The major chronic diseases of our time have direct links to movement and physical activity—which means that physical therapists (PTs) and physical therapist assistants (PTAs) have an important opportunity to make an impact on what are literally matters of life or death.
During their June 5 presentation, some of physical therapy's top experts on the profession's role in chronic disease shared an overview of a few of the world's most pressing health issues—rheumatoid arthritis (RA), cancer survivorship, diabetes, and cardiovascular disease (CVD)—and how PTs and PTAs can be life-changers.
The strongest theme shared by all 4 presenters: PTs should not only participate in an interdisciplinary approach to chronic diseases, their participation should be considered necessary.
Presenter Maura Iverson, PT, DPT, SD, MPH, FNAP, described risks for RA and conditions that RA can exacerbate. Because RA has such a strong link to CVD, diabetes, and osteoporosis, she explained, it's imperative that PTs engage patients with RA in activities such as strength and interval training—once their tolerance for those activities has been established. PTs are also uniquely positioned to impact the lives of individuals with RA because of their skills at motivating the important lifestyle changes that make a difference long after the patient has left the clinic.
Similar to Maura, Amy Litterini, PT, DPT, pointed out not only the risk factors for cancer, but the health risks associated with cancer survivorship, a term applied to the entire span of time from a cancer diagnosis to death. While some of those risks—environmental conditions, for example—may be beyond the control of the PT, many others—particularly obesity and physical activity rates—are very much in the PT's wheelhouse.
Making the problem even more challenging, she explained, is that many of the most debilitating parts of cancer survivorship are attributable to the treatments used to battle the disease, and the ways in which these conditions persist over time. The key is to engage an interdisciplinary team that recognizes that disease management doesn't end with discharge from the oncology clinic. It's not about helping them through the initial measures and saying "good job" when they end, she said.
In her part of the discussion, Mary Jane Myslinski, PT, EdD, said that when it comes to diabetes, one axiom of pediatric physical therapy—that children aren't just "small adults"—needs to be challenged.
"Children are small adults when it comes to this disease," she said. "They suffer from the same problems as adults with diabetes." And the disease is reaching younger and younger ages.
Myslinksi outlined opportunities for PTs to participate in both prevention and treatment of the disease, but she advised that early testing is key. Typically, individuals develop type 2 diabetes 9 to 12 years before the disease is diagnosed, developing as well the disease's familiar comorbidities all the while.
What can PTs do? Obviously the profession's promotion of physical activity and healthy diet are among the profession's best opportunities to make a difference, but PTs can also contribute to efforts to catch the disease early. Myslinski suggested one very easy way to stay on top of a potential diagnosis: regularly check the blood pressure of the children you work with.
In her presentation on CVD, Anne Mejia-Downs, PT, MPH, said that the PT's role is "all about managing risk factors." She explained how physical activity can not only slow the development of vascular plaque, but how, as part of an overall lifestyle change, plaque can actually be reduced. Coupled with the PT's ability to function as an effective teacher and lifestyle counselor, the profession's role in treating CVD should not be ignored.
When it comes to the ways in which movement and activity can affect CVD, "we are the experts," Mejia-Downs said. "We should be educating the rest of the health care team."
The PT's important role in chronic disease is emphasized in the 2015 House of Delegates adopted position Health Priorities for Populations and Individuals (RC 11-15). APTA members will be able to view videos of all open sessions of the 2015 House of Delegates online after sessions are edited to account for executive sessions. Final language for all actions taken by the House will be available by September after the minutes have been approved.
Last Updated: 6/8/2015
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