Historical Introduction to Physical Therapy
This is historical introduction to physical therapy essay. There were two events in history that helped create the profession of physical therapy. The poliomyelitis epidemics and the disease and injuries caused by World War 1 and World War 2. The Reconstruction Era which took place prior to world War 1 between 1914 and 1919, during this time is when physical therapy had its beginning. Americans thought of disability as irreversible, but due to the large number of men returning home from the war with disabilities, the concept of irreversibility was changed.
The first major polio outbreak took place in New York in 1916. The only treatment being done around this time was bed rest, isolation, and splinting and casting of the persons legs, which ended up weakening the patient’s legs and back, which then required the patient to have some form of exercise and physiotherapy. Marguerite Sanderson and Mary McMillan were the first two reconstruction aids that made a big contribution to the physical therapy profession. Marguerite Sanderson graduated from the Boston Normal School of Gymnastics and later was appointed as supervisor of reconstruction aides. She was in charge of recruiting and training aides, as well as sending them to Europe to help the wounded troops. In 1922 Sanderson married and withdrew. The training program for the reconstruction aides took place at the Walter Reed General Hospital and was assigned to an aide named Mary McMillan. Between 1919 and 1920 the number of physical therapy reconstruction aides was reduced due to a major postwar decrease in military hospitals. On January 15, 1921 McMillan and 30 former reconstruction aides became the first association of PTs, which was called the American Woman’s Physical Therapeutics Association. At the first conference in 1922 the name was changed to the American Physiotherapy Association, due to the organization recognizing both men and women as capable of doing the profession. New schools were also opened around this time at Harvard Medical School and in New York City. In 1923 after the association had gained recognition, McMillan stepped down and that is when Inga Lohne became president. In 1926 the Committee on Education and Publicity was formed to draft the minimum standard curriculum for schools offering a complete course in physical therapy, which was later published in 1928. In 1930 there were 11 schools that met or exceeded the minimum standards set by the committee. By 1934 there were 14 approved physiotherapy schools. In 1916 the American Physiotherapy Association had to confront the polio epidemic which resulted in many infantile paralysis cases. By 1934 approximately 2500 cases of polio were treated at just on hospital, which was the los Angeles County General Hospital. In 1929 the great depression closed down many hospitals and medical practices reducing the amount of physical therapy services. In 1952 the Salk vaccine was created by Jonas Salk and was later approved for commercial production in 1955.
In the 1960s the due to the expanding amount of elderly and the growing amount of people becoming more health conscious, the demands for PTs and physical therapy services grew in demand. By 1965 and 1966 due to the introduction of the medicare and Medicaid programs, the demand for services sky rocketed. As a result in 1967 the APTA introduced a policy statement that created the PTA position and helped make the programs to be able to train people for the position. In 1969 the first 15 PTAs graduated with associate degrees from Miami Dade College and College of St. Catherine. By 1973 eligible PTAs were admitted as affiliate members in the national association. During the 1970s and 1980s the physical therapy profession continued to expand. Due to the establishment of OSHA by the department of labor, physical therapy practices related to prevention, work management, and job injuries and compensation also developed. In 1975 the individuals with disabilities education act was passed, which helped physical therapy expand into treatment of children with disabilities in public schools. In August 1997, President Clinton signed the balanced budget act to eliminate the medicare deficit. Which then took effect in 1999, it applied an annual cap of $1500 per beneficiary for all outpatient rehabilitation services. As a result there was a huge reduction in rehabilitation services. Many graduate PTs and PTAs had a difficult time finding jobs or getting hours. In 2005 the effects of the balanced budget act of 1997 were still influencing the future of rehab services. Providers and patients urged congress to eliminate the threat that seniors and individuals with disabilities would have to pay out of pocket for services. In march 2010, the patient protection and affordable care act became a law. It included a healthcare reform and package that extended the therapy cap exception process until December 31, 2010.
From 2006 to today, the roles of physical therapists have become more dependent on the application of the scientific method in clinical practice and finding new evidence-based approaches for disease prevention and health promotion. PTAs were delegated with important responsibilities as the only individuals permitted to assist PTs in selected interventions.
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