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Physical therapy is a dynamic profession, with physical therapists working in a wide variety of roles. Still, many individuals don’t realize all of the unique and specialized settings a physical therapist can work in. In this article, we explore multiple settings and roles of the physical therapist in an effort to spread more awareness of the value and services they bring to the healthcare ecosystem.
Outpatient
Perhaps the most well-known setting is outpatient physical therapy. Many conditions can be addressed in the outpatient setting, such as musculoskeletal diagnoses, chronic pain, pelvic health needs, lymphedema, and post-operative rehabilitation. Individuals of all ages and many diagnoses can be found as patients in an outpatient clinic. However, some clinics specializing in certain diagnoses and services might reflect such in the patient population. Outpatient physical therapy often involves having patients come into a clinic 1-3 times per week to meet with their physical therapist. In this setting, patients receive specialized mobility and exercise drills to improve function and optimize performance in addition to other treatment modalities depending on their needs. Now with the use of technology, clinics can also introduce hybrid services that allow patients to receive care in between in-person visits and increased guidance with their programs from home as well.
Early Intervention And School-based
Physical therapists can specialize in the treatment of pediatrics, working in various settings such as the patient’s home, daycares, and school systems. Since physical therapists are movement experts, they play an integral role in identifying when motor milestones are not met in childhood. They will work with the child, family, and any additional caregivers to promote optimal gross motor development and learning. Pediatric physical therapists also help promote physical activity and functional mobility in children – an important foundation for an active life into adulthood! In school-based settings, the primary role of the physical therapist is to ensure the child has access to their academic environment. This is facilitated in many ways and can include introducing adaptive equipment and assistive devices, incorporating therapeutic exercise and activity for necessary gross motor skills, and even sensory integration training depending on the needs of the child.
Acute Care
Acute care typically refers to a hospital setting. Physical therapists can be found throughout the hospital on cardiopulmonary, oncology, neurology, orthopedic, and intensive care units. In the acute care setting, physical therapists meet with patients to assess their functional mobility levels, provide appropriate exercises, instruct gait and mobility training, and facilitate safe discharge planning to home or the next level of care.
Acute Rehabilitation
Acute rehabilitation settings differ from acute hospital settings in the sense that the patient is medically stable enough and cleared for intensive, in-patient rehabilitation. Typically in acute rehabilitation settings, patients receive large doses of therapy each day and can receive services from multiple disciplines including physical therapy, occupational therapy, and speech therapy.
Subacute Rehabilitation And Skilled Nursing
Patients who need skilled rehabilitation but are not candidates for more intensive in-patient acute rehabilitation programs or those who need more long-term care can receive services in a subacute or skilled nursing setting. Those admitted for subacute rehabilitation typically receive one to three hours of therapy from physical, occupational, and speech therapists combined five days a week. Subacute rehab is still intensive, but to a lesser extent than acute rehabilitation. The goal remains to return the patient to prior level of function and prepare for safe discharge home or to the next level of care.
Skilled nursing facilities have residents who live on-site and receive care from the nursing staff. These patients may have medical conditions they can no longer manage on their own, limited functional mobility, or cognitive impairments rendering it most safe for them to live in a facility with 24-hour care staff available. Physical therapists who work in skilled nursing settings perform regular functional mobility screens on residents to identify any declines so that patients can be put on therapy programs – maximizing strength, mobility, and independence within the facility. Physical therapists may also lead group exercise, balance, and walking groups to promote physical activity and health amongst residents.
Home Health
Physical therapists who work in home health schedule visits to the patient’s home where they can assess how the patient functions in a natural environment. Home health physical therapists offer valuable insight into safe home setup, assistive device use within the home, and prescribing exercises and therapeutic activities for the patient to add to their routine. Patients may receive home health physical therapy after surgery, a hospital stay for an illness, or if they are unable to attend in-person visits to an outpatient facility for various reasons.
Chronic Condition Management
Physical therapists help those with chronic medical conditions stay active, mobile, and as independent as possible. Therapeutic exercise and activity have been shown to improve outcomes in patients with chronic conditions such as diabetes, chronic obstructive pulmonary disease (COPD), arthritis, and more. Now, physical therapists are playing an integral role in helping those overcome long covid symptoms with safely paced endurance and strength training while monitoring symptoms and response to physical activity.
Health And Wellness Promotion
As movement experts, physical therapists are highly qualified to lead efforts that promote health and wellness within various communities and patient populations. Physical therapists can help individuals safely increase their physical activity – an important factor for healthy living that has been shown to decrease the risk of many chronic diseases and improve quality of life. Physical therapists can also play a role in smoking cessation programs, cardiovascular conditioning, fitness training, mindful exercise training, pelvic floor and sexual wellness programs, and many more.
Telehealth
Many healthcare professionals are turning to technology to increase access to care and optimize patient outcomes – and physical therapy is no exception. Digital physical therapy allows increased patient access to care and heightened insight into patient function when implemented properly. Treating patients in their own environment offers increased convenience, adherence, and patient satisfaction. Prescribing digital home exercise programs that use interactive videos engages patients and ensures they are performing the exercise with proper form and pacing. Chat and video messaging features open lines of communication that enable the patient to receive important and timely feedback from their physical therapists. At OneStep, we are committed to leveraging technology to improve the physical therapy experience for both patients and providers.
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