HOW TO CHOOSE THE RIGHT PHYSICAL THERAPY PROVIDER

HOW TO CHOOSE THE RIGHT PHYSICAL THERAPY PROVIDER

The role of the physical therapists is to use the knowledge of the musculoskeletal system to help the patient get better on their own. Different studies have highlighted the benefit patients get when using a physical therapist. Having knowledge of these studies and the specialty of the physical therapy provider will aid in the decision process when choosing the right provider.

What Does A Physical Therapist Do:

In a study performed by Hinman et al., the effectiveness of aquatic physical therapy for management of hip and knee osteoarthritis was studied.1 A total of 71 volunteers with hip and knee osteoarthritis participated in the study. The study was designed as a randomized control trial where participants randomly received 6 weeks of aquatic physical therapy treatment or no treatment at all. The variables that were measured were pain, physical function, physical activity levels, quality of life, and muscle strength. The therapy resulted in less pain and joint stiffness. It also resulted in greater physical function, quality of life, and hip muscle strength. A total of more than 70% of the participants reported improvement in pain and function, compared with less than 20% of the control participants. Benefits were maintained 6 weeks after the treatment. More than 80% of the participants even continued the course of treatment well after the study was over.  Another role that physical therapists do is manual therapy, meaning that, they will manipulate manually to treat their patients.  A randomized controlled clinical trial was performed by Deyle et al., to look at the effectiveness of manual therapy on osteoarthritis.

2 The setting was in an outpatient physical therapy department of a large military medical center. 83 patients with osteoarthritis were randomly assigned to either receive treatment or placebo. The treatment group received manual therapy that was applied to the knee as well as to the lumbar spine, hip, and ankle as required. A standardized knee exercise program was given at home. The placebo group had an ultrasound to the knee. Both groups were treated at the clinic twice a week. The variable measured was the distance walked in 6 minutes. In the physical therapy group, there was significant clinical and statistical improvement in the distance walked during the 6 minute time. This proves that a combination of manual physical therapy and exercise helps yield functional benefits for patients with osteoarthritic knees.

Another randomized, double blind, placebo controlled study showed the effectiveness of physical therapy in pain relief.3 71 subjects, which were 40 years or your younger with persisting patellofemoral pain of one month or longer were randomly selected for a physical therapy or placebo group. A standardized treatment group consisted of six treatment sessions, once weekly. The physical therapy session included quadriceps muscle retraining, patellofemoral joint mobilization, patellar taping and daily home exercises. The placebo treatment consisted of sham ultrasound, light application of a non-therapeutic gel, and placebo taping. 66 participants completed the trial. The physical therapy group showed significant greater reduction in the scores for average pain, worst pain, and disability than the placebo group.

Physical Therapist’s Message:

The take home message is that physical therapy is a great benefit to the patient. But what is the best method of picking the best physical therapist?

Here are some suggestions:

Location– Physical therapy can be performed in many setting, from clinics, offices, inpatient rehabilitation facilities, to private homes. It will all depend on the patient’s needs and conditions. Physical therapy can be conducted several times a week, so it may be a benefit to schedule a therapist close to the patient’s home. If an inpatient rehabilitation center is selected, it may be best to select one that is close to family or friends.

Quality– Quality is important. There are several websites such as wheretofindcare.com to find ratings of physical therapists.

License– It is important to verify the licensure and certifications of physical therapist. The treatment can be administered by a physical therapist (PT) or a physical therapist assistant (PTA) under the guidance of a PT.

Consider what each physical therapist offers – Consider what your patient needs and what each facility has to offer. Each physical therapist will ask what they have to offer as far as services (manual therapy, aqua therapy, etc.)

References

  1.  Hinman, Rana s. et al.  (2007). Aquatic Physical Therapy for Hip and Knee Osteoarthritis:  Results of a Single-Blind Randomized Controlled Trial.  Journal of the American Physical Therapy Association.  87(1) 32-43
  2. Deyle, Gail. D. et al. (2000).  Effectiveness of Manual Physical Therapy and Exercise in Osteoarthritis of the Knee.  A Randomized, Controlled Trial.  Annals of Internal Medicine.  132(3) 173-181
  3. Crossley et al.  (2002).  Physical Therapy for Patellofemoral Pain A Randomized, Double-Blinded, Placebo-Controlled Trial. American Journal of Sports Medicine 30 (6) 857-865.