Health Occupations
Physical Therapy
Specialty Module
Designed by:
Jim Tracy MS PT
Lori Tracy MS PT NCS
East Carolina University
Department of Physical Therapy
Sponsored by
Eastern Area Health Education Center
In collaboration with
Office of Generalist Programs at
East Carolina University Brody School of Medicine
and
The North Carolina Department of
Public Instruction
Introduction
Welcome to the physical therapy specialty
module. You have decided to undertake a very
challenging endeavor. The purpose of this
module will be to acquaint you with the major
clinical areas in which physical therapists
practice by doing observation and
demonstrations. We hope after this experience
you will be more excited than ever about
pursuing a career in physical therapy.
How to use this module
Read through this PowerPoint presentation
 Click on Links
 Links include videos from this CD and links
to Websites
 This is designed to be a student directed
learning activity
 After review of this material you should be
able to meet most of the objectives of this
specialty module

Student Goals of Module
Complete all required objectives
 Keep a journal of your clinical experiences
 Gain an understanding of the four areas of
clinical practice in physical therapy
 Demonstrate specific objectives as outlined

How long do I need to go to
school to become a physical
therapist?
Physical therapy programs are either masters level
(MPT) or entry level doctoral programs be required to
complete an undergraduate (DPT).
You can get a degree in the field of your choice as long
as certain prerequisites are met.
Start inquiring when you are first starting college about
the specific requirements of the school(s) you are
interested in attending.
Link: Introduction to the Physical Therapy Profession
(website)
Definition of Physical Therapy
These links provide the student with some
definitions of Physical Therapy
Links:
Definition of Physical Therapy (website)
Another Definition of Physical Therapy (website)
North Carolina Physical Therapy Practice Act
(website)
American Physical Therapy
Association “APTA”
This link provides information on the American
Physical Therapy Association
Links:
American Physical Therapy Association (website)
Physical Therapy Practice
Includes Four Main Areas:
Cardiovascular
 Musculoskeletal
 Neurological
 Integumentary (skin)

Let’s Get Started
Medical Terminology
You should have a basic understanding of medical
terminology, the link below will give you an
overview. The following links will give you an
introduction to medical terminology
Links:
Medical terminology (website)
Medical terminology (website)
Vital Signs
Vital signs are pulse, blood pressure
and respiration. You should be able
to monitor each of these
Important points about taking a
patient’s pulse
Count a patient’s pulse for 15 sec then
multiply by 4
 Pulse is measured in beats per minute
 Never take a pulse with your thumb
 Don’t press too hard or you will occlude the
pulse
 Note the rhythm, rate and force

Pulses
The links below shoe the therapist monitoring
each of these pulses
Links:
Brachial artery (video)
Radial artery (video)
Carotid artery (video)
Femoral artery (video)
Measuring pulses (website)
Blood Pressure
The website link below will take you
through the steps to accurately measure
blood pressure and the video will
demonstrate correct technique
Links:
Measuring blood pressure (website)
Measuring blood pressure (video)
Patient Transfers
The links below will demonstrate correct transfer
techniques for each of the following transfers
Links:
Supine to sit (video)
Standing pivot transfer (video)
Squat pivot transfer (video)
Sliding board transfer (video)
Dependent transfer (video)
Two person floor to mat transfer (video)
Assist floor to mat (video)
Ankle Taping
The links below demonstrate correct
technique for ankle taping and a link
to the National Athletic Trainers
Association Webpage
Links:
Ankle taping (top view)
Ankle Taping (side view)
Ankle taping (website)
NATA (website)
Bones
This link has anatomical models of all
the bones of the body
Links:
Bone box (website)
Massage
Definition: The scientific manipulation of
the soft tissue (skin and muscle) with the
purpose of increasing blood supply,
increase tissue flexibility, decreasing
edema, decrease pain and provide
psychological benefits
Massage
The links below demonstrate basic massage
strokes
Links:
General Massage for Low Back (Video)
General Massage for Low Back (Video top view)
The art of massage (website)
Passive Range of Motion
(PROM)
Clinical Definition: Therapist moves selected
joint(s) through full range of motion with no
assistance from the patient
Important points on passive range
of motion
Adequately stabilize patients joints as you
move them. (some patients may have no
active movement)
 Don’t cause pain other than stretching
 Perform 5-10 motions per joint movement
 Familiarize yourself with normal directions
and degrees of movement for each joint
 Listen to patient

