The Movement System: Don't Miss the Boat
By Sue Whitney, PT, DPT, ATC, PhD, FAPTA, board-certified neurologic clinical specialist
In many ways, those of us in the physical therapy profession are like the crew on a ship—a collection of individuals with many different areas of expertise, all of whom are important for keeping the ship operational and moving forward.
You could think of other health professions in the same way—each a crew member of a ship that sails as part of the health care fleet. And to be sure, we have a lot in common with other professions because we sail in the same waters.
But we also have a distinctive set of knowledge, skills, and tools that we use to optimize human movement, promote health and wellness, mitigate the progression of impairments, and to prevent additional disability. Our ship makes it possible to accomplish that goal, and being a crew member makes it easier for us to explain our unique contribution to ourselves and others.
Our ship keeps us moving forward together as we explore new horizons in practice, education, and research. But what is our ship exactly?
I say we're all crew on the SS Movement System. And now it's time to set sail. The Movement System is ready to move, and we need all hands on deck.
A quick history
Hopefully, the Movement System is a familiar term by now. But just in case, here's a little background.
In June 2013, our House of Delegates (House) adopted the following new vision for our profession: "Transforming society by optimizing movement to improve the human experience."
Along with this vision statement, the House adopted guiding principles to articulate how the profession and society will look when the vision is achieved. The first guiding principle, "identity," states the following:
"The physical therapy profession will define and promote the movement system as the foundation for optimizing movement to improve the health of society. Recognition and validation of the movement system is essential to understand the structure, function, and potential of the human body. The physical therapist will be responsible for evaluating and managing an individual's movement system across the lifespan to promote optimal development; diagnose impairments, activity limitations, and participation restrictions; and provide interventions targeted at preventing or ameliorating activity limitations and participation restrictions. The movement system is the core of physical therapist practice, education, and research."
In response to the House action, an APTA Board of Directors (Board) work group developed a 2-part definition of the movement system that was reviewed, modified, and approved by the Board.
The first part of the definition succinctly describes the movement system.
"The movement system is the term used to represent the collection of systems (cardiovascular, pulmonary, endocrine, integumentary, nervous, and musculoskeletal) that interact to move the body or its component parts."
The second part of the definition describes the relationship of the movement system to physical therapist practice.
"Human movement is a complex behavior within a specific context.
- Physical therapists provide a unique perspective on purposeful, precise, and efficient movement across the lifespan based upon the synthesis of their distinctive knowledge of the movement system and expertise in mobility and locomotion.
- Physical therapists examine and evaluate the movement system (including diagnosis and prognosis) to provide a customized and integrated plan of care to achieve the individual's goal-directed outcomes.
- Physical therapists maximize an individual's ability to engage with and respond to his or her environment using movement-related interventions to optimize functional capacity and performance."
With a definition in place, the Board next created a Movement System Task Force to begin implementing an action plan recommended by the work group to [do what]. The Movement System Task Force first convened the Movement System Summit in December 2016. At the summit, the action plan was reviewed, revised, and adopted for implementation. Since that time, information about the movement system has been presented in many sessions at national meetings and in APTA publications.
Important next steps—with your help needed
But now we've reached a critical juncture—and we need your contribution.
In the past year, 2 sub-groups of the Movement System Task Force began to address 2 specific items from the action plan: drafting a process for developing movement system diagnoses, and developing a movement system screen. These important documents are now ready for your input.
Here's what we're asking: review 2 draft movement system templates and provide your feedback by June 1. The instructions for each one, though slightly different, are easy to follow.
Movement System Diagnosis Template
Step 1: Open the online draft diagnosis template and fill in the fields to submit an example of a movement system diagnosis (examples provided within the draft template): Online Draft Movement System Diagnosis Template.
Provide feedback about the draft movement system diagnosis template.
Movement Screen Template
Step 1: Download the movement screen, a tool designed to detect movement impairments observed during functional tasks/activities that will help therapists decide which additional tests and measures to include in the patient and client examination: Draft Movement System Screen Template (.pdf). (You are not expected to fill out and submit this template.)
Provide feedback about the draft movement screen template.
