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New Quizlet Question
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New Quizlet Question - January 6, 2001 4:44:00 PM
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Randy Moore
Posts: 103
Joined: July 6, 1999
From: Columbus, OH USA
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For more information about the quizlet question (at the bottom of this page, or on the home page), or to read the full position statement follow this link: [URL=http://www.apta.org/PT_Practice/PatientClient_Management/Use_of_Personnel_/Excl]www.apta.org/PT_Practice/PatientClient_Management/Use_of_Personnel_/Excl[/URL]
[This message has been edited by Randy J Moore (edited January 06, 2001).]
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Re: New Quizlet Question - January 7, 2001 1:32:00 PM
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edilling
Posts: 139
Joined: January 10, 2000
From: pullman,wa,usa
Status: offline
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The position of the APTA (and apparently many of those who participate in this forum) is that PTA's should not be allowed to perform peripheral or spinal mobilization.
Are patients in any more danger if these techniques are performed by a PTA vs PT? Is it that PTA's just cannot handle performing the techniques?
It is my position that a properly trained PTA can and should be allowed to perform mobilization. It is the responsibility of the PT to ensure the safety of the patient by determining if the PTA they work with is appropriately trained. It is also the PT's responsibility to screen for contraindications and precautions prior to treatment and to be resonably sure that the PTA can recognise if they may need more guidance.
Those of you who agree with the APTA, please explain the reasoning.
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Re: New Quizlet Question - January 7, 2001 1:42:00 PM
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Barrett
Posts: 967
Joined: July 28, 1999
From: Cuyahoga Falls, Ohio
Status: offline
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I work alone and therefore don't really have to worry about this, but unless peripheral joint mobilization has changed remarkably since I taught it back in the 70s, I'm certain that it's safer than classic passive ROM in several instances. This is mainly due to the leverage employed. I can't see why it's thought to be potentially dangerous, if that is in fact the origin of this decision.
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Re: New Quizlet Question - January 8, 2001 3:37:00 AM
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mcap
Posts: 652
Joined: February 8, 2000
Status: offline
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Group:
I would have to say that I don't see why PTAs cannot perform peripheral joint mobilization. After all, PROM is a joint mobilization anyway (a physiological as opposed to an accessory mob). Where are we going to draw the line.
I would also have to say that too many in our profession treat joint mobilization as some mystical, all healing super powerful weapon. I will admit that many experienced manual therapists work and study really hard to learn their craft. They seem to get really good results. But they need more research to demostrate that they are feeling what they think they feel and to demonstrate long term outcomes.
I also think that some therapists apply manual techniques without enough thought as to what they are really doing. For example, I have heard therapists tell me that they need to increase the ROM of L1-L2 relative to L5-S1 without any idea as to what the norms are from the research. Or PTs who try and force frozen shoulders that clearly aren't going to move.
Let me step off of the soap box. I guess what I am trying to say is that anyone who applies force to a patient should be concientious, know what they are doing, know the supporting research, and be concious of potential risks as well as benefits. This applies to physiological as well as accessory motion. If it is a PT or a PTA they should be responsible enough to know what they are doing. If a PT is supervising a PTA they he/she needs to feel comfortable with that person's skill level and capabilities. If they are, then I don't see why they can't do it. And therapists should not be forcing manual therapy when it isn't warrented.
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Re: New Quizlet Question - January 16, 2001 9:15:00 AM
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SamCopp
Posts: 10
Joined: January 31, 2000
From: Bolivar, MO. USA
Status: offline
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Dear Group:
I educated PTA's for 4 years out west and found the following practical matters at work:
1-we did not have the time to properly educate the students in the use of mobilization, and saturation occurred just teaching them the myriad of ther. exercise procedures
2-the APTA did not take a strong stand at the time, so we put the responsibility onto the individual clinics to train them by way of CEU courses
3-our staff thought that it involved continual evaluation with its daily use and that it was above the entry-level assessment scope of the PTA
4-we maintained policies within our program that we needed to document a minimal competency of each student for each type of treatment before they entered clinic-we could not show this outcome after the demonstrations and brief overview that we gave.
Hope this helps explain the liability side of teaching a student something that was in the gray zone before the APTA stance was established.
The same thing occurred with wound debridement at that time, since not even our state regs. were clear as to whether even a PT could perform sharps...so we sided on the conservative side, deciding to only introduce the student to it and let the facility take the responsibilty for it.
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Re: New Quizlet Question - January 18, 2001 5:25:00 AM
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edilling
Posts: 139
Joined: January 10, 2000
From: pullman,wa,usa
Status: offline
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While PTA's may not be educated in joint mobilization at entry level the question remains:
Why is performing joint mobilization outside the scope of practice for PTA's? Is there anyone willing to explain their (or the APTA's) position.
I was not instructed on orthotic Rx, manipulation, sharp debridment... yet all of these are within my scope of practice.
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Re: New Quizlet Question - January 18, 2001 5:26:00 AM
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edilling
Posts: 139
Joined: January 10, 2000
From: pullman,wa,usa
Status: offline
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While PTA's may not be educated in joint mobilization at entry level the question remains:
Why is performing joint mobilization outside the scope of practice for PTA's? Is there anyone willing to explain their (or the APTA's) position.
I was not instructed on orthotic Rx, manipulation, sharp debridment... yet all of these are within my scope of practice.
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