Passive Range of Motion
(PROM)
These links demonstrate correct technique when
doing passive range of motion on a patient
Links:
PROM Upper extremity (video)
PROM lower extremity (video)
Passive range of motion techniques(website)
Goniometric Measurement
Measurement of joint motion by the
therapist using a goniometer
Important points on Goniometric
measurement
Motions measured can be either active or
passive
 Standardized techniques are used for each
joint
 Normal ROM measurements can be found
in charts
 Joints should be adequately stabilized
during measurement

Goniometric Measurements
These links show the therapist demonstrating
goniometric measurement for the selected
movements
Links:
Wrist extension (video)
Elbow flexion (video)
Knee flexion (video)
Hip abduction (video)
Goniometric examples (website)
Manual Muscle Testing (MMT)
Definition: subjective testing done by
the therapist to assess a patients
muscle strength. The muscle strength
is graded to be either normal, good,
fair, poor, trace or zero
Muscle Grades
Normal: patient holds contraction against maximal resistance
at end range
Good: patient holds contraction against moderate resistance
at end range
Fair: patient moves through full range of motion against
gravity but unable to hold against resistance at end range
Poor: patient moves through full range of motion in a gravity
minimized position
Trace: therapist palpates muscle contraction as patient
attempts to move
Zero: therapist is unable to palpate any muscle contraction as
patient attempts to move
Muscle Grades
Normal =
Good =
Fair =
Poor =
Trace =
Zero =
5/5
4/5
3/5
2/5
1/5
0/5
Important points on manual
muscle testing
Need to place patient in standardized
position
 Isolate only one joint motion
 Don’t allow patient to compensate for
weakness
 Compare same muscle bilaterally
 Be consistent and reliable with testing

Manual Muscle Testing
The following links demonstrate correct
manual muscle testing
Links:
Shoulder flexion (video)
Elbow flexion (video)
Hip flexion (video)
Knee extension (video)
Muscle testing (website)
Muscle testing examples (website)
Types of Muscle Contractions
Isometric: muscle stays at same length during
contraction ex: pushing against an immovable
object like arm wrestling
 Concentric: Muscle shortens during contraction
ex: biceps during arm curls
 Eccentric: Muscle lengthens during contraction.
Ex: quadriceps when going down steps
This link discusses the different types of muscle
contractions used in functional activities
Link :
Types of muscle contractions

Muscle Attachments
This link gives you all the muscle attachment
of every muscle in the body
Links:
Muscle attachment list (website)
Functional Movements

Describe the muscle contractions of the
muscles in the lower extremities during this
functional movement. Click here
Dermatomes
Definition: specific areas areas on the skin
that represent sensory innervation from a
specific root level
Important points when testing
dermatomes
Refer to dermatome chart for specific areas
 Testing is usually done with a blunt object
(paperclip) or a pin.
 Compare same area on opposite side
 Ask patient is it the same increased
(hypersensitive) or reduced (hyposensitive)

Dermatomes
These links demonstrate correct sensory testing of
the dermatomes and a dermatome chart. Links:
Pinwheel test instrument (video)
Upper extremity sensory testing (video)
Dermatome Chart (website)
Cutaneous innervation (website)
Dermatome testing (sensory testing) (website)
Learn your nerves (website)
Two Point Discrimination
Patient is tested on how well they can
discriminate between on and two
points using this instrument
(click here)
Important points when testing
2-point discrimination
Pressure to both points must be equal
 Usually done on the hand where
discrimination is important to fine motor
control
 Patient should be able to discriminate points
as close together as 2-3 mm on hand
 Is a measure of dorsal column integrity

2-Point Discrimination
These links demonstrate correct
testing of 2 point discrimination
Links:
2-pt testing on arm (video)
2-pt testing on hand (video)
Proprioception
These links show the therapist performing
proprioceptive testing
Links:
Wrist proprioception (video)
Ankle proprioception (video)
Big toe proprioception (video)
Reflexes


Represent
monosynaptic reflex
loop at spinal levels
Check integrity of
lower motor neuron
loop at specific spinal
levels
Reflexes
These links describe reflex testing and show the
therapist demonstrating reflex testing
Links:
Monosynaptic reflex arc (Website)
Triceps reflex (video)
Biceps reflex (video)
Brachioradialis reflex (video)
Knee jerk reflex (video)
Knee jerk reflex (video)
Achilles reflex (video)
Important points when testing
reflexes
Use light grip on reflex hammer
 Compare bilaterally
 Grade as normal hyperactive or hypoactive
 Results are used with dermatome to
determine spinal root problem

