Commission on Accreditation in Physical Therapy EducationServes the public by establishing and applying standards that assure quality and continues improvement in the level preparation of PTs and PTAs.Medicare Ahospital visitsMedicare BOutpatientMedicare C"medical insurance" Combination of bothMedicare DPrescription drugsMedicare level that is; 720 minutes two separate therapists one therapy five days a week one therapy three days a weekUltra HighVery High500 minutes (34 units/8.3hrs) must be given therapy 5 days a weekHigh325 minutes (22 units/5.4 hrs) must average 4.3 total units/dayMedium325 minutes (22units/5.4hrs) must average 4.3 total units/day must be seen 5 days a weekLow45 minutes of therapy 3 units Patient must be treated 3 days minute 45 minutes of therapy -restorative nursing provides atleast two activties daily during at least 6 days weekStandards of Ethical Conduct: Standard #1Physical therapist assistants shall respect the inherent dignity and rights of all individualsStandards of Ethical Conduct: Standard #2Physical therapist assistants shall be trustworthly and compassionate in addressing the rights and needs of patients/clientsStandards of Ethical Conduct: Standard #3Physical therapist assistants shall make sound decisions in collaboration with the physical therapist and within the boundaries established by laws and regulationsStandards of Ethical Conduct: 4Physical therapists assistants shall demonstrate integrity in their relationships with patients/clients, families, colleagues, students, other health care providers employers, payers, and to the publicStandards of Ethical Conduct: #5Physical therapist assistants shall fulfill their legal and ethical obligationsStandards of Ethical Conduct: Standard 6#Physical Therapy assistants shall enhance their competence through the lifelong acquisition and refinement of knowledge, skills and abilitiesStandards of Ethical Conduct: Standard #7Physical therapy assistants shall support organizational behaviors and business practices that benefit patients/clients in societyStandards of Ethical Conduct: Standard #8Physical therapist assistants shall participate in efforts to meet the health needs of people locally, nationally, or globally.Standards of Conduct: 4Ephysical therapist assistant shall not engage in any sexual relationship with any of their patients/clients, supervisees or studentsStandards of Conduct: 1APhysical therapist assistants shall act in a respectful manner toward each person regardless of age, gender, race, nationality, regligion, ethnicity, social or economic status, sexual orientation, health condition or disabilityStandards of Conduct: 2APTA shall act i nthe best interest of patientsclients over the interests of the PTAStandards of Conduct: 3CPhysical therapist assistant shall make decisions based upon their level of competence and consistent with patient/client valuesStandards of Conduct: 3EPhysical Therapist Assistant shall provide physical therapy services under the direction and supervision of a physical therapist and shall communicate with the physical therapist when patient/client status requires modification to the established plan of careStandards of Conduct: 6APhysical therpaist assistnat shall achieve and mainatian clinical competenceStandards of Conduct: 6BPhysical therapist assistant shall engage in lifelong learning consistent with changes in their roles and responsibilities and advances in the practice of physical therapy.Standards of Conduct: 7DPhysical therapist assistants shall ensure that documentation for their interventions accurately reflects the nature and extent of services providedStandards of Ethical Conduct #7BPhysical Therapist assistants shall not accept gifts or other considerations that influence or give an appearance of influencing their decisionsExplanation of BenefitsThe report you recieve from your health insurer whenever you recieve a medical service from any provider. It expalins for each service how much was paid to the provider and what your responsibility will be for the deductible and co-insurancepre-certificaitonThe process of confirming elgibility and collecting information prior to inpatient admissions and selected ambulatory procedures and servicesMedical NecessityServices or items reasonable for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body memberdevelopment milestonesfunctional goals for a childeducation of all handicapped children act (EHCA)passed in 1975, was that all children age 6 to 21 years of age regardless of disability are entitled to free and appropriate public educationIndividuals with disabilities education act (IDEA)children from birth till age 5. are able to go to school and you are required to give them the least restrictive environmentdevelopment delaya child that has not