With so much information available, it’s understandable why descriptions about types of physical therapy can be confusing.
Not only is it important for patients and caregivers to understand the categories and specifics, but students seeking to learn more about PT will find this information helpful.
It is highly recommended that potential students see several settings to determine what they most enjoy.
Although diving into this information might create additional questions, the number of opportunities in the field of physical therapy require a deeper look.
In This Article
Types of Physical Therapy Specialties
Although the word “types” is used readily when people attempt to describe or inquire about physical therapy, I have realized that most questions pertain to either PT specialties or settings.
Types might be an umbrella term but is often used when there is not a full understanding of what is available.
First, we will look at the main specialties of physical therapy.
Specialties are not actually based on PT treatment but rather a medical diagnosis, like a category.
These are recognized by insurance, and each brings a specific plan for treatment in physical therapy.
A diagnosis is given by a medical doctor and involves a specific system of the body, or sometimes more than one.
While there are numerous specialties of PT, these are the top three categories that are commonly treated in physical therapy.
1. Orthopedics
This category includes any focus on the skeletal system which includes the bones.
Since bones are moved by muscles, the complete musculoskeletal system is the involvement for orthopedics.
Situations in this specialty can include accidents, injuries, congenital situations, and numerous other areas.
Treatment in this category can include surgical repair. From a PT standpoint it includes strengthening and flexibility, range of motion, and stability. This is true whether there was surgery or not.
2. Neurology
Neurology includes situations that pertain to the brain and nervous system.
Some common neurological diagnoses are stroke, multiple sclerosis, Parkinson’s disease, and diabetic neuropathy.
This is a challenging category and may involve a variety of symptoms which can be equally difficult to treat from a PT standpoint.
It also often involves a change or lack of mental focus which is important to address.
3. Cardiology
This specialty involves anything that pertains to the heart, veins, arteries, for circulation of the blood.
Some common diagnoses in this specialty are heart attack, coronary artery disease, and high blood pressure.
Cardiology can bring on symptoms such as dizziness and shortness of breath.
Please be advised that these symptoms can also come readily under other types of specialties as well.
Types of Physical Therapy by Age
The next two specialties are age-related and can involve any of the body systems.
Because there is a need for definitive identification and treatment, these populations are recognized as specialties rather than lumped into one group with others.
While we all have the same body systems, there are specific focuses and needs depending on what stage of life we are in.
An overall view is to keep fit no matter what age you are.
1. Pediatrics
While this specialty is often listed as a type of PT, it is based on age, not diagnosis.
Pediatrics is described as the field that includes children, usually to age eighteen.
This is not a description of a particular body system, but is a specialty based on kids having needs for diagnosis and treatment versus adults.
Whether by physician or therapist, children usually require a different focus than the general population.
Especially when considering PT treatment, children have specific needs.
2. Geriatrics
Just as with pediatrics, geriatrics is a type of physical therapy, or specialty, based on age rather than a particular body system. Populations on either end of the age spectrum bring unique needs for medical care and PT treatment.
As we age, our bodies respond differently not only to medical care, but also to physical care. So, PT solutions in this population are different than in the general age ranges.
In addition to strengthening and flexibility, endurance and balance are a focus to promote wellness in this age group.
Types of Physical Therapy Settings
We have discussed a variety of PT specialties, but the other “types” of physical therapy that are often mentioned are settings.
Instead of a focus on the body systems or medical diagnosis, these categories involve where physical therapy takes place.
When inquiring about “types,” it is often that people are seeking greater knowledge about what in involved with treatment in different realms.
One key difference to remember about specialties versus settings is that with specialties, there can be many things going on within the body.
However, it does not necessarily always involve PT, although it’s a possible needed intervention.
Regarding settings, when these are discussed, they predominantly do involve physical therapy and what takes place in each specific place.
Let’s look at the seven of the most common settings for physical therapy:
1. Acute Hospital Care
This setting includes a new onset of decreased health and can be for a variety of reasons and lengths of hospital stay. There are a number of challenges, but therapy can address these for a successful outcome.
When therapy is received in this setting, it can be on different types of intensive care units, general care floors of the hospital, or in other specialty areas discussed previously. (Check out information for situations behind the scenes in healthcare.)
While an acute onset can turn into a longer stay, the term still refers to time involved immediately after a new onset.
In this setting, physical therapy addresses strengthening, getting out of bed, and focuses on increasing activities such as sitting, walking, and endurance.
2. Inpatient Rehabilitation (Rehab)
Once a patient is medically stable and ready to move from acute care, they may need extra assistance to perform the normal tasks they once could do before their health declined.
