Physical therapists and physical therapist assistants (PTAs) under the direction and supervision of a physical therapist are the only providers of physical therapy services. In many practice settings, physical therapists rely on the PTA to assure that all patients/clients have access to physical therapy services. Physical therapy has a long history of returning individuals to their maximum level of physical function and in many cases, patients are being sent to physical therapy instead of surgery. Patients/clients value the individualized, "hands on" approach that characterizes physical therapy care. When a physical therapist sees a patient/client for the first time, he or she examines that individual and develops a plan of care that promotes the ability to move, reduces pain, restores function, and prevents disability. The physical therapist may choose to utilize a PTA in the provision of components of the physical therapy treatment. The physical therapist, PTA, and the patient/client then work side-by-side to make sure that the goals of the plan or care are met.
Depending on the particular needs of a patient/client, physical therapists may direct components of a patient/client's interventions (treatments) to a PTA. PTAs provide a variety of physical therapy techniques as they carry out the physical therapist's plan of care for the patient, including therapeutic exercise, functional training, deep soft tissue massage, and physical modalities such as electrotherapy and ultrasound. PTAs may also assist the physical therapist by working with individuals to prevent loss of mobility by implementing fitness- and wellness-oriented programs for healthier and more active lifestyles.
Typical Day of a Physical Therapist Assistant
The physical therapist assistant works closely with a supervising physical therapist to provide quality, evidence-based patient/client care. Once the physical therapist has completed the patient examination and a diagnosis has been determined, the physical therapist designs a plan of care that includes short- and long-term functional goals. The physical therapist may choose to provide all of the interventions (treatment) or utilize a PTA to provide some or all of the interventions identified in the plan of care. Interventions that a PTA may perform includes, but is not limited to, therapeutic exercise, traction, massage, ultrasound, electrotherapy, balance and gait training, motor learning and development, and patient and family education. Interventions will often include the use of assistive and adaptive devices such as crutches, wheelchairs, orthotics, and prosthetics. An important component of patient interventions involves teaching the patient appropriate ways to move or perform particular tasks to prevent further injury and to promote health and wellness.
PTAs also provide the physical therapist with information about the patient's response to treatment, including objective data documented in the patient's medical record. PTAs are trained to respond to emergency situations in the clinical environment.
In addition to patient/client care, PTAs often participate in activities related to billing and coding, quality improvement, risk management, and other administrative activities within the department or facility.
PTA Work Settings
The vast majority of PTAs, approximately 72%, work in hospitals or privately owned physical therapy practices. Others work in home health, schools, and rehab units. 28% of PTAs work part-time.
Acute Care - In this setting, physical therapy is provided to individuals who are admitted to a hospital for short-term patient care for reasons such as illness, surgery, accident, or recovery from a trauma. The goal in this setting is to discharge the person as soon as he or she is medically stable and has a safe place to go.
Rehab/Sub Acute Rehab
- Rehabilitation Hospital - In this setting, physical therapy is provided to individuals who are admitted to a facility or rehabilitation unit. The goal is this setting is to provide intense therapy to improve the person's ability to care for himself or herself (typically 3 hours or more per day).
- Sub-Acute Rehabilitation - In this setting, physical therapy is provided to individuals who are admitted to a special hospital that provides medical and/or rehabilitation care. The rehabilitation is less intense (typically less than 3 hours per day).
Extended Care Facility /Nursing Home/Skilled Nursing Facility - In this setting, physical therapy is provided to individuals who are admitted to a facility that typically cares for elderly patients and provides long-term nursing care, rehabilitation, and other services.
Outpatient Clinic (also known as a Private Practice) - In this common physical therapy setting, individuals visit a physical therapist in a clinic, office, or other health care facility primarily to address musculoskeletal (orthopedic) and neuromuscular injuries or impairments.
School/Pre-school - In this setting, physical therapy is provided within an educational environment, including pre-school, elementary, or secondary education (high school and vocational) facilities.
