The past several blog posts have focused on the different types of physical therapy settings a physical therapist could work at. The purpose of the following blog post, however, is to describe some of the most common exercises seen at each setting. The ideal audience for this blog post would be undergraduate or graduate students pursuing physical therapy.
Being aware of the different types of exercises each setting uses can be extremely beneficial for assimilating into a professional therapy environment. Even if a student has no prior hands-on experience in a particular setting, having a background on the most common therapies can help them adapt and quickly becoming a contributing member of the therapy team.
Physical Therapist: What It Takes to Be a DPT. 2012. Exercsie-science-guide, Austin, TX.
Out-patient physical therapy techniques were discussed briefly in a prior blog post because it is the most common therapy setting. In out-patient physical therapy, oftentimes exercises machines, not unlike the ones seen at the gym, are utilized alongside body weight exercises, and manual manipulation of the injured area. Therapy exercise machines may not differ from the ones offered at the gym, such as the leg press or seated row machine. The benefit from exercising on these machines at the clinic rather than the gym is that the physical therapist is on location, observing the patients to critique technique and modify the therapy schedule. Body weight exercises often incorporate tools such as balance boards or exercise balls. Each clinic is unique in the types of exercises utilized, however it is common to see exercises on the balance board for strengthening lower extremity muscles. Most clinics also work in manual therapy, where the physical therapist uses their hand to manipulate the sore and injured muscles, and give passive range of motion to the patients.
Early-childhood intervention therapy can be extremely fun, with equipment including adapted gymnasiums and toys, such as twister. Allowing a child to play games during therapy can be extremely effective, because not only does it teach functional skills, but it helps socialize the children and create a fun learning environment. More information about pediatric physical therapy can be found here. It is common to adapt toys and games for children with disabilities to play. For instance, adapting the popular sport volleyball can be as simple as lowering the net and utilizing a balloon. By lowering the net, children in wheelchairs can be accommodated, and the balloon allows for increased tracking and hand-eye coordination development. Since volleyball is a team sport, socialization is incorporated. There are several ways to adapt each game for children with disabilities, and students should be prepared with creative ideas before working at a clinic that focuses on children.
Geriatric facilities often focus on enhancing movements that contribute to performing activities of daily living, such as walking up a flight of stair or getting up out of a chair. The goal is fall prevention and increased mobility in geriatric physical therapy. Geriatric physical therapy was discussed in a previous blog post. Common exercises include chair-rise tests, and 6 meter walk tests, both of which assess the mobility of the patient. Increasing muscle power is critical for fall prevention, so oftentimes patients utilize therabands (resistance bands) instead of weights, because it is safer for older adults.
Physical Therapy Bands. 2015. FlexActive Sports. Web.
In-patient facilities see the most injured patients, so the exercises seem fairly basic. Rather than basic, they are actually critical in restoring mobility for severely injured patients, sometimes the day after they received surgery. Since most of in-patient therapy occurs within a hospital, there are typically important guidelines depending on the type of injury the patient has. For joint replacements, the goal is to achieve full range of motion. Typically, the patient is in too much pain to actively move the joint, so the first day of therapy includes passive range of motion. Unlike replacements, where the joint is now replaced with hardware that works perfectly, joint repairs need more gentleness. Joint repairs allow the ligaments and bone to stay intact, however they are still fragile. Some doctors recommend exercising the surrounding supporting muscles, rather than the injured muscle itself for the first couple of weeks post-surgery.