Physical therapy assistants help to restore physical function in people with injury, birth defects, or disease. They assist physical therapists with a variety of techniques, such as exercise, massage, heat, and water therapy.
Physical therapy assistants work directly under the supervision of physical therapists. They teach and help patients improve functional activities required in their daily lives, such as walking, climbing, and moving from one place to another. The assistants observe patients during treatments, record the patients’ responses and progress, and report these to the physical therapist, either orally or in writing. They fit patients for and teach them to use braces, artificial limbs, crutches, canes, walkers, wheelchairs, and other devices. They may make physical measurements to assess the effects of treatments or to evaluate patients’ range of motion, length and girth of body parts, and vital signs. Physical therapy assistants act as members of a team and regularly confer with other members of the physical therapy staff. There are approximately 59,000 physical therapy assistants employed in the United States.
Physical Therapy Assistant Career History
The practice of treating ailments with heat and exercise is very old. For many centuries, people have known of the therapeutic value of hot baths, sunlight, and massage. The ancient Greeks and the Romans used these methods, and there is a long tradition of them in the far northern part of Europe.
Two factors spurred the development of physical therapy techniques during this century: the world wars and epidemic poliomyelitis. These catastrophes created large numbers of young but seriously disabled patients.
World War I brought about great strides in medicine and in our understanding of how the human body functions. Among these was the realization that physical therapy could help shorten the recovery time of the wounded. A Reconstruction Aide corps in the U.S. Army was organized to perform physical therapy in military hospitals, and the Army organized the first department of physical therapy in 1916. Training programs were hastily started to teach physiotherapy, as physical therapy used to be called, to those administering services.
The American Physical Therapy Association was organized in 1921, thus establishing physical therapy’s professional stature. In 1925, the association took on the responsibility of identifying approved training programs for physical therapy personnel.
During World War II, physical therapy’s benefits were recognized. Because medical teams in the armed forces were able to rehabilitate seriously injured patients, this field gained acceptance from the medical world.
Between the wars, polio became a major health problem, especially because it left many of its victims paralyzed. In 1944, the United States suffered the worst polio epidemic in its history. Public demand for improved physical therapy services led to more therapists and improved techniques. As knowledge grew and the number of people in the field grew, physical therapy services were redefined and expanded in scope. Physical therapy is now available in many settings outside the hospital. Currently there is preventive musculoskeletal screening for children in pediatric clinics and public schools, therapy in industrial settings for workers recovering from injuries on the job, therapy for the elderly in nursing homes and in community health agencies, and therapy for people with athletic injuries in sports medicine clinics.
The physical therapy assistant’s occupation is rather new. It was developed in 1967 to help meet this greatly expanded interest in physical therapy services. Physical therapy assistants and physical therapy aides (another new occupational category, requiring less education than an assistant) specialize in some of the less complex treatments that were formerly administered by the physical therapist.
Physical Therapy Assistant Job Description
Physical therapy personnel work to prevent, diagnose, and rehabilitate, to restore physical function, prevent permanent disability as much as possible, and help people achieve their maximum attainable performance. For many patients, this objective involves daily living skills, such as eating, grooming, dressing, bathing, and other basic movements that unimpaired people do automatically without thinking.
Physical therapy may alleviate conditions such as muscular pain, spasm, and weakness, joint pain and stiffness, and neuromuscular incoordination. These conditions may be caused by any number of disorders, including fractures, burns, amputations, arthritis, nerve or muscular injuries, trauma, birth defects, stroke, multiple sclerosis, and cerebral palsy. Patients of all ages receive physical therapy services; they may be severely disabled or they may need only minimal therapeutic intervention.
Physical therapy assistants always work under the direction of a qualified physical therapist. Other members of the health team may be a physician or surgeon, nurse, occupational therapist, psychologist, or vocational counselor. Each of these practitioners helps establish and achieve realistic goals consistent with the patient’s individual needs. Physical therapy assistants help perform tests to evaluate disabilities and determine the most suitable treatment for the patient; then, as the treatment progresses, they routinely report the patient’s condition to the physical therapist. If they observe a patient having serious problems during treatment, the assistants notify the therapist as soon as possible. Physical therapy assistants generally perform complicated therapeutic procedures decided by the physical therapist; however, assistants may initiate routine procedures independently.
