
• Optimize recovery process post injury to promote return to function/school/sport.
• Perform graded aerobic exercise testing after concussion.
• Create individualized rehabilitation programs for patients/clients with autonomic nervous system dysfunction.

Emergency Department

• Perform consultations as part of a comprehensive, interprofessional emergency department team with physical therapist screening and providing immediate therapeutic intervention, especially for patients/clients who are experiencing low back pain, mobility limitations, gait disturbances, dizziness, or falls.
• Provide equipment recommendations and training, as well as discharge/follow up recommendations.

Geriatrics

• Provide physical therapy services with a focus on the aging population in roles of advocacy, direct care, consultation, supervision, and education.
• Provide direct care in acute, long term, rehabilitation, home health, hospice, or outpatient settings.
• Geriatric Clinical Specialist Board Certification can be earned.

Military

• Provide physical therapy services to military personnel and family members.
• Evaluate, treat, and rehabilitate patients/clients with a variety of injuries and illnesses and prevent future injuries.
• Prescribe certain medications, order imaging, and order durable medical equipment (DME).
• Can be embedded in a unit to provide on-site, direct access care for soldiers.

Neonatology

• Provide physical therapy care for newborns and infants in the intensive care setting.
• Collaborate as essential members of the healthcare team, including patient/client families, to care for newborns and infants, who are critically ill, across the continuum of care.
• Neonatal Physical Therapy Fellowships exist for specialized training.

Neurology

• Evaluate and treat patients/clients with developmental, systemic, and traumatic disorders that affect the neuromuscular system and use preventive, evaluative, and perform rehabilitative physical therapy procedures as appropriate.
• Work in acute, inpatient rehabilitation, long term, home health, and outpatient practice settings to provide specialized care to persons of all ages with neurologic dysfunction.
• Neurologic Clinical Specialist Board Certification can be earned.

Oncology

• Manage the musculoskeletal, neuromuscular, integumentary, and cardiopulmonary rehabilitative needs of patients/clients living with and beyond cancer and other chronic illnesses, including HIV.
• Services encompass acute secondary sequelae of treatments such as surgery, radiation therapy, chemotherapy, and immunotherapy as well as long-term secondary sequelae of treatments and palliative care.
• Oncologic Clinical Specialist Board Certification can be earned.

Orthopaedics

• Perform preventative services and evaluate and treat patients/clients with dysfunction of the musculoskeletal system and its related neurovascular components.
• Focus on both the actual and the potential dysfunctions of physical capacity and movement.
• Perform advanced techniques and interventions to assist patients/clients toward optimal function through corrective, adaptive, and prophylactic management of the neuromusculoskeletal system.
• Orthopaedic Clinical Specialist Board Certification can be earned.

Pediatrics

• Evaluate and treat children with traumatic, developmental, and systemic disorders.
• Practice within this specialty encompasses all appropriate evaluative, habilitative, and rehabilitative procedures with respect to children.
• Pediatric Clinical Specialist Board Certification can be earned.

Pelvic Health

• Evaluate and treat patients/clients with pain and dysfunction related to the pelvis and its corresponding muscles, bones, and soft tissue structures.
• Treat all individuals with pelvic floor dysfunction, which can involve bowel/bladder issues, pain, sexual dysfunction, and instability of the pelvis.
• Women’s Health Clinical Specialist Board Certification can be earned.

Performing Arts

• Perform specialized evaluation and treatment for performing artists with a variety of complex conditions.
• Treat a variety of performing artists including actors, circus artists, dancers, gymnasts, musical theater performers, musicians, production crews, and stunt performers.
• Address the physical and psychological needs of artists/athletes and stress the importance of balancing athletic abilities with artistic expression through generalized conditioning and technical training.
• Focus on flexibility, balance, strength, and conditioning related to areas of injury and areas of performance.

Sports / Athletes

• Evaluate and treat athletes with physiological, psychological, pathological, and performance problems.
• Provide extensive musculoskeletal focus post injury or surgery, working with orthopedic physicians/surgeons. 
• Provide emergency response on the field or court.
• Optimize recovery process post injury to return to sport.
• Sports Clinical Specialist Board Certification can be earned.

Temporomandibular Dysfunction

• Perform examination and evaluation to determine differential diagnosis of temporomandibular disorders (TMD).
• Provide therapeutic interventions to treat patients/clients with TMD.

Vestibular Rehabilitation

• Evaluate and treat patients/clients with vestibular dysfunction causing dizziness and imbalance.
• Perform canalith repositioning maneuvers for individuals with benign paroxysmal positional vertigo (BPPV).
• Prescribe and facilitate habituation and gaze stabilization exercises.
• Advanced Vestibular Physical Therapist Certification can be earned.

Wound Management

• Evaluate and treat patients/clients with wounds due to accidents, injuries, burns, circulation problems, diabetes, or immobility and perform wound prevention education.
• Perform wound debridement including sharp debridement and pulsed lavage with suction.
• Perform dressing selection and changes including negative pressure wound therapy.
• Wound Management Clinical Specialist Board Certification can be earned.

Wrist/Hand

• Evaluate and treat patients/clients with pathological upper limb conditions resulting from trauma, disease, or congenital or acquired deformity.
• Create static and dynamic splints for the upper extremity.
• Perform upper extremity rehabilitation that includes screening and/or treating cervical spine.
• Hand Therapy Specialist Certification can be earned.