Your input will help shape the future of the movement system as it becomes more widely applied across the profession.
So please, come aboard, and together let's move full steam ahead.
Sue Whitney chairs the APTA Movement System Task Force
Planning on attending the NEXT Conference and Exposition June 12-15? Be sure to check out the special Movement System presentation track.
Tell Your Patient's Story: Tips for Defensible Documentation
By Donna Diedrich, PT, DPT, and Jaclyn Warshauer, PT
As physical therapists (PTs), you've no doubt heard the saying, "The work is not done until all the paperwork is done." However, this often is easier said than done. While you're highly trained professionals who identify with a doctoring profession, you may at times struggle to effectively communicate your expertise. The challenge is multiplied when you consider the components that constitute an accurate and timely record of skilled physical therapist services, as well as the audiences it reaches such as physicians, payers, patients, and consultants if/as indicated.
Effective documentation must provide details related to the therapy episode, outlining the complex factors that necessitate skilled PT services for your patient or client. This includes specific medical necessity and skilled service interventions that require the unique skills of a physical therapist or physical therapist assistant—skills that cannot be provided by other health care providers.
When documenting your services, it helps to consider 2 questions: Why now? And why you?
Why Does This Patient Need PT Services Now?
To address" why now," consider what caused the patient visit and within what timeframe, as well as how the symptoms presented. Did Mrs Chen fall this past weekend with resulting stiffness and new-onset low back pain (LBP)? Or did she fall 3 months ago and is now experiencing exacerbation of chronic LBP secondary to arthritis that is not responding to usual care?
As you gather facts supporting the timeframe, you need to include relevant medical and psychosocial events that may be influencing the patient's presentation. For example: Is Mr Sanchez's hip replacement new or longstanding? Is he recently widowed, and was his spouse his primary caregiver? Is his current functional limitation influenced by both recent hip surgery and underlying complications from Parkinson disease?
Tell the story to relate the functional history to the current limitation of impairments. For example: "Prior to fall and hip fracture, Mrs Davis was independent in community mobility and driving, including attending church regularly with navigation up and down 12 steps without assistive devices. Her current limitations 1 week post fall surgical repair of left hip fracture with weight bearing as tolerated includes need for front-wheeled walker and contact guard to minimal assist of 1 for 25' level ground mobility, minimal assist of 1 and bilateral handrail for 2-3 step navigation and inability to drive."
Why Does This Patient Require Your Skilled PT Services?
Demonstrate the "why you" component with a thorough assessment that captures the patient's goals, uses differential diagnosis to identify the musculoskeletal and/or neurological causes integrating symptom and movement presentation, and aligns interventions with your physical therapist scope of practice. This skill needs to be evident in the written documentation of tests and measures used to rule in—or rule out—causes and how, based on evidence, you determine the most appropriate intervention intensity, exercise dosing, frequency, and duration.
It's critical to remember that "skilled" services must be complex and sophisticated enough, or the condition of the patient complex enough, that the treatment could be safely and effectively performed only by a physical therapist or a physical therapist assistant. Below is an excerpt from a denial-of-payment letter from the Centers for Medicare and Medicaid Services (CMS) (emphasis added):
The progress made does not support the need for ongoing PT. The patient could have been placed on a maintenance program with periodic assessment to determine progress. No new therapeutic techniques, compensatory strategies, or effective cueing were identified or implemented during these service dates. The documentation failed to support that the services provided were at a level of complexity and sophistication that the unique skills of a licensed therapist were necessary for their delivery.
This statement supports progress; however, it emphasizes that the physical therapist failed to justify the "why you?" component of need. Place yourself in the shoes of the reviewer as you write the progress note. Ensure you not only describe what the patient did, but clearly and succinctly communicate what you measured, analyzed, adjusted, fabricated, adapted, facilitated, and/or educated, and that it was at such a level to require your skills and expertise. Make sure to include the tests and measures you use and relative comparisons to normal values for a population similar to your patient.