These procedures may include physical exercises, which are the most varied and widely used physical treatments. Exercises may be simple or complicated, easy or strenuous, active or passive. Active motions are performed by the patient alone and strengthen or train muscles. Passive exercises involve the assistant moving the body part through the motion, which improves mobility of the joint but does not strengthen muscle. For example, for a patient with a fractured arm, both active and passive exercise may be appropriate. The passive exercises may be designed to maintain or increase the range of motion in the shoulder, elbow, wrist, and finger joints, while active resistive exercises strengthen muscles weakened by disuse. An elderly patient who has suffered a stroke may need guided exercises aimed at keeping the joints mobile, regaining the function of a limb, walking, or climbing stairs. A child with cerebral palsy who would otherwise never walk may be helped to learn coordination exercises that enable crawling, sitting balance, standing balance, and, finally, walking.
Patients sometimes perform exercises in bed or immersed in warm water. Besides its usefulness in alleviating stiffness or paralysis, exercise also helps to improve circulation, relax tense muscles, correct posture, and aid the breathing of patients with lung problems.
Other treatments that physical therapy assistants may administer include massages, traction for patients with neck or back pain, ultrasound and various kinds of heat treatment for diseases such as arthritis that inflame joints or nerves, cold applications to reduce swelling, pain, or hemorrhaging, and ultraviolet light.
Physical therapy assistants train patients to manage devices and equipment that they either need temporarily or permanently. For example, they instruct patients how to walk with canes or crutches using proper gait and maneuver well in a wheelchair. They also teach patients how to apply, remove, care for, and cope with splints, braces, and artificial body parts.
Physical therapy personnel must often work on improving the emotional state of patients, preparing them psychologically for treatments. The overwhelming sense of hopelessness and lack of confidence that afflict many disabled patients can reduce the patients’ success in achieving improved functioning. The health team must be attuned to both the physical and nonphysical aspects of patients to assure that treatments are most beneficial. Sometimes physical therapy personnel work with patients’ families to educate them on how to provide simple physical treatments and psychological support at home.
In addition, physical therapy assistants may perform office duties: They schedule patients, keep records, handle inventory, and order supplies. These duties may also be handled by physical therapy aides.
Physical Therapy Assistant Career Requirements
High School
Does this work sound interesting to you? If so, you can prepare for it while still in high school by taking biology, health, and mathematics classes. Psychology, sociology, and even social studies classes will be helpful, because they will give you an understanding of people. And, since you will be working so closely with clients as well as other professionals, you will need excellent communication skills. Therefore, take English courses and other classes that will improve these skills, such as speech. It is also a good idea to take computer science classes since almost all employers require their employees to have computer communication skills.
Postsecondary Training
In order to do this work, you will need a degree from an accredited physical therapy assistant program. Accreditation is given by the Commission on Accreditation in Physical Therapy Education (CAPTE), which is part of the American Physical Therapy Association (APTA). These programs, leading to an associate’s degree, are usually offered at community and junior colleges. Typically lasting two years, the programs combine academic instruction with a period of supervised clinical practice in a physical therapy setting. According to APTA, there are 234 accredited schools offering assistant programs as well as several programs in development. The first year of study is typically taken up with general course work, while the second year is focused on professional classes. Classes you can expect to take include mathematics, biology, applied physical sciences, psychology, human growth and development, and physical therapist assistant procedures such as massage, therapeutic exercise, and heat and cold therapy.
In recent years, admission to accredited programs has been fairly competitive, with three to five applicants for each available opening. Some physical therapy assistants begin their careers while in the armed forces, which operate training programs. While these programs are not sufficient for state licensure and do not award degrees, they can serve as an excellent introduction to the field for students who later enter more complete training programs.
Certification or Licensing
More than 40 states require regulation of physical therapy assistants in the form of registration, certification, or licensure. Typically, graduation from an CAPTE-accredited program and passing a written exam are needed for licensing. Because requirements vary by state, you will need to check with your state’s licensure board for specific information.
Other Requirements
Physical therapy assistants must have stamina, patience, and determination, but at the same time they must be able to establish personal relationships quickly and successfully. They should genuinely like and understand people, both under normal conditions and under the stress of illness. An outgoing personality is highly desirable as is the ability to instill confidence and enthusiasm in patients. Much of the work of physical retraining and restoring is very repetitive, and assistants may not perceive any progress for long periods of time. At times patients may seem unable or unwilling to cooperate. In such cases, assistants need boundless patience, to appreciate small gains and build on them. When restoration to good health is not attainable, physical therapist assistants must help patients adjust to a different way of life and find ways to cope with their situation. Creativity is an asset to devising methods that help disabled people achieve greater self-sufficiency. Assistants should be flexible and open to suggestions offered by their coworkers and willing and able to follow directions closely.