If they are unable to move or complete daily tasks at the same level they could before, rehab may be an opportunity to gain much needed strength and increase physical ability.
Rehabilitation usually involves more aggressive treatment than most other settings, and a patient can be seen twice a day for therapy.
As the name states, the patient temporarily lives at the rehab facility as an inpatient, so that they can get the most out of their treatment.
Rehab takes greater motivation than most other settings. In addition, continued physical treatment takes a strong mindset.
Therapists in rehab can treat any diagnosis to include the mentioned specialties.
An inpatient rehab stay can be as short as a week, or as long as several months, depending on the patient’s needs.
Physical therapy has a greater expectation of progress in rehab, so it includes more strengthening, walking, greater endurance with impact on activity, and sometimes learning again to do tasks from scratch.
In addition, medical equipment is often needed to assist the patient with therapy and can be overwhelming to caregivers and patients.
A great site to learn more about assistive devices and helpful equipment with excellent explanations is Rehabmart.
3. Skilled Nursing Facility (SNF)
This setting involves treatment of a variety of diagnoses but specifically focuses on the geriatric population.
SNF can involve those that have recently had a hospital stay and are not yet able to go home, and it also is for people who need a place to stay long-term if family or caregivers are unable to administer their care.
This might include nursing needs or inability to physically care for the patient.
Side note: Although rehab and SNF sound similar where PT is concerned, rehab is more aggressive with a greater progression expected. A skilled nursing facility has the focus of a slower progression for the geriatric population. It is understood that there are limitations due to age.
Physical therapy in this setting still includes strengthening, walking, bed mobility, getting out of bed, and many of the same treatments but is acclimated to this special population.
PT in this setting also addresses muscle contractures and how to alleviate and avoid them for greater comfort and mobility.
4. Independent Living/Assisted Living/Specialty Care Assisted Living
These three facilities are categorized as types of settings in the geriatric population.
Each setting requires progressively more assistance than the one prior.
Independent living is just as it sounds. A person can do most everything on their own but might want a facility that provides meals or activities.
This differs from a regular apartment in that it has a variety of staff that may include concierge, dining, activities, fitness, etc.
Each member of the staff is trained in the specific needs of this population.
Assisted living can involve the same type of apartment but is for someone that needs more help.
This could include nursing care, having meals delivered, a care assistant to help bathe, or a variety of other things.
Having staff on standby for assistance is the main perk of assisted versus independent living.
Finally, specialty care assisted living, or SCALF, involves an even greater need for a caregiver.
The patient usually has cognition or memory deficits and might need help remembering to shower, eat, dress, move around safely, or can also involve mild behavioral situations.
PT in these settings involves strengthening, balance, fall risk safety, daily living activities, walking, sitting, and much more.
5. Early Intervention/School Therapy (Pediatrics)
Regarding the opposite end of the spectrum from geriatrics, we will address physical therapy settings that involve children.
Early intervention is considered for a child aged 0 to 3. In addition, school therapy involves treatment for children 4 and above.
These types of treatment involve special paperwork and plans to maintain forward progression and good communication with all parties involved.
Early intervention treatment may be at a child’s home or in a clinical setting.
School therapy is provided at a child’s school and is a great way to educate staff on specific needs and goals for a child’s outcomes.
This type of therapy includes steps for a child to allow better participation in school and may involve training with equipment, walking, sensory needs, sitting, participation in physical education, and strengthening.
6. Outpatient Therapy
This setting involves an outpatient clinic that the patient travels to for participation in treatment when healing the body physically.
Physical therapy in this setting can address a variety of situations and is usually performed for patients that get around well, who are able to leave their homes, and can go to the facility.
Patients have more opportunity to use strengthening equipment, as in a gym. They often perform more independent therapy following a program under the direction of the therapist.
The focus could include strengthening, high level performance, balance, and manual therapy performed by the therapist.
Chronic injuries are often treated in this setting along with an assessment of ergonomics.
7. Home Health
A home health setting involves a patient living at home, but they may have difficulty getting around and performing various tasks.
They might even be completely bed bound.
If a patient is unable to leave their home for treatment, they may qualify to receive therapy at home.
PT in this setting would include strengthening, a focus on physical ability such as walking and sitting, and most anything that would benefit the patient to make them more mobile at home.
Final Thoughts About Types of Physical Therapy
We have addressed numerous categories that may be considered types of physical therapy.
Although extensive, this list does not encompass all specialties and settings but includes the most common.
It is important to realize the difference in medical specialties and PT settings for receiving the best care as a patient or finding information as a caregiver and advocate.
This knowledge can help caregivers and patients better understand and stay optimistic about what they may be facing when the need for physical therapy arises.