Payment Is Not Necessarily Linked to Patient Progress
Remember that progress alone is not a requirement for payment. CMS reminded us via the 2013 Jimmo Settlement Agreement that payment for skilled therapy services can be medically necessary not only to restore function but to maintain it or to prevent or slow deterioration. But to justify your services, documentation must state the expertise, knowledge, clinical judgement, and decision making used that only a physical therapist can provide. This is needed whether progress is noted or your skills and analysis are required to maintain or deter decline.
Consider the following examples of documentation to support the restoration of function or maintenance of mobility:
Important, But Unskilled
Demonstrates Skill and Expertise
|Patient ambulated 50' with a wheeled walker and minimal assistance.
||Minimal assist to ambulate 50’ with front-wheeled walker. Required manual facilitation to stabilize right pelvis/hip during stance phase and verbal cueing for right toe clearance during swing phase for safe forward mobility on level surfaces.
Documentation can be daunting, but you know your patient's medical, psychosocial, and environmental story. It's up to you to paint a complete picture of the episode of care for payers.
Donna Diedrich, PT, DPT, is vice president of clinical operations at Aegis Therapies. She is a board-certified clinical specialist in geriatric physical therapy. Jaclyn Warshauer, PT, is the national director of medical review and quality services at Aegis Therapies.
For more information on this topic, visit APTA's Defensible Documentation webpage.
Switching Your Game Plan for Reporting MIPS Data This Year? Some Dates You Need to Know
First-quarter data collection for the Merit-based Incentive Payment System (MIPS) has just ended. If you are a participating physical therapist who doesn't yet have a firm plan for *how* to submit your data, or you need a new plan, you have some decisions to make-and soon.
CMS Allows Providers to Switch Reporting Methods
As a refresher, there are 3 ways to report MIPS data:
- Claims-based. Improvement activities need to be entered manually through the CMS website.
- Qualified registry. This includes many electronic health record (EHR) vendors.
- Qualified Clinical Data Registry (QCDR), such as APTA's Physical Therapy Outcomes Registry. QCDRs offer more measures than qualified registries.
Here are some possible scenarios you may find yourself in.
- You're moving from claims-based MIPS reporting to reporting through your new EHR system that integrates with the Physical Therapy Outcomes Registry.
- You're already reporting via an EHR system and receiving a quarterly MIPS score but thinking about signing up with a QCDR to get rregular feedback that could improve your MIPS score and possibly offset your investment through a potentially increased payment incentive.
- You're not required to participate in MIPS but are considering joining the Registry in order to monitor your MIPS performance and decide whether to participate in 2020.
(And if you aren't sure if you are required or eligible to do so, you can check your participation status using this tool from CMS.)
Key 2019 Deadlines
If you are considering APTA's Physical Therapy Outcomes Registry, here are some key 2019 deadlines to keep in mind.
June 30: Registry enrollment deadline for 2019. While APTA accepts new enrollees in the Registry all year long, physical therapists who wish to submit data to CMS as part of the 2019 MIPS reporting year (which will determine the payment incentive or penalty for 2021) must indicate their intent to do so by enrolling in the Registry by June 30, 2019.
July 1: Registry enrollment opens for the 2020 reporting year. You can beat the rush by enrolling earlier rather than later, ensuring your participation.
December 31: Data collection concludes for the 2019 reporting year. This will be followed by the actual data submission process.
Get our detailed annotated list of MIPS milestones for 2019 and 2020.
What Else You Should Be Thinking About
Does your current EHR integrate with the Registry? Here is a list of participating EHRs. If you want to participate and your EHR isn't listed, check with Registry staff at email@example.com.
Monitor your MIPS score regularly! Whatever your reporting mechanism, you should check your MIPS score regularly. Checking your stats on at least a quarterly basis will help you make needed adjustments throughout the year to maximize your payment incentive.
Collect data, all the time. If you decide on June 1 that you are going to sign up with the Registry, either to participate in MIPS or to monitor your potential MIPS score, you'll need to have that data. On a practical note, APTA Director of Quality Heather Smith, PT, MPH, says, "Collecting and reviewing your data on a regular basis is crucial to understanding and communicating your practice's performance and the value you bring to the table."
The bottom line? If you're still on the fence about participating in the Physical Therapy Outcomes Registry, reach out to APTA's MIPS experts at firstname.lastname@example.org. We are here to help you.
