Pedorthist - Orthotist - Physical Therapist distinctions

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Pedorthist

A Certified Pedorthist, or C. Ped. is a specialist in using footwear -

which includes shoes, shoe modifications, foot orthoses and other

pedorthic devises - to solve problems in, or related to, the foot and

lower limb.

Primarily, a C.Ped will select, make and/or modify footwear and foot

control devices to help people maintain or regain as much mobility as

possible or to optimize their lower extremity biomechanics. Their

scope of practice is typically defined in layperson's terms as the

ankle and below.

When ability to walk is affected, everything that surrounds or

touches a foot - whether it is foot orthoses (commonly known as

orthotics or arch supports), shoes, boots, slippers, sandals, socks,

hosiery, night splints, bandages, braces, partial-foot prosthetics,

or other devices - interacts with a foot. That makes footwear a

crucial part of a recommended treatment plan.

Most often, it is Certified Pedorthists, not Podiatrists (or

D.P.M.s), who create foot orthotics, whether custom-molded, or pre-

molded. A Podiatrist will often take an image of the foot by means of

a plaster cast, foam mold, or computer scanned image. He or she will

then make recommendations for changes to that image, and send the

mold to a lab where the Pedorthist produces the final product.

Becoming a C.Ped. requires completing the educational requirements

approved by the American Board for Certification in Orthotics,

Prosthetics and Pedorthics (ABC) and passing a written credentialing

exam.

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An orthotist is a person who measures, designs, fabricates, fits, or

services orthoses, and/or assists in the formulation of orthoses. An

orthosis is a device that is intended to be fitted to a person to

correct a disability, or to support the person who has a disability.

Orthoses are usually prescribed by a licensed physician. Orthotists

take referrals from these physicians.

A Certified Orthotist or CO is an Orthotist who has passed the

certification standards of The American Board of Certification in

Orthotics & Prosthetics, Inc. and maintains certification through

mandatory continuing education program and adherence to the Board's

Code of Professional Responsibility.

A Licensed Orthotist is an Orthotist who is recognized by the

particular state in which they are licensed to have met basic

standards of proficiency as determined by examination and experience

to adequately and safely contribute to the health of the residents of

that state.

A BOC Certified Orthotist or BOCO is an Orthotist who has passed the

certification standards of The Board for Orthotist/Prosthetist

Certification and maintains certification through mandatory

continuing education program and adherence to the Board's Code of

Professional Responsibility.

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Physical therapy, also known as Physiotherapy in many English

speaking countries, is a health care profession which provides

services to individuals and populations to develop, maintain and

restore maximum movement and functional ability throughout the

lifespan. This includes providing services in circumstances where

movement and function are threatened by aging, injury, disease or

environmental factors. Functional movement is central to what it

means to be healthy.

Physical therapy is concerned with identifying and maximizing quality

of life and movement potential within the spheres of promotion,

prevention, treatment/intervention, habilitation and rehabilitation.

This encompasses physical, psychological, emotional, and social well

being. Physical therapy involves the interaction between physical

therapist (PT), patients/clients, other health professionals,

families, care givers, and communities in a process where movement

potential is assessed and goals are agreed upon, using knowledge and

skills unique to physical therapists. Physical therapy is performed

by either a physical therapist (PT) or an assistant (PTA) acting

under their direction.

PTs utilize an individual's history and physical examination to

arrive at a diagnosis and establish a management plan, and when

necessary, incorporate the results of laboratory and imaging studies.

Electrodiagnostic testing (e.g. electromyograms and nerve conduction

velocity testing) may also be of assistance.

Physical therapy has many specialties including cardiopulmonary,

geriatrics, neurologic, orthopaedic and pediatrics to name some of

the more common areas. PTs practice in many settings, such as

outpatient clinics or offices, inpatient rehabilitation facilities,

extended care facilities, private homes, education and research

centers, schools, hospices, industrial workplaces or other

occupational environments, fitness centers and sports training

facilities.

Educational qualifications vary greatly by country. The span of

education ranges from some countries having little formal education

to others requiring masters and doctoral degrees.

The integration of research evidence into practice has been, and

continues to be, a challenge across the scope of medicine and

physical therapy is no exception to this.

History

Physicians like Hippocrates and are believed to have been the

first practitioners of a primitive physical therapy, advocating

massage and hydrotherapy to treat people in 460 B.C. The earliest

documented origins of actual physical therapy as a professional

group, however, date back to 1894 when four nurses in England formed

the Chartered Society of Physiotherapy. Other countries soon followed

and started formal training programs, such as the School of

Physiotherapy at the University of Otago in New Zealand in 1913, and

the United States' 1914 College in Portland, Oregon, which

graduated " reconstruction aides.

Research catalyzed the physical therapy movement. The first physical

therapy research was published in the United States in March 1921 in

The PT Review. In the same year, McMillan organized the Physical

Therapy Association (now called the American Physical Therapy

Association (APTA)). In 1924, the Georgia Warm Springs Foundation

promoted the field by touting physical therapy as a treatment for

Polio.

