The stroke patient is referred to acute physical therapy. Upon initial examination and evaluation of the patient, the physical therapist (PT) is responsible for determining the nature, status, and extent of the stroke. Based on the patient history, review of systems, and the results of the tests and measures of the examination, the PT makes a “clinical judgment” based on the collected data. A diagnosis and prognosis is established once consultation with other health professionals, such as a neurologist, is reviewed. A plan of care is designed and short- and long-term goals are outlined. Physical therapy goals may include performance in transitioning between sitting and standing, posture, balancing while standing and walking, and improved gait training. According to our textbook, motor development and control are affected in stroke patients. Motor control relearning is important in restoring neurodevelopment to pre-accident status. It is also important that the PT also educate the patient about the reasons behind these exercises. These interventions, which include physical therapy, speech therapy, and home exercises, are imperative in order to restore full independence. These interventions can change along the length of treatment and the PT is solely responsible for discharging the patient once goals are reached. Wk-2
The first topic which caught my attention on the Physical Therapy Board of California website was Section 1398.44 of the Physical Therapy Regulations. This section states what physical therapist assistant are not allowed to. In the interest of saving space for my two other topics I will simply list a few from the list. The physical therapist assistant can not collect patient data prior to the physical therapist evaluation, document patient evaluation and reevaluation, write a discharge summary, and establish or change a plan of care. The second section which caught my eye was Section 2620 of the Business and Professions (B&P) Code. Essentially this section states the extent of how much advice a licensed physical therapist in California can provide through the Internet or telephone. Again, I will simply list a few topics from the list. A physical therapist can instruct a person how to obtain physical therapy care in the State of California, can cite a possible range of treatment available, and offer wellness advice. The third topic which caught my attention was Senate Bill 1485, which states that a physical therapist can provide wellness if it’s within their scope of practice. The definition they provide for physical therapy is “the promotion and maintenance of physical fitness to enhance the bodily movement related to health and wellness of individuals through the use of physical therapy interventions.” However, if the treatment is for correction of a medical condition a diagnosis must be attained from a physician or duly licensed practitioner. http://www.ptbc.ca.gov/forms_pubs/ptasuper.shtml
If a patient was referred to a physical therapist for pressure ulcers, the first thing that he/she would do would be the examination which would include an evaluation, diagnosis, prognosis, and determine a plan of care for the patient. An examination of the wound should include a thorough history and physical assessment of the cause, depth, and size of the wound and signs of infection. The skin adjacent to or otherwise associated with the wound should also be examined for any alteration from normal function (e.g., sensation temperature, hair growth, mobility, pliability) and appearance (e.g., texture and color). All ulcers, regardless of their cause, should be examined for size and depth. Along with the above assessments, the PT should also evaluate the patient’s ability to communicate and comprehend, joint mobility, muscle performance, gait, ventilation, circulation, and sensory. After the plan of care is...
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