Can I ask about physical therapy?

Physical Therapy in Medical Care: Guidelines and Applications

Yes, you can ask about physical therapy as it plays an important role in many medical conditions and treatment plans.

Role of Physical Therapy in Different Medical Conditions

Cancer Care

• Physical therapy is considered safe during cancer treatment and offers benefits including improved bone health, muscle strength, and quality of life measures 1
• During chemotherapy and/or radiation therapy, patients may need to exercise at lower intensity or for shorter periods, with the goal of remaining as active as possible 1
• For those unable to exercise during cancer treatment, physical therapy can help maintain strength and range of motion while reducing fatigue and depression 1
• After cancer treatment, physical therapy can assist in recovery and improve overall fitness 1

Bell's Palsy

• Current evidence does not conclusively support or refute the effectiveness of physical therapy for Bell's palsy patients 1
• Several therapy modalities have been studied, including thermal treatment, electrotherapy, massage, facial exercise, and biofeedback, but no standardized protocols exist 1
• Mime therapy (including massage, relaxation exercises, inhibition of synkinesis, and emotional expressive exercises) is the most common form of physical therapy offered for Bell's palsy 1
• A Cochrane systematic review found no significant difference between rehabilitation techniques and untreated control groups 1

Osteoarthritis

• For patients with hip or knee osteoarthritis, physical therapy is recommended as part of an individualized treatment plan 1
• The 2023 American College of Rheumatology and American Association of Hip and Knee Surgeons guideline conditionally recommends proceeding to total joint arthroplasty without delaying for a trial of physical therapy in patients already indicated for surgery 1
• However, physical therapy remains valuable for patients with moderate-to-severe osteoarthritis who are not yet candidates for surgery 1

Fall Prevention

• Exercise interventions, which include physical therapy, are recommended by the US Preventive Services Task Force for community-dwelling older adults at increased risk for falls 1
• These interventions have been shown to reduce the risk of falls with moderate certainty of a moderate net benefit 1

Physical Therapy Referral and Prescription

• When writing a physical therapy prescription, physicians should include the diagnosis, type/frequency/duration of therapy, goals, and safety precautions 2
• Physical therapists play an important role in recognizing when patients need referral to physicians for further medical evaluation 3
• In a review of case reports, physical therapists appropriately referred patients to physicians in 74.4% of cases at the initial session, leading to diagnoses of various medical conditions including fractures, tumors, and cardiovascular disorders 3

Barriers to Physical Therapy Access

• Lack of accessible physical therapy providers for medically underserved adults is a significant barrier 4
• Inadequate knowledge about the full scope of physical therapist practice may impede access to those most in need of services 4
• Opportunities exist for physical therapist involvement in screening, wellness and prevention, consultation, education, and program development 4

Physical Therapists as Health Models

• Physical therapists, physical therapist assistants, and student physical therapists exercise at higher rates than the general US adult population and other health-diagnosing professionals 5
• This modeling of healthy behavior may positively influence their ability to counsel patients on physical activity 5

Physical therapy represents an important component of medical care across various conditions, though evidence for its effectiveness varies by condition. When considering physical therapy, it's important to understand the specific goals, expected outcomes, and limitations based on the patient's condition.