Because the job can be physically demanding, physical therapy assistants must be reasonably strong and enjoy physical activity. Manual dexterity and good coordination are needed to adjust equipment and assist patients. Assistants should be able to lift, climb, stoop, and kneel.
Exploring Physical Therapy Assistant Career
While still in high school, you can experience this work by getting summer or part-time employment or by volunteering in the physical therapy department of a hospital or clinic. Also, many schools, both public and private, have volunteer assistance programs for work with disabled students. You can also gain direct experience by working with disabled children in a summer camp.
These opportunities will provide you with direct job experience that will help you determine if you have the personal qualities necessary for this career. If you are unable to get direct experience, you should talk to a physical therapist or physical therapy assistant during career-day programs at your high school. It may also be possible for you to arrange to visit a physical therapy department, watch the staff at work, and ask questions.
Employers
Physical therapy assistants are employed in hospitals, rehabilitation centers, schools for the disabled, nursing homes, community and government health agencies, physicians’ or physical therapists’ offices, and facilities for the mentally disabled. There are approximately 59,000 physical therapy assistants employed in the United States.
Starting Out
One good way to find a job is to access the resources available at the career services office of your educational institution. Alternatively, you can apply to the physical therapy departments of local hospitals, rehabilitation centers, extended-care facilities, and other potential employers. Openings are listed in the classified ads of newspapers, professional journals, and with private and public employment agencies. In locales where training programs have produced many physical therapy assistants, competition for jobs may be keen. In such cases, you may want to widen your search to areas where there is less competition, especially suburban and rural areas.
Advancement
With experience, physical therapy assistants are often given greater responsibility and better pay. In large health care facilities, supervisory possibilities may open up. In small institutions that employ only one physical therapist, the physical therapist assistant may eventually take care of all the technical tasks that go on in the department, within the limitations of his or her training and education.
Physical therapy assistants with degrees from accredited programs are generally in the best position to gain advancement in any setting. They sometimes decide to earn a postbaccalaureate degree in physical therapy and become fully qualified physical therapists.
Earnings
Salaries for physical therapy assistants vary considerably depending on geographical location, employer, and level of experience. Physical therapy assistants earned median annual salaries of $39,490 in 2005, according to the U.S. Department of Labor. The lowest 10 percent earned less than $25,640; the highest 10 percent earned more than $54,480. According to Salary.com, the national average median salary for physical therapy assistants in 2006 was $39,979, with 50 percent earning between $36,912 and $43,294, annually.
Fringe benefits vary, although they usually include paid holidays and vacations, health insurance, and pension plans.
Work Environment
Physical therapy is generally administered in pleasant, clean, well-lighted, and well-ventilated surroundings. The space devoted to physical therapy services is often large, in order to accommodate activities such as gait training and exercises and procedures requiring equipment. Some procedures are given at patients’ bedsides.
In the physical therapy department, patients come and go all day, many in wheelchairs, on walkers, canes, crutches, or stretchers. The staff tries to maintain a purposeful, harmonious, congenial atmosphere as they and the patients work toward the common goal of restoring physical efficacy.
The work can be exhausting. Physical therapy assistants may be on their feet for hours at a time, and they may have to move heavy equipment, lift patients, and help them to stand and walk. Most assistants work daytime hours, five days a week, although some positions require evening or weekend work. Some assistants work on a part-time basis.
The combined physical and emotional demands of the job can exert a considerable strain. Prospective assistants would be wise to seek out some job experience related to physical therapy so that they have a practical understanding of their psychological and physical capacities. By exploring their suitability for the work, they can make a better commitment to the training program.
Job satisfaction can be great for physical therapy assistants as they can see how their efforts help to make people’s lives much more rewarding.
Physical Therapy Assistant Career Outlook
Employment prospects are very good for physical therapy assistants; the U.S. Department of Labor predicts that employment will grow much faster than the average through 2014. Many new positions for physical therapy assistants are expected to open up as hospital programs that aid the disabled expand and as long-term facilities seek to offer residents more adequate services.
A major contributing factor is the increasing number of Americans aged 65 and over. This group tends to suffer a disproportionate amount of the accidents and chronic illnesses that necessitate physical therapy services. Many from the baby boom generation are reaching the age common for heart attacks, thus creating a need for more cardiac and physical rehabilitation. Legislation that requires appropriate public education for all disabled children also may increase the demand for physical therapy services. As more adults engage in strenuous physical exercise, more musculoskeletal injuries will result, thus increasing demand for physical therapy services.