attained predictable movement patterns or behavior associated with children of a similar chronologic ageautisma severe disorder in the group of conditions called PDDscongenital muscular torticollis (CMT)one condition that may be associated with these in utero constraintsjuvenile rheumatoid arthritis (JRA)inflammation of connective tissue manifested as a painful inflamed jointClubfootposition of the affected foot, which is turned inward and slanted downwarddevelopment dysplasia of the hipresults from abnormal devlopment of structres surrounding the hip jointDown syndromeCongenital development disability caused by presence of a extra copy chromosomeActivities of daily living (ADL)PT for older people to perform activities such as bathing, cooking, and dressingInstrumentals activities of daily living (IADLs)For older people to perform activities such as using public transportation and shoppingwell ederly65 years of age or older who are NOT experiencing physical limitationsFrail elderlypeople over 65 years of age with conditions that impair daily functionsPresbycusisOlder peoples hearingHypokinesisDecreased activity or movementOsteoarthritisBone joint disease most commonly found in African AmericansRheumatoid arthritis (RA)Disease of the immune system that cause chronic inflammation of the joints more common in women 40-60 years of ageOsteoporosisCommon disease in older people its decreased mineralization of the bonesFunctional reach testMeasures how FAR the person can reach forward without losing balanceDynamic balanceHow long it takes the older person to walk a set distancearteriosclerosisplaque build up in inner wall which decreases elasticity of vesselmyocardial infractionlack of oxygen due to blockage of blood flow to heartishemicinsufficient blood flowanginachest pain from ishemiacongestive heart failureheart is compromised to the point it can not move blood volume effectivelychronic obstructive pulmonary diseasegroup of disorders the produce a chronic productive cough, excessive mucus production, changes in sound when air passes bronchial tube, and shortness of breathbronchitisinflammation of bronchiemphysematrapping of air in alveoliperipheral airway diseasecollapse of terminal bronchiolesbronchial asthmaspasm like contractions of bronchicystic fibrosisdysfunction of mucus glands, causing blockage of bronchirestrictive lung diseasedecrease in lungs ability to expand causing decrease in the volume of air that can move in and out of the lungscardiac muscle dysfunctionvarious conditions associated with heart failurecoronary heart diseasearteriosclerosis in coronary arteriesinspirationdiaphragm and lungs contract ton increase in space in thoracic cavityexpansiondiaphragm and lungs expand to breathconducting airwaystubes that transport air to and from the lungsdyspneashortness of breathspirometertool used to measure various volumes and airflow ratiodiagnosisdescription of specific diseaseprognosismaximum level of improvement patient will experienceembolusclot formed by substance detached from elsewhererespirationexchange of carbon dioxide and oxygen between a person and cellcardiac catheterizationpassing of catheter into an artery until it reaches a heart then measures how much pressure is generated in chamberspercutaneous coronary interventionsmechanically dilating a blood vesselechocardiographyhigh frequency ultrasound used o asses size of heart chamber pumping ability, and the motion of chamber walls and heart valveselectrocardiogramassessment of heart rate and rhythmexercise stress testinghow cardiovascular and pulmonary systems respond to controlled increased activitychest imagingbaseline images that provide info if there is fluid in the lungs, air spaces, rib fractures, heart size, and nodules in lungsbronchoscopytube placed in bronchial tube to permit visualization of structures and suction any secretionpulmonary function testassessment of respitory musculature and integrity of airways and lung tissueblood and gas analysisassessing arterial blood to determine concentration of oxygen and carbon dioxidecoronary artery bypass graftattaching a small artery to a point beyond blockage to reestablish blood flowAnencephalyA form of neural tube defect that results from a lack of the neural tube closure at the base of the brain. Not compatible with life and results in fetal death or death shortly after delivery.Cerebral palsy (CP)Group of conditions caused by a non-progressive lesion on the brain most often it has its origin before birth, at birth, or after birth and is caused by an interruption of oxygen to the brain of the fetus or new born.AutismA neural developmental disorder characterized by impairments in social interaction, communication skills, and repetitive behaviors.Club footDisorder in which the foot is turned inward and