The body of knowledge of physical therapy is large, and therefore physical therapists may specialize in a specific clinical area. While there are many different types of physical therapy, the
American Board of Physical Therapy Specialties lists ten current specialist certifications. Most physical therapists practicing in a particular specialty will have undergone further training, such as an accredited
residency program, although individuals are currently able to sit for their specialist examination after 2,000 hours of focused practice in their respective specialty population, in addition to requirements set by each respective specialty board.
Cardiovascular and pulmonary Cardiovascular and pulmonary rehabilitation
respiratory practitioners and physical therapists offer therapy for a wide variety of cardiopulmonary disorders or pre- and post-cardiac or pulmonary surgery. An example of cardiac surgery is
coronary bypass surgery. The primary goals of this specialty include increasing endurance and functional independence. Manual therapy is used in this field to assist in clearing lung secretions experienced with
cystic fibrosis. The treatment of pulmonary disorders,
heart attacks, post
coronary bypass surgery,
chronic obstructive pulmonary disease, and
pulmonary fibrosis can benefit from cardiovascular and pulmonary specialized physical therapists. It may be both safe and effective in improving physical and possibly mental state, while reducing disability with few adverse events. Other commonly used interventions include exercise, edema control, splinting, and compression garments. The work done by physical therapists in the integumentary specialty is similar to what would be done by medical doctors or nurses in the emergency room or triage.
Neurology Neurological physical therapy is a field focused on working with individuals who have a
neurological disorder or disease. These can include a stroke, chronic back pain, Alzheimer's disease,
Charcot-Marie-Tooth disease (CMT),
ALS, brain injury,
cerebral palsy,
multiple sclerosis,
Parkinson's disease,
facial palsy and spinal cord injury. Common impairments associated with neurologic conditions include impairments of vision, balance, ambulation,
activities of daily living, movement, muscle strength and loss of functional independence. The techniques involve in neurological physical therapy are wide-ranging and often require specialized training. Neurological physiotherapy is also called
neurophysiotherapy or
neurological rehabilitation. It is recommended for neurophysiotherapists to collaborate with psychologists when providing physical treatment of movement disorders. This is especially important because combining physical therapy and psychotherapy can improve neurological status of the patients.
Orthopaedics Orthopedic physical therapists diagnose, manage, and treat disorders and injuries of the
musculoskeletal system, including rehabilitation after
orthopedic surgery, acute trauma such as sprains or strains, and injuries of insidious onset such as tendinopathy, bursitis, and deformities like
scoliosis. This specialty of physical therapy is most often found in the outpatient clinical setting. Orthopedic therapists are trained in the treatment of post-operative orthopedic procedures, fractures, acute sports injuries, arthritis, sprains, strains, back and neck pain, spinal conditions, and amputations. Joint and spine mobilization/manipulation,
dry needling (similar to
acupuncture), therapeutic exercise, neuromuscular techniques, muscle reeducation, hot/cold packs, and
electrical muscle stimulation (e.g.,
cryotherapy,
iontophoresis,
electrotherapy) are
modalities employed to expedite recovery in the orthopedic setting. Additionally, an emerging adjunct to diagnosis and treatment is the use of
sonography for diagnosis and to guide treatments such as muscle retraining. Those with injury or disease affecting the muscles, bones, ligaments, or tendons will benefit from assessment by a physical therapist specialized in orthopedics.
Pediatrics Pediatric physical therapy assists in the early detection of health problems and uses a variety of modalities to provide physical therapy for disorders in the pediatric population. These therapists are specialized in the diagnosis, treatment, and management of infants, children, and adolescents with a variety of congenital, developmental, neuromuscular, skeletal, or acquired disorders/diseases. Treatments focus mainly on improving
gross and
fine motor skills,
balance and coordination, strength and endurance as well as cognitive and
sensory processing/integration.
Sports Physical therapists are closely involved in the care and wellbeing of athletes, including recreational, semi-professional (paid), and professional (full-time employment) participants. Sports injuries can be anything from minor problems like sprains and strains to more serious ones like joint instability or tendinitis. The ideal physical treatment for sports injuries is quite specific and is determined by the athlete's history, recovery objectives, and the kind and severity of the injury. This area of practice encompasses athletic injury management under 5 main categories: • Acute care – assessment and diagnosis of an initial injury; • Treatment – application of specialist advice and techniques to encourage healing; •
Rehabilitation – progressive management for full
return to sport; • Prevention – identification and address of deficiencies known to directly result in, or act as precursors to injury, such as
movement assessment • Education – sharing of specialist knowledge with individual athletes, teams, or clubs to assist in prevention or management of injury Physical therapists who work for professional sports teams often have a specialized sports certification issued through their national registering organization. Most physical therapists who practice in a sporting environment are also active in collaborative sports medicine programs (see also
athletic trainers).
Women's health Women's health and
pelvic floor physical therapy mostly address women's issues related to the female reproductive system, child birth, and post-partum. These conditions include lymphedema, osteoporosis, pelvic pain, prenatal and post-partum periods, and urinary incontinence. It also addresses pelvic pain, pelvic organ prolapse and other disorders associated with
pelvic floor dysfunction. Manual physical therapy has been demonstrated in multiple studies to increase rates of conception in women with infertility.
Oncology Physical therapy in the field of oncology and palliative care is a continuously evolving and developing specialty, both in malignant and non-malignant diseases. Physical therapy for both groups of patients is now recognized as an essential part of the clinical pathway, as early diagnoses and new treatments are enabling patients to live longer. it is generally accepted that patients should have access to an appropriate level of rehabilitation, so that they can function at a minimum level of dependency and optimize their quality of life, regardless of their life expectancy.
Musculoskeletal and point-of-care sonography Physical therapists may be credentialed by the APCA in musculoskeletal and point-of-care sonography as sonologists performing and interpreting ultrasound examinations. == Physical therapist–patient collaborative relationship ==