Wellness/Prevention/Sports/Fitness - In this setting, physical therapy is provided to individuals with a focus on wellness. This approach to health care emphasizes preventing illness and injury and promoting a healthy lifestyle, as opposed to emphasizing treatment of diseases. Settings may include but aren't limited to fitness centers and sports training facilities.
Home Health - In this setting, physical therapy is provided in the patient's place of residence. While the majority of patients are senior citizens, there also are pediatric patients with developmental disabilities and other conditions, and individuals of all ages who need rehabilitation because of injury or other causes. Home care may actually be provided in the patient's residence, the caregiver's home, a hospital emergency room, skilled nursing facility, residential facility, group home, hospice, or elsewhere in the community.
Hospice - In this setting, physical therapy is provided to patients in the last phases of incurable disease so that they may maintain functional abilities for as long as possible and manage pain.
Industrial, Workplace, or Other Occupational Environments - In these settings, physical therapy is provided to individuals primarily to help them return to work or for the purpose of enhancing employee health, improving safety, and increasing productivity in the workplace.
Local, State, and Federal Government - In these settings, physical therapy is provided to civilians and military personnel. PTAs are employed by federal agencies, including the Veteran's Health Administration (VHA), Department of Defense, and Indian Health Service (IHS).
Research Center - In this setting, physical therapists and other professionals conduct research to improve patient/client care outcomes and support the body of knowledge in the field physical therapy.
Some of the Conditions Treated by Physical Therapists/ PTAs
Explore APTA's official consumer information website, MoveForwardPT.com, to see some the numerous symptoms and conditions treated by physical therapists, which include:
- Back Pain
- Carpal Tunnel Syndrome
- Developmental Delays
- Chronic Obstructive Pulmonary Disease (COPD)
- Hand Injuries
- Pelvic Pain
- Sports Injuries
- Traumatic Brain Injury (TBI)
There is a high demand for physical therapist assistants in the workforce despite the economic downturn. According to the Bureau of Labor Statistics, employment of physical therapists is expected to grow by 35 percent from 2008 to 2018, much faster than the average for all occupations. The need for PTAs is expected to increase into the foreseeable future as the U.S. population ages and the demand for physical therapy services grows.
More than 68,000 physical therapist assistants are licensed in the U.S. today. The median salary for a physical therapist is $45,000 depending on position, years of experience, degree of education, geographic location, and practice setting. (Source: APTA 2009 Median Income of Physical Therapist Assistants Summary Report.)
After graduation from an accredited physical therapy education program* candidates must pass a state-administered national exam to obtain licensure or certification required in most states. Other requirements vary from state to state according to physical therapy practice acts or state regulations governing physical therapy. Visit the Federation of State Boards of Physical Therapy (FSBPT) Web site for more information about PTA licensure/certification requirements.
* The Commission on Accreditation in Physical Therapy Education (CAPTE) is the only accrediting agency recognized by the US Department of Education.
Physical therapist assistants have the opportunity to become recognized for advanced proficiency through APTA. Through the recognition program, physical therapist assistants demonstrate their achievement of a greater depth of knowledge and experience related to a particular area of physical therapy. The recognition program is voluntary and PTAs are not required to be recognized in order to work in a specific area.
Future of Physical Therapy
APTA's vision statement for the physical therapy profession is "Transforming society by optimizing movement to improve the human experience." The guiding principles to achieve the vision demonstrate how the profession and society will look when the vision is achieved.
In Their Words
The inspirational Defining Moment column of APTA's PT in Motion magazine spotlights a particular moment or incident that led the writer to a career in physical therapy or reinforced why he or she became a physical therapist or physical therapist assistant. Read the columns or download the podcasts.
The following "PTAs Today" columns from APTA's PT in Motion magazine (formerly PT Magazine) illustrate some of the unique career paths taken by PTA members.
Aquatic Physical Therapy: Get Wet (.pdf)
Sports Medicine Physical Therapy: Sporting Duel Credentials (.pdf)
Neurologic Physical Therapy: Many Happy Returns (.pdf)
Working as a Traveling PTA: On the Road Again (.pdf)
PTA Career Growth and Development: Climbing the Career Ladder (.pdf)