slanted upwardCongenital muscular torticolis (CMT)(Twisted neck) the muscle extending down the side of the neck is tight and shortened. An infant holds his or her head to one side and has difficulties turning the headCystic fibrosis (CF)Most common inherited chronic pulmonary disease among white children, characterized by production of thick mucous with progressive lung damageDevelopmental coordination disorder (DCD)Motor condition in children with dysfunctions and motor coordination problems such as: awkward running, frequent falling, slow reaction times, immature balance reactions, poor handwriting, difficulty with AILDsDevelopmental delayFailure to obtain predictable movement patterns or behaviors associated with children of a similar chronological ageDevelopmental dysplasia of the hip (DDH)Dislocation caused from abnormal development of structures surrounding the hip joint; allows the head of the femur to move in and out of the hip socketDevelopmental milestoneMovement pattern that appears at a certain stage of growth and developmentDisablement processExamination that focuses on an individual's impairments, functional limitations, disability, and resultant restrictions in activitiesDown syndromeCongenital developmental disability caused by a defect of chromosome 21 (trisomy 21)Duchenne muscular dystrophy (DMD)Progressive pelvic muscle weakness and waisting in a male child, combined with enlarged yet weak thigh muscles and tight heel chordsDynamical systems theoryTreatment approach in children that incorporate all of the body's systems with the environment to facilitate or inhibit movements, emphasizes the process of moving rather than the product of a movementEclectic approachCombination of therapeutic approaches used by the physical therapist and thought to be useful for a treatment of a given clientEnablement processExamination process focusing on an individual's structural body and concurrent abilities while addressing age appropriate movement patterns and activitiesFamily assessmentFamily interview, survey, or discussion used to obtain the families insights regarding a patient, especially a child; family history, relationships, concerns, needs, resourcesFetal alcohol syndrome (FAS)Most severe condition in a continuum of alcohol induced disabilities related to high levels of alcohol consumption during pregnancyGoal-directed movement approachTreatment approach that emphasizes the importance of task and environment features as a primary impetus for movementIndividualized education plan ( IEP)A collaboration of therapists and family members, educators, and other healthcare team members to provide direct intervention in the classroom settingIndividualized family service plan (IFSP)Detailed total plan of care for the child and the context of the family unitJuvenile rheumatoid arthritis (JRA)Rheumatic disease characterized by inflammation of the connective tissue that manifests as a painful inflamed joint begins in childhoodMeningoceleBenign herniation of meninges manifesting as a soft tissue cyst or lump surrounding a normal spinal cord and producing no neurologic deficitsMeningomyeloceleOpen congenital spinal cord region with minimal to no skin protection covering the deeper nerve roots most severe of these cases results in loss of motor function and sensation of the lower part of the bodyNeural tube defectThe neural tube fails to clothes completely during the first month of gestational developmentNeural developmental treatment (NDT)Analyzes and treats neurologic disorders of posture an movement. Uses a motivating environment and a patients active participation.manual facilitation and inhibition techniques are employed by the therapist to present the patient with a "normal" sensory experienceNorm referencedAssessment based on a large number of participants to create a comparison groupNormal developmental theoryTherapy goals and objectives that are designed to follow the progression of a normal motor development, this assumes children with central nervous system damage will acquire motor skills in a similar way as children with normal developing systemsOsteogenesis imperfecta (OI)Common and severe bone impairment of genetic origin, affects the formation of collagen during bone development resulting in frequent fractures during fetal and new-born periodPervasive developmental disorder (PDD) (PDI)A group of disorders of neural development characterized by impairments and social interaction and communication and the presence of unusual behaviour a such as repeating actions and poor play skillsPlagiocephalyDeformation of the skull during development caused by prolonged positioning in uterine or in the first few months of lifePrenatal cocaine exposureFetal exposure to cocaine in utero owing to maternal cocaine use during