Financial Literacy Month Podcast: Improve Your Personal Financial Health With APTA Member Benefits
Student loans are a source of stress, not only for current students but for physical therapists and physical therapist assistants in the workforce. APTA provides 2 valuable resources to help members make educated financial decisions. Enrich is an individualized financial education platform that teaches members about money management, financial services, credit scores, and planning for retirement. Laurel Road is a student loan refinancing program that provides a discounted interest rate for eligible APTA members.
In a new podcast, Kevin Soehner, of Enrich, and Alex Macielak, from Laurel Road, offer tips on managing your debt and planning your financial future. "It's never too early to get started on your strategy, where you are, and where you want to be," says Macielak.
Listen to the interview to learn how to:
- Ask the right questions when choosing student loans and exploring repayment options
- Manage loans and other debt once you've graduated
- Balance student loan repayment with supporting a family and buying a home
- Decide when it makes sense to invest your cash vs aggressively pay down loans
Soehner and Macielak emphasize that no single strategy will lead to achieving financial health, because everyone's situation is unique. Enrich and Laurel Road can empower members as they navigate the seemingly complex topic of personal finance and develop a strategy that works for them. Because, Soehner notes, "Student loans shouldn't dictate your financial plan."
Learn more about these and other member value programs at www.apta.org/ValuePrograms/.
Listen to the full podcast here.
[Editor's note: APTA continues to advocate for student debt relief options on Capitol Hill, too, and is a strong supporter of a bill that would include PTs among the professions included in the National Health Services Corps (NHSC). NHSC providers can receive relief for up to $50,000 in student debt.]
Building a Strong PT-PTA Relationship: What One Award-Winning Team Has to Say
From left to right: Jodi Maron Barth, PT; APTA President Sharon L. Dunn, PT, PhD; and Gincy Lockhart Stezar, PTA, at NEXT 2018
Jodi Maron Barth, PT, and Gincy Lockhart Stezar, PTA, co-owners of the Center for Facial Recovery in Rockville, Maryland, received the 2018 APTA Outstanding PT-PTA Team Award. They also are clinical instructors and members of the Maryland Physical Therapy Association House of Delegates. #PTTransforms interviewed Barth and Stezar for their insights into building a strong PT-PTA relationship.
#PTTRANSFORMS: Jodi, to start off, how and why did you became a PT?
Jodi Maron Barth: I was a high school athlete and really wanted to do something with sports medicine. My cousin was a physical therapist, and he said, "You don't want to be an athletic trainer, you want to be a physical therapist, because you can do a lot more." I graduated from Ithaca College and started out at an acute care hospital, Albert Einstein, in the Bronx, where because of rotations I had great exposure to all areas of service.
Later on, I was still geared to the sports medicine side of things and got bored. I started doing more with spines and manual therapy. When I was working with low back patients, I noticed that their feet were a problem, and I started specializing in orthotics assessments. Later, I began evaluating the jaw.
Currently I specialize in treating temporomandibular joint (TMJ) disorders. About 10 years ago one of my referring docs asked me if I could do anything for a patient who had an acoustic neuroma and developed facial palsy. I had to do some research and training, and Gincy and I combined the skills and techniques we learned with our background in manual therapy to develop our own technique using neuromuscular reeducation.
#PTTRANSFORMS: Gincy, what was your journey to becoming a PTA like?
Gincy Lockhart Stezar: I have a degree from the University of Maryland, and I was fitness director for NASA. When I was working with the employees, they were always coming in injured and complaining about one thing or another. And I was always going to my anatomy book and saying, "If it hurts when you're doing this and this is the muscle involved, you probably shouldn't be doing this; you should be doing that."
I realized I loved solving those problems, so while I took time off to raise my 2 children, I decided to pursue a PTA degree. There was a program at Montgomery College, which was close to where I live. I decided that I wanted to work with patients, and it was something where I wouldn't have to go back for 4 years of training. I interviewed in 2004 at MedStar National Rehabilitation Hospital (NRH). Jodi became my mentor.
