Physical therapy: Experience vs. equipment

One of the questions we hear quite frequently as therapists involves the importance of equipment versus experience. Equipment plays an important role in the recovery process, though it is not, in our view, the defining role. When available, sophisticated equipment can be a great tool for patients’ recoveries. Some equipment can help or provide “another set of hands” to aid therapists so they can concentrate their skills while the equipment supports patients.

For example, those who have had a stroke and experience significant weakness or paralysis affecting one leg can benefit from an overhead track or harness to support them while they work on walking. A harness allows therapists to use their hands to offer physical guidance and assistance with specific components of a gait instead of supporting patients’ body weight.

Equipment also can help quantify patients’ abilities, such as a machine that measures balance and balance reactions. The machine supports patients as they are challenged in a variety of ways (movement, sway, visual elements). A report that can be generated during and after treatment shows their abilities and, hopefully, will show improvement. This information can benefit the patient, provider and insurance company. In addition, people often enjoy using equipment, which can add variety, specificity and novelty to physical therapy.

However, therapists’ experience plays a crucial role in patients’ recoveries. As with any other business or profession, we learn a lot “on the job.” Experienced therapists are likely better at using all the information gathered in an examination to critically analyze and quickly determine the best course of treatment.

Experienced therapists may also have more and varied tools to approach patients’ problems from more than one angle. In addition, continuous education may help us become better listeners and educators and more sensitive to patients’ different needs.

We don’t think recovery will be slowed by older equipment, as equipment is only one of many tools available to therapists. If they lack the expertise to best treat the patient, however, therapists must refer the patient to another provider. Ultimately, the goal of therapy is to transition patients to an exercise and activity program they can safely perform at home or in the community when therapy is done. Access to equipment may be limited to clinical settings, so we have to know how to achieve and maintain great results with and without equipment to make sure transitions are successful.

To provide great care, physical therapists must use all tools available to them to treat patients. They must analyze and incorporate patients’ goals, preferences and motivations into the plan. They must add their expertise into treatment recommendations and use resources in the clinic, community and patients’ home to achieve the desired outcome.

If you or your patients don’t have access to state-of-the art equipment, we suggest the following tried-and-true therapy interventions:

• Walk in clinics, on sidewalks, up/down inclines, up/down stairs to work on gait, aerobic conditioning and strength
• Stand/walk on grass, foam pads or other compliant surfaces
• Balance drills like side stepping, obstacle courses, reaching/throwing
• Use resistance like body weight (push ups, sit to stand), dumbbells, cuff weights or resistance bands/tubing

None of these options require highly-specialized equipment.

Skilled and experienced therapists critically analyze evaluation results and develop individualized treatment plans. Some of the best treatments require therapists to touch, mobilize or manipulate joints, muscles or tissue. Your experience, therefore, will always be your greatest asset—and will certainly be the best tool you have to offer to those who need you.

Kristy Brown, MS, CCC-SLP has more than 25 years of management experience as CEO/ President of Centrex Rehab and formerly executive director of therapy services at Augustana Therapy Services. Brown can be reached at kbrown@CentrexRehab.com.

Debbie Hanka, PT, DPT, GCS, CEEAA, is a clinical program and education specialist at Centrex Rehab and has spent more than 20 years as a physical therapist. Hanka can be reached at dhanka@CentrexRehab.com.

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