Physical therapy, occupational therapy, and speech therapy are three related disciplines in rehabilitation that work together to treat patients as a whole. Each discipline has a different focus, but there are some areas of overlap. For patients with injuries or medical conditions that limit their physical capabilities, a combination of the three therapies can help restore their life.
When a patient walks into the Rehab Select clinic, specialists from all three disciplines will evaluate the patient to understand the areas of opportunity that could be addressed through therapy. Our physical therapists, occupational therapists, and speech therapists make up a team with open lines of communication. Together, they formulate a treatment plan for the patient and continuously collaborate throughout the course of the treatment.
“Each of the three different types of therapists guides patients through a developmental sequence to achieve the highest possible level of mobility and functioning possible given their individual circumstances,” says Beth Ann Roseberry, Rehab Select's Therapy Director.
Physical Therapy
“At Rehab Select, physical therapists focus on strengthening the lower extremity, the part of the body from the hip to the toes,” Roseberry said.
Physical therapy helps patients move from restoring the most basic mobility to progressively more challenging types of movement and physical function. Physical therapy focuses on:
- Bed mobility (rolling from side to side)
- Going from laying down to sitting up
- Sitting on the side of the bed
- Balance
- Weight shifting
- Gate training (putting one foot in front of the other and walking)
- Lower extremity strengthening, including range of motion and muscle strengthening
- Wheelchair independence
Physical therapists also evaluate the patient for needs with adaptive equipment. Patients may need canes, walkers, splints, braces, or other types of adaptive equipment to help them move.
Occupational Therapy
“Occupational therapists at Rehab Select focus on upper body strengthening and coordination, the activities of daily living (ADLs) and the Instrumental Activities of Daily Living (IDLs),” Roseberry says.
The difference between physical and occupational therapy is that occupational therapy strives to help patients not just with mobility but the functioning of everyday life. There are certain activities that are essential for basic survival and well-being, as well as more complex types of tasks that are important to daily life. This discipline focuses on:
Activities of Daily Living (ADLs) – activities that are essential to basic survival and well-being, such as:
- Feeding
- Grooming
- Hygiene
- Dressing
- Bathing
- Toilet transfers
- Tub transfers
Instrumental Activities of Daily Living (IADLs) – more complex activities that support daily life such as:
- Cooking
- Cleaning
- Laundry
- Shopping
- Driving
- Care of pets
- Care of others
Occupational therapists also teach patients compensatory strategies, which are techniques or modifications to behavior that make it easier for patients to do a particular activity. For example, an occupational therapist might teach a patient an energy conservation technique such as alternating light and heavy activities to make it possible for the patient to complete various activities during the day.
Identifying adaptive equipment to use is also one of the key compensatory strategies. Adaptive equipment is any tool or device that assists with daily living. An occupational therapist might assess whether the patient needs a bedside commode, an elevated toilet seat, a handheld shower, elastic shoelaces to make it easier to put on their shoes, or a special type of utensil with a different grasp for eating.
Another important area of occupational therapy is safety judgment, which is the ability to make sound judgments about how to safely perform an activity. For example, an occupational therapist might teach a patient with high blood pressure to better understand whether they need to stay still for a minute after standing before walking to make sure that they don’t feel faint.
Speech Therapy
Speech therapy focuses two areas of function: swallowing and cognition. Speech therapists will help patients gain better capacity to swallow food or drink water. This might include making sure the water is going into the stomach and not the lungs or determining whether the patient can’t drink liquids but needs to drink fluids that have a nectar consistency. Speech therapists may do studies such as a FEES (fiber endoscopic esophageal study) by placing a tube up the patient’s nose that contains a tiny camera to view parts of the patient’s throat as they swallow. Through speech therapy, the patient may also undergo electronic stimulation to strengthen the muscles in the throat.
Speech therapy also helps patients that are suffering from problems with cognition, which are the mental processes of gaining information, comprehending it, and making decisions. There are many cognitive skills that could be affected by injury or a medical condition, especially conditions of aging such as dementia or Alzheimer’s. Speech therapists work with patients on key cognitive issues such as:
Orientation – Helping patients understand who they are, where they are, the time and date, and what’s happened to them.
Sequencing – Helping patients with the capacity to understand and execute a set of actions in a particular order.
Memory – Helping patients develop compensatory strategies for memory deficits, such as ways to retrieve the word they can’t remember.
Working As a Team
There are many areas of overlap between the three different disciplines of physical therapy, occupational therapy, and speech therapy. Safety judgment is a key component of both speech therapy and occupational therapy. Cognition is a major part of speech therapy but can also be the domain of an occupational therapist. Physical therapy and occupational therapy both deal with mobility, though occupational therapy also has the important added dimension of helping patients function in daily life.
“At Rehab Select, our physical therapists, occupational therapists, and speech therapists work together to gain a detailed picture of the patient as a whole person,” Roseberry said. “Throughout the course of treatment, our therapists in the three different disciplines will meet weekly to discuss each patient and their progress, sharing ideas, observations, and strategies that help move the treatment plan forward. These weekly meetings help ensure that our team is both supporting each other and not duplicating efforts, resulting in a team-based care plan that best serves the patient and their families.” Schedule a tour of Rehab Select today.