JMB: I was a regional director and ran a couple of clinics. At the same time, I was trying to see a fairly full load of facial palsy and TMJ patients that nobody else knew how to treat. I thought Gincy had great hands-on skills and the potential to become a super PTA. It was a perfect opportunity to train Gincy on what I was doing, and she acted as an extender of my treatment to allow us to see more patients and give them more quality time.
#PTTRANSFORMS: How did you come to found the Center for Facial Recovery?
JMB: The center was formed out of passion. I was heading toward the administrator track at NRH, and I didn't want to do that. Gincy was running one of the clinics. We both love patient care—that's why we went into this profession—and we knew there was a need for treatment for facial palsy patients. Not too many therapists have an expertise in facial palsy and, honestly, not many therapists want to work with this population. But we do. Of all the patients we have treated through the years, facial palsy patients are the most cooperative. All they want to do is get better, and it's such a team approach between us and the patient.
#PTTRANSFORMS: So do you only treat patients with facial palsy or do you see other patients as well?
GLS: We also see former patients from time to time who come to us for treatment for cervical, low back pain, and other orthopedic dysfunctions.
JMB: Most of our patients are kind of head-to-toe patients. There's not just a jaw problem. It's not just a shoulder problem. But our specialty, and where we feel we shine, is treating facial palsy and TMJ patients.
#PTTRANSFORMS: When you were nominated for the APTA Outstanding PT-PTA Team Award, several people mentioned your mutual trust and respect. If I were to see you in operation as a team, how would I see that manifested?
GLS: Jodi does the evaluation and she sets up the plan of care. We've worked together for so long that once she sets the plan of care, we just take it from there.
JMB: We treat the patient together. I'll start with one patient and she'll finish with that patient, or she'll start treatment with one patient and I'll finish with that patient. We believe patients should get the best of both worlds.
One of our patients said once—because when we "hand off" we physically hand off—that it was such a smooth transition, he didn't even realize that Gincy's hands were on him versus my hands until he saw me talking to someone else.
GLS: Even though Jodi is doing the evaluation, I'm recording a lot of the information and hearing as much as Jodi is about what the patient's aches and pains, complaints, and concerns are. I'm not starting treatment with a patient without knowing anything about them other than what's written down. I get to know them from the very beginning—and they also get to know me.
#PTTRANSFORMS: You both also are clinical instructors, is that right?
#PTTRANSFORMS: It's so funny that you answer at the same time!
JMB: It happens all the time.
#PTTRANSFORMS: Has your working relationship like always been as strong and collaborative as it is now, or has it grown over time?
GLS: I definitely think it's congealed. The attraction in the beginning was that we had a very similar philosophy of care. I liked the way Jodi treated her patients—I thought that was the way patients should be treated. As time went on it came into a natural ebb and flow of treatment. She doesn't have to tell me all the time: "You need to do this. You need to do that." I know this is what needs to be done, and what the next steps will be. We've worked together long enough that we know what each other is thinking.
JMB: I would say also that our work ethic is the same. So no one is working harder than the other. And, even though she has a PTA degree, [when we first started working together] Gincy was diligent about looking things up and asking a lot of questions. She worked hard to get up to her current performance level.
GLS: The other thing that's helpful is that we take classes together. We come back with the same knowledge, and that reinforces our collaboration.
#PTTRANSFORMS: Do you also conduct research together?
JMB: We do. With the help of some great supporters, we've established a nonprofit foundation geared toward research for facial palsy and TMJ. We've published articles together. Many years ago, we actually went to Italy to teach therapists there how to treat facial palsy.
We also teach workshops with the performing artists at schools such as the University of Maryland and Penn State and have presented at conferences for the National Association of Teachers of Singers.
#PTTRANSFORMS: What would you say is the most important element in building a healthy strong PT-PTA collaboration?
GLS: Communication and respect. I feel respected by Jodi even though I don't have a physical therapist degree. She instilled in me that, just because I don't have that degree, it doesn't mean I can't think.
JMB: I think, [for a PT], the willingness to learn from a PTA. And for the PTA to realize [he or she] is not a technician. Many PTAs I've worked with were happy with putting on the hot pack, doing electrical stimulation, doing some massage, teaching some exercises, and sending the patient on their way. Gincy wanted to learn more. She wanted to be the best that she could be.