Posture Body Mechanics and
Lifting
Links:
Posture (video)
Normal curves (video)
Straddle lift (video)
Tripod lift (video)
Golfer’s lift (video)
Ergonomics (website)
Balance
Definition: Maintaining center of mass within
your base of support
Other Terminology used to describe balance:
Center of Gravity
Equilibrium
Cone of Stability
Balance
The following links will help you understand
balance related to functional activities and some
ways therapists test a patient’s balance
Links:
Practicing Balance (website)
Falls in elderly (website)
Dynamic sitting balance (video)
Dynamic sitting balance (top view) (video)
Berg Balance Assessment (video)
Gait
Other terms used to describe gait:
Ambulation/Locomotion
Controlled movement of your base of
support.
Gait Assessments
Determining safety and efficiency of
ambulation.
These links will demonstrate the therapist
performing gait assessment tests
Links:
Timed Get up and Go Test (video)
Dynamic Gait Index (video)
Gait with Assistive Devices
Determining appropriate assistive device is based
upon: Client safety, client preference,
impairment/injury, and environmental
circumstances
 Types of devices may include:
 Straight Cane
 Quad Cane (Large or Small)
 Walker (Standard or wheeled)
 Hemiwalker
 Crutches (Axillary/Loftstrand)
Physical Therapy and Gait
Training
Determining appropriate device
 Measuring device for proper fit
 Education of gait with assistive device
 Sitting, standing and balancing with
assistive device
 Progression of gait to include environmental
surfaces client will encounter during daily
activities.

Device Fitting and Ambulation
These links will demonstrate correct
instruction and assistance with gait
Links:
Measurement of Device (Video)
Gait Patterns:
Two point reciprocal gait pattern (Video)
Gait with standard walker (video)
Crutch training non-weight bearing swing to(Video)
Crutch training non-weight bearing swing through (video)
Stair training with crutches non-weight bearing (video)
Thermal Modalities
Modalities used to increase
circulation (vasodilatation), increase
tissue extensibility, decrease pain
Thermal Modalities
Hot packs
 Diathermy
 Fluidotherapy
 Ultrasound
 Microwave
 Infrared
 Whirlpool
 Paraffin
These links will describe physiological rationale for
thermal modalities
Links: Introduction to Thermal Modalities (website)
Thermal agents (website)

Cryotherapy
The use of cold modalities for the purpose
of vasoconstriction to produce a decrease
in the following: cell metabolism,
inflammation, pain and muscle spasm
These links will describe physiological rationale for use
of cold modalities
Links:
Cryotherapy (website)
Another Cryotherapy (website)
Electrical Modalities
The use of electrical current for
specific physiological effects on the
body such as contraction of muscle,
reduction of pain, diagnostic purposes
wound healing decreased spasticity
Electrical Modalities
These links will describe physiological rationale for
use of electrical modalities and some description of
different uses of electrical stimulation
Links:
Electrical therapeutic modalities (website)
Transcutaneous Electrical Stimulation (TENS) (website)
TENS (website)
Wound Management
Physical therapists are often involved in the
treatment of wounds that are caused from trauma,
infection , diabetes or circulatory problems.
Wound Care
These links describe different kinds of
wounds and explain how to best treat them
Links:
Selection of Dressings (website)
World Wide Wounds (website)
Wound care information (website)
Wound Care institute (website)
Wound Care Strategies (website)
Cultural Competency
This link provides extensive information on
different cultures
Links:
Cultural competency (website)
Another site cultural competence (website)
Interpersonal Communication
Skills
Patient Interaction
Communication with Health Professionals
Note Writing
Interpersonal Communication
This link provides some tips to better
communicate with patients
Links:
Interpersonal communication (website)
Physical Therapy Note Writing
These links show examples of medical notes
using the S.O.A.P. format
Links:
Documenting patient care (website)
S.O.A.P. Notes (website)
S.O.A.P. Notes (website)
Case Studies
The following links are case studies for you to
review
Links:
Total Hip replacement case study (website)
Information about total hip replacement
(website)
Wound Management case study (website)
Self Study Test
When you have finished the specialty
module you are ready to take this 50
question Self Study Test
Link: Self Study Test
Conclusion
You have now completed this
specialty module in physical therapy.
Please fill out the evaluation for this
module by clicking on this link.
Course Evaluation