pregnancy symptoms after birth include hyper irritability, poor feeding patterns, high respiratory and heart rates, increase tremulous, irregular sleeping patternsScoliosisLateral curvature of the spine; may be idiopathic neuromuscular or congenitalSecondary conditionCondition that is potentially preventable and is a direct or indirect consequence of inadequate attention to a disabilitySensory integration (SI)Technique based on the theory that poor integration and use of sensory input (feedback) prevent subsequent motor planning (output) Providing controlled vestibular and somatosensory experiences enables the child to integrate the sensory info. To evoke a spontaneous, functional responseSpina bifidaCongenital incomplete closure of the vertabraeSpina bifida acultaCongenital incomplete closure of a vertebrae (separation of the spinous process) that is not associated with disabilitySpinal muscular atrophyGenetic disorder characterized by severe muscle weakness in infancy and progressive respiratory failureStandardized testingType of formal test in which the evaluation procedures remain the same when administered by different therapists and at various test locationsarterial insufficiencydeficiency or occlusion of blood flow through an arterychronic inflammationlow grade, protracted inflammatory processcollagensupportive, strong, and fibrous connective tissue protein that is found in dermis, tendon, cartilage fascia, ligament, and bone.dermisportion of the skin directly under the dermis; made up of fibrous connective tissue and supports sweat glands, sebaceous glands, nerves, and nerve endings, blood and lymph vessels, hair follicles and their allied smooth muscleepidermisouter layer of the skinground substancesupportive amorphous, gel-like substance secreted by fibroblasts; fills space between connective tissue fibers and cellshypertrophic scarexcess of collagen deposited at the site of a healing or healed wound that is noticeably different from the normal skin; scar remains within the boundaries of the original woundinflammatory phasephase of wound healing encompassing vascular reactions that decrease blood loss and initiate vessel repair, and cellular responses that moderate blood loss, fight infection, and provide nutrition and oxygen to initiate and sustain tissue repairinflammatory skin diseasesdiseases of the skin whose causes invoke an inflammatory responseintegumentskinkeloid scarexcess of collagen deposited at the site of a healing or healed wound that is noticeably different from normal skin: scar commonly extends beyond the boundaries of the original woundmaturation phasephase of wound healing that includes collagen synthesis and lysis, as well as reorientation of the collagen fibers that remain at wound site; remodling phaseneoplastic skin diseasescancers affecting the skinneopathic (nuerotropic) ulcerskin lesion caused by a decreased cutaneous sensation that disallows protective responses such as weight transfer; these ulcers are commonly associated with diabetes mellituspressure ulcerskin lesion caused by ischemia of the integument secondary to pressure; generally located at bony prominencesprolifterative phasephase of wound healing that involves increased activity of fibroblasts, instigation of aggressive wound contraction, and epithelializationscar contracturepermanent or relatively permanent lack of mobility of the scar tissue that results in functional and/or cosmetic impairmenttotal body surface area (TBSA)the extent of the surface of the body covered by skin ; percent used to describe size of skin injuryVancouver Burn Scar Scaleclinical method for assessing scar tissues. Characters of scar that are examined include pigmentation, vascularity, pliability, and heightvenous insufficiencydeficiency or occlusion of blood flow through veinConditions that affect the musculoskeletal system are the primary domain of physical therapists who specialize inorthopedic physical therapyPhysical Therapy for musculoskeletal conditions is the focus on apatients functionDysfunctions of the musculoskeletal system result insymptoms of pain, stiffness, edema(swelling, muscle weakness or fatigue, or loss of range of motionRange of Motion( ROM)movement of a jointThe increased use of computers and other technical machinery recurring repeated motions has also had an impact on the incidence of overuse injuries in the upper extremity. They are at risk of...the development of muscle injury or nerve entrapment requiring intervention by a PTA orthopaedic PT may work withathletes but may also treat a variety of musculoskeletal conditions that are not related to sports activitiesMusculoskeletal injuries are sustained throughathletic participation, work related injuries, conditions resulting from orthopedic surgical procedures and degenerative