#PTTRANSFORMS: Jodi, what advice would you give another PT who might be struggling to form a better more effective or supportive relationship?
JMB: PTs should go into the relationship open-minded and take each person as an individual. If that PTA is there for them, the PT should be responsible for getting them up to the level of care that the PT is providing.
#PTTRANSFORMS: Gincy, what advice would you give a PTA?
GLS: Show what you have to offer, and show your interest. Find someone you have a good rapport with, and who respects you, and will listen to you—and build on that.
Your PTA brain is equal to any PT's brain. You just have limitations on your evaluation and discharge, and that sort of thing.
JMB: But I do think the PTA needs to do due diligence: You have to do reading, you have to do research, get into continuing education. Going to classes with the PT is very helpful, because we learn those new skills together. There has to be a give and take, but there also must be respect—and that, I think, has to come from the PT.
Tell Your Story on Capitol Hill at the APTA Federal Advocacy Forum
By Katy Neas
The Federal Advocacy Forum is right around the corner (March 31-April 2, 2019), and you're not going to want to miss it.
This year is a historic year for APTA advocacy: For the first time in more than 2 decades, the Medicare therapy cap is not the lead priority on the association's public policy agenda. Thanks to you, the hard cap has been permanently addressed. But more work remains.
Our nation is at a crossroads between health and the health care delivery system. Too many Americans are limited by chronic conditions such as diabetes, hypertension, and obesity. Too many people with disabilities struggle to secure appropriate support services that allow them to live independently in the community. Too many lives have been shattered by opioid addiction. Our health care system too often pays for treating illness rather than advancing the wellness and prevention services necessary to achieve and support good health. The United States spends more per capita on health care than any other developed country, yet our citizens are limited by poor health. This must change.
Daunting though these challenges may seem, progress is possible through effective advocacy. Your elected officials need to hear directly from you about your efforts to build a community that advances the profession of physical therapy to improve the health of society. The Federal Advocacy Forum will enable you to make your collective voices heard on the issues affecting physical therapy and your patients and clients.
The APTA 2019–2020 Public Policy Priorities are grounded in 4 overarching goals. The association wants Congress and the Administration to:
- Enact policies that empower people to live healthy and independent lives,
- Eliminate barriers to health care services,
- Support efforts to increase efficiencies in the delivery of health services that reduce administrative burden to providers and ensure transparency to patients, and
- Prioritize research and clinical innovation to access appropriate value-based health care services.
When you come to Washington, DC, next month, you'll have the opportunity to share your expertise with Congress. There are many new faces on Capitol Hill: 10 new senators and 101 new members of the House of Representatives. Some of these individuals may not be expert in health policy and may not understand fully the contribution this profession makes to children, adults, and seniors in their community. They may not realize how specific policy changes could impact the health of their constituents.
That's why your stories are so important. In addition to asking legislators to support specific bills, you will want to educate them about your practice, your area of expertise, and how you empower your patients to achieve positive outcomes. I can assure you, when they know more about you, what you do, and who you serve, they will be impressed.
Have no fear—the APTA government affairs staff will provide you with all the tools that you'll need to make this Federal Advocacy Forum the best one yet!
Finally, please accept a note of sincere thanks from me. I have seen the significant contribution that physical therapists make in acute hospitals, critical care units, inpatient rehabilitation facilities, and home health over the past 7 months, as my husband continues a very long recovery from Guillain-Barré syndrome. During his 179 days in a hospital, I have witnessed the strength and grace of the physical therapists who have helped him regain strength after each of his 5 relapses. Each of these amazing professionals played critical roles in his recovery—teammate, coach, cheerleader, advocate, and friend. I will always be grateful. My family's experience only reinforces my commitment to APTA's work to expand patient access to physical therapist services and to secure fair and adequate payment for these important interventions.
I look forward to seeing you in March, and I thank you for all that you do!
Katy Neas is executive vice president, public affairs, at APTA.
To attend the Federal Advocacy Forum, register now at www.apta.org/FederalForum. Registration closes March 18.