Treatment through the 1940s primarily consisted of exercise, massage,

and traction. Manipulative procedures to the spine and extremity

joints began to be practiced, especially in the British Commonwealth

countries, in the early 1950s. Later that decade, physical therapists

started to move beyond hospital based practice, to outpatient

orthopedic clinics, public schools, college/universities, geriatric

settings (skilled nursing facilities), rehabilitation centers,

hospitals, and medical centers.

Specialization for physical therapy in the U.S. occurred in 1974,

with the Orthopaedic Section of the APTA being formed for those

physical therapists specializing in Orthopaedics. In the same year,

the International Federation of Orthopaedic Manipulative Therapy was

formed, which has played an important role in advancing manual

therapy worldwide ever since.

Specialty areas

Because the body of knowledge of physical therapy is quite large,

some PTs specialize in a specific clinical area. While there are many

specialty areas in physical therapy, the following are the six most

common specialty areas in physical therapy:

Cardiopulmonary

Cardiovascular and pulmonary rehabilitation physical therapists treat

a wide variety of individuals with cardiopulmonary disorders or those

who have had cardiac or pulmonary surgery. Primary goals of this

specialty include increasing endurance and functional independence.

Manual therapy is utilized in this field to assist in clearing lung

secretions experienced with cystic fibrosis. Disorders, including

heart attacks, post coronary bypass surgery, chronic obstructive

pulmonary disease, and pulmonary fibrosis, treatments can benefit

from cardiovascular and pulmonary specialized physical therapists.

Geriatric

Geriatric physical therapy covers a wide area of issues concerning

people as they go through normal adult aging, but is usually focused

on the older adult. There are many conditions that affect many people

as they grow older and include but are not limited to the following:

arthritis, osteoporosis, cancer, Alzheimer's disease, hip and joint

replacement, balance disorders, incontinence, etc. Geriatric physical

therapy helps those affected by such problems in developing a

specialized program to help restore mobility, reduce pain, and

increase fitness levels.

Neurological

Neurological physical therapy is a discipline focused on working with

individuals who have a neurological disorder or disease. These

include Alzheimer's disease, ALS, brain injury, cerebral palsy,

multiple sclerosis, Parkinson's disease, spinal cord injury, and

stroke. Common symptoms of neurological disorders include paralysis,

vision impairment, poor balance, inability to ambulate, and loss of

functional independence. Therapists work to improve these areas of

dysfunction and treat the patients.

Orthopaedic

Orthopaedic physical therapists diagnose, manage, and treat disorders

and injuries of the musculoskeletal system including rehabilitation

after orthopedic surgery. This specialty of physical therapy is most

often found in the out-patient clinical setting. Orthopedic

therapists are trained in the treatment of post-operative orthopaedic

procedures, fractures, acute sports injuries, arthritis, sprains,

strains, back and neck pain, spinal conditions and amputations. Joint

and spine mobilization/manipulation, therapeutic exercise,

neuromuscular reeducation, hot/cold packs, and electrical stimulation

(e.g., cryotherapy, iontophoresis, electrotherapy) are modalities

often used to expedite recovery in the orthopedic setting.

Additionally, an emerging treatment in this field is the use of

sonography for diagnosis and to guide treatments such as muscle

retraining. Those who have suffered injury or disease affecting the

muscles, bones, ligaments, or tendons of the body will benefit from

assessment by a physical therapist specialized in orthopaedics.

Pediatric

Pediatric physical therapy assists in early detection of health

problems and uses a wide variety of modalities to treat disorders in

the pediatric population. These therapists are specialized in the

diagnosis, treatment, and management of infants, children, and

adolescents with a variety of congenital, developmental,

neuromuscular, skeletal, or acquired disorders/diseases. Treatments

focus on improving gross and fine motor skills, balance and

coordination, strength and endurance as well as cognitive and sensory

processing/integration. Children with developmental delays, cerebral

palsy, spina bifida, or torticollis, may be treated by pediatric

physical therapists.

Integumentary

Integumentary (treatment of conditions involving the skin and related

organs). Common conditions managed include wounds and burns. Physical

therapists utilize surgical instruments, mechanical lavage, dressings

and topical agents to debride necrotic tissue and promote tissue

healing. Other commonly used interventions include exercise, edema

control, splinting, and compression garments.

Education

In the United States, training in physical therapy culminates in

either a masters degree or a doctor of physical therapy (MSPT, or

DPT) from an accredited physical therapy program. All US programs

used to grant the BSPT degree before transitioning to the MSPT

degree. All US programs are now transitioning to grant the DPT degree

nationwide. There are still many physical therapists currently

practicing in the US who were trained with a BSPT degree. Physical

therapist education includes clinical internships. All states also

require physical therapists to pass the National Physical Therapy

Examination before they can practice. Each state regulates licenses

for physical therapists independently.

According to the American Physical Therapy Association, there were

210 accredited physical therapist programs in 2008–of those 23

offered the Master of Physical Therapy, and 187 offered the Doctor of

Physical Therapy (DPT) degree. Most programs are in transition to a

DPT program.