changes that accompany the aging processOveruse injuriesrepeated stress to the musculoskeletal system can cause oversees injuries that may result in pain, inflammation, and dysfunction.Bursitisan inflammation of bursa, which are fluid-filled sacs located throughout the body that decrease friction between structures. Bursa become irritated and painful when they are repeatedly pinched between structures. EX: injury at the shoulder, the subacromial bursa may be pinched during repeated movements when the shoulder is in a overhead position, such as painting, reaching or throwing.TendinopathyTendons are the structures that connect muscle to bone. Repeated use or rapid over stretching of muscles can overload and injure the tendons. see pg. 176Nerve EntrapmentPressure on a nerve. Symptoms: tingling, pain, weakness, or any combination of these. Common Condition: Carpal Tunnel syndrome, patients usually complain of numbness in hands or fingers which is from the result of repeated activities with the wrist in a flexed position.Traumatic InjuriesMusculoskeletal injuries that occur as a result of direct trauma. Bones, muscles, ligaments, and other soft tissue may be injured when they sustain a direct blow or when they are placed under excessive stretch.Ligament Sprainsupporting structures of joints that serve to stabilize the joint and prevent excess movement. When ligaments are overstretched fibers tear and cause pain and instability at the joint. Ex: ACL- result of a cutting or twisting movement of the knee when the foot is planted , commonly occurring in sports.FractureDirect trauma to the bone causing a break. Most common in older adults. Radiographs are used to diagnose.Muscle StrainA sudden contraction of a muscle fiber or excessive stretch on a muscle can cause tearing of the muscle fibers.Total Joint ArthroplastyJoints most commonly replaced are weight-bearing joints. A variety of plastic and stainless steel implants are used to effectively replace degenerated joint surfaces.AmputationPostoperative physical therapy often includes exercises to maintain strength in the remaining of the limb, functional training with a prothesis, and activities to improve overall fitness and well being.Subjective Examination/Objective ExaminationThe History of the Patient/The Remaining PartsQuestions asked during a patient interviewabout the onset of the condition, current symptoms, previous physical therapy treatments, past medical history, and lifestyle and health habits pertaining to work and recreation. See page 179Review of Symptoms(ROS)is usually preformed by using checklists of common symptoms typically associated with various systems of the body.Systems Reviewthe objective portion of the examination refers to quantize or qualitative measurements that are taken by the Pt.Active Range of Motionrefers to the ability of the patient to voluntarily move a limb through an arc of movement. "willingness of patient to move"Passive Range of Motionrefers to the amount of movement at a joint that is obtained by the therapists moving the segment without the assistance from the patient.Gonimetermeasures joint anglesStrengthcan be defined as the amount of force produced during voluntary muscular contractionManual Muscle testingallows the therapist to assign a specific grade to the muscle.Flexibilityrefers to the ability to move a ligament through specific ROM. The amount of flexibility at a given joint depends on: the soft tissue surrounding the joint most be pliable to allow movement between the joint surfaces. Also, the muscles crossing the joint must be at the appropriate length allow motion to occur.Accessory Motionthe ability of the joint surfaces to glide, roll, and spin on each other.Outcome Measuresare standardized instruments that measure an individuals actual or perceived activity limitations and participations restrictions and an individuals quality of life or health status.Special Testsused to examine specific joints to indicate the presence or absence of a particular problem.PalpatationPT's use their sense of touch, to assess what is occurring below the skin. The PT feels for areas of tenderness, areas of restrictions, swelling, and proper orientation of structures.Patient Specific Functional Scale (PSFS)The patient is asked to list up to five activities that he or she is having difficulty preforming because of his or her injury or condition. zero to 10 scalePhysical Agentsare available for PTs to incorporate into the plan of care when treating patients with musculoskeletal problems. EX: heat, cold, electrical stimulationFluidtherapyis the use of a self-contained unit filled with corncobs finely chopped into a sawdust type substance.Hydrotheraphythe use of therapeutic effects of waterThermal Ultrasoundthe use of therapeutic of high frequency sound