Vision, Courage, Compassion: Black Physical Therapists Who Transformed the Profession
Photos courtesy of American Physical Therapy Association Archive. From left: Lynda Woodruff, Vilma Evans, Arnold Bell, Thelma Brown Pendleton, Mary McKinney Edmonds, and Leon Anderson.
For this Black History Month, we dug into APTA's Archive to take a look back at some truly ground-breaking African American physical therapists who achieved greatness despite obstacles, transforming the profession along the way. Now deceased, they offer us all examples to strive for as individuals and as a profession, urging us to keep "moving forward" and challenge the status quo.
Lynda D. Woodruff, PT, PhD, was a trailblazer since 1962 when, at age 13, she was 1 of 2 African American students to desegregate E. C. Glass High School in Lynchburg, Virginia—an experience that greatly influenced her approach to life: "I could never trust anyone. I ceased asking by the time I was 14 for help, because if you asked for it, and they gave you something, 9 times out of 10 it would be the wrong information, or the wrong feedback. And that was more detrimental than having no feedback."
After receiving her master of physical therapy degree from Case Western Reserve University, Woodruff went on to become the first African American to join the physical therapy department at University of North Carolina at Chapel Hill. She was a founding director of the department of physical therapy at North Georgia State College and established the first DPT program at Alabama State University. She joined the faculty of Georgia State University in 1978, where she received her PhD. Woodruff was appointed to the appointed Georgia State Board of Physical Therapy and served for 10 years. As an APTA member, Woodruff was a strong advocate for diversity and inclusion, helping to establish APTA's Advisory Council on Minority Affairs, as well as for true mentorship, especially for women and minorities.
Woodruff was a founding member of the Section on Clinical Electrophysiology, at a time when PTs who conducted electromyography testing were being charged with practicing medicine without a license. She received numerous awards for her leadership, including the Lucy Blair Service Award. In recognition of her many achievements, the Georgia Senate declared February 24, 2006, as Dr Lynda D. Woodruff Appreciation Day.
One of Woodruff's mentors, Mary McKinney Edmonds, PT, PhD, FAPTA, had originally intended to be a physician. But just a few weeks from her 1953 graduation from Spelman University, Edmonds attended a lecture by physical therapist Wilmotine Jackson. "[Jackson] spoke about raging polio epidemics, and I just got totally excited," Edmonds said in an oral history recorded for APTA. She earned her physical therapy certificate from the University of Wisconsin. Before the phrase "social determinants of health" was popularized, she noticed how black and white women with diabetes who came to rehab would have above-the-knee amputations vs toe amputations, leading her to complete graduate degrees in sociology at Case Western Reserve University. During her postdoctoral fellowship at University of Michigan, Edmonds examined how social class affected people's experiences with health and health care.
Edmonds founded Cleveland State University's physical therapy program, was dean of Bowling Green State University's College of Health and Community Services, and was vice provost at Stanford University, as well as a professor at Stanford Medical School. She was a prolific author and presenter on issues related to cultural competency throughout her career. As a member of the APTA Commission on Accreditation (precursor to the Commission on Accreditation in Physical Therapy Education), Edmonds helped lead the fight for autonomy from the American Medical Association. Edmonds was the first African American PT to become a Catherine Worthingham Fellow of the American Physical Therapy Association.
Edmonds was hired for her first physical therapy position by Leon Anderson Jr, PT, who was then chief physical therapist at Highland View Hospital in Cleveland, Ohio. Anderson, who completed his degree in physical education at Johnson C. Smith University, didn't know much about the profession before he attended physical therapy school at Boston University, he just knew he "didn't want to preach or teach"—prominent professions for black Americans at the time. Ironically, after getting his master's degree in education, Anderson did spend several years as an assistant professor at Case Western Reserve University. After 20 years as director of physical therapy at University Hospitals of Cleveland, Anderson left to start a private practice with 6 colleagues. The first African American member of APTA's board of directors, Anderson held more than 15 elected positions at APTA throughout his career and chaired the Advisory Council on Minority Affairs.