waves that penetrate tissue and increase tissue temperature to promote healing and reduce pain.Short-wave diathermythe use of electromagnetic energy to produce deep heating effectsCreyotherapytherapeutic cold may be applied to decrease tissue temperature.akinesiaLoss of voluntary movementsamyotrophic lateral sclerosis (ALS)also known as Lou Gehrick disease rapidly progressive neurological disorder associated with a degeneration of the motor nerve cellsangiographytechnique in which radiopaque material is injected into the blood vessels to to better visualize and identify such as blockage of blood vessels, aneurysms, and vascular malformationsbradykinesiaslowness of movementBruunstorm approachNeurologic technique based on the natural sequence of recovery after a strokecomputed (axial) tomography (CAT) (CT)computer synthesis of x-rays transmitted through a specific plane of the bodyConstraint-induced movement therapyis a form of rehabilitation therapy that improves upper extremity function in stroke and other central nervous system damage victims by increasing the use of their affected upper limbelectroencephalgraphytechnique for recording the electrical potential or activity in the brain by placing electrodes on the scalpelectromyography (EMG)technique for recording the electrical activity in the muscle during a state of rest and during voluntary contractionexpressive aphasiaimpaired ability to express oneselfhypertoniahigh muscle tonehypotonialow muscle toneloco motor trainingtype of therapy to help improve and recover your walking movement through challenged practice and lower extremity weight bearing. You may benefit from therapy to recover locomotor abilities if you're experiencing: Impaired movement and sensations (impaired neurological body functions)lumbar puncture (LP)injection of a hypodermic needle into the lumbar sub-arachnoid spacemagnetic resonance imaging MRIcreation of computer image by placing the body part in a magnetic fieldmotor controlability to manipulate movement and non movement of the body's musculoskeletal componentsmotor developmentage related processes of change in motor behaviormotor learningbody's mechanism for acquiring or learning voluntary motor controlmultiple sclerosis MSdisease in patches of demyelination occur in the nervous system, leading to disturbances in conduction of action potential along the nervesnerve conduction velocity (NCV)study that records the rate at which electrical signals are transmitted along peripheral nerves.neurodevelopmental treatment (NDT)Approach to both analyze and treat neurological of posture and movement.neuroplasticitythe ability to of neurons in the brain to compensate for injury or diseaseparaplegiaspinal cord damage and resultant loss of sensory or motor function affecting the lower leg trunk and legsParkinson's diseaseprogressive condition caused by a lack of the neurotransmitter dopamine, characterized by tremors, rigidity, and bradykinesia and alkinesiaperceptionability to to integrate various simultaneous sensory inputs and to respond appropriatelyproprioceptive nueromuscular facilitation (PNF)technique used to enhance movement and motor control, emphasizing proprioceptive (joint and position sense) stimuli but also using tactile, visual, and auditory stimulireceptive aphasiadiminished ability to receive and interpret verbal or written communicationrigiditydisturbance of muscle tone; manifests as a resistance when the limbs are passively movedsensationability to receive sensory input from within and outside the body and transmit it through nerves to interpret in brainspasticity(from Greek spasmos-, meaning "drawing, pulling") is a feature of altered skeletal muscle performance with a combination of paralysis, increased tendon reflex activity and hypertonia. It is also colloquially referred to as an unusual "tightness", stiffness, or "pull" of muscles.spinal cord injury (SCI)damage to the spinal cord that results in neurological dysfunctionstroke or cerebrovascular accident (CVA)neurological problem arising from disruption of of blood flow in the brainsystems modeltask-oriented approachintervention technique used for nueromuscular conditons that focuses on the specific intended task and retraining using functional activities to accomplish the tasktetraplegiaspinal cord damage damage resulting in loss of sensory or motor function in all limbstonetension exerted and or maintained by muscles at rest and during movementtraumatic brain injury (TBI)damage to the brain caused by physical means and resulting in dysfunctiontremoralternating contractions of opposing muscle groupsvertigosensation of spinning or whirling that occurs as a result of a disturbance in balanceblankblanktesttest

HOSA Physical Therapy

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