Thelma Brown Pendleton, PT, and Vilma Evans, PT, EdD, were among the first black physical therapists in the United States. Pendleton originally was a nurse; although she aspired to be a PT, black students were not allowed to enroll in physical therapy programs at the time. In the mid-1940s she was finally able to enroll at Northwestern University and get her PT certificate, becoming the fifth African American PT. She founded and headed the physical therapy program at Provident Hospital and later was chief physical therapist at La Rabida Children's Hospital and Research Center. Pendleton also supervised clinical instructor education programs at Northwestern University for many years, and was an active member of the Illinois Physical Therapy Association.
Evans was born in New York City, attended school in Jamaica, and returned to New York for high school. Like Brown Pendleton, Evans had a hard time applying to PT school due to her race. She earned a degree in zoology from Hunter College, a physical therapy certificate from University of Pennsylvania in 1951, a master's in physical therapy in 1956 from New York University, and later a doctorate in education. Evans was director of physical therapy at St Elizabeth Hospital in Danville, Illinois, for 26 years. A lifetime APTA member, she received the Illinois Chapter's Outstanding Service in Physical Therapy Award in 1976 and APTA's Lucy Blair Service Award in 1985, and was a member of the APTA sections for education, geriatrics, and health policy and administration. Early on, Evans decided she "wanted to be part of the ‘inner workings' [of APTA] because that's that way I—or anyone else—could make changes. Members can't all sit on the outside and expect someone else to carry on. If you want change in your organization, you have to get involved."
Arnold Bell, PT, PhD, ATC, was one of the first African American ABPTS-certified clinical specialists in sports physical therapy. Born in the Bronx, he earned his bachelor's degree from Springfield College, a physical therapy certificate and a master's degree in exercise science at Columbia University, and a PhD at Florida State University. He established Florida A & M University's physical therapy program, teaching there for over 30 years. Bell was an athletic trainer at the 1984 and 1996 Olympic Games, and was inducted into the Springfield College Olympic Alumni Hall of Fame and the Florida A & M Sports Hall of Fame. A longtime APTA member, Bell was a member of the Advisory Committee on Minority Affairs.
Another PT with an Olympic connection was Theodore "Ted" Corbitt, PT, MPT, Army veteran, professor, and clinician for 44 years at the International Center for the Disabled in New York City. After returning from World War II, Corbitt earned an MA in physical therapy from New York University (NYU)—and 2 years later became the first African American Olympic marathon runner to represent the United States. He is known as the "father of American distance running." A professor at Columbia University for 20 years, he was one of the first PTs to teach connective tissue massage, proprioceptive neuromuscular facilitation, progressive resistance exercise, and applied kinesiology. Always setting records, Corbitt walked 303 miles in a single 6-day race—at age 82. Corbitt was active in the New York Chapter of APTA. Read more about this American pioneer.
Another NYU graduate, Roberta F. Cottman, PT, MEd, from Greensboro, North Carolina, received her bachelor's degree from Bennett College in 1945. According to her oral history, "as a young black woman" it was not possible for her to attend North Carolina medical schools. So she went to PT school. For one of her clinicals in a New York state-owned rehab facility, she was not allowed to stay in the dormitory with the white students and had to stay in a private home. She found that, once she entered the field, "nobody cared then what color you were or where you came from. As long as you knew your skills and were able to translate that…into clinical practice." Later, as director of the physical therapy department at Henry Ford Hospital in Detroit, she hired a PT named Jane S. Mathews-Gentry, PT, MS—who later became APTA president.
Cottman received a scholarship from APTA to pursue her doctorate and was the first female student in the department of anatomy at Wayne State University in Michigan. However, the physical therapy department asked her to assist them as they navigated a crisis, and she never finished her dissertation. Still, she became a tenured professor there.
A charter member of APTA's Committee on Minority Affairs, Cottman also served on the Congressional Black Caucus' Health Braintrust, was a consultant to members of the US Congress, and attended the United Nations Fourth World Conference on Women, held in Beijing in 1995. She observed that health care in the United States is not a human right but "is still based on privilege and the ability to pay. We must begin to look at individuals and the issues of health which surround our citizens, not wait until they become ill."
Do you know of a PT or PTA who deserves to be recognized? Do you have your own stories to share? Let us know in the comments.