Physical Therapy Observation Report

On Friday January 12, 2018 I was privileged to observe with Kathy Schwartz, PT at Warm Springs Outpatient Physical Therapy Center off Sonterra Blvd in San Antonio, TX. I began my visit at 8:30 am where I was introduced to all the staff and oriented to the facility. Following this, I received a brief background on the patients I would be seeing during my visit. Which included: two patients with Parkinson’s disease (PD), one patient with complex regional pain syndrome and one patient with a total hip replacement. The first patient I encountered at 9:15 am was a 65-year-old female presenting with balance and gait disturbances. Patient prior history includes depression, hypothyroidism, hypertension, neurogenic orthostatic hypotension, peripheral

Within the treatment area there is only one desk area for the Occupational Therapist and one large mat that is split between one PT and one Physical Therapy Assistant (PTA), a recumbent stepper, a set of parallel bars and a small hallway for walking; leaving little room for other activities within the space. Therefore, I was able to see the creativity in which the therapist used the space. For example, when looking for a place to do the modified CTSIB, the therapist shut a closet door to reveal a small foam pad in the corner with other tools that had been stashed

Which I feel, does not build a wall between patient and therapist, therefore, allowing the patient to be more comfortable with the therapist. Another contrast from the classroom was the session durations. In lectures and labs, all professors give examples in which therapists spend an hour with each patient and perform electronic documentation. However, this clinic only gives 45-minute slots per patient and still performs paper documentation. Which means that the therapist and patients must be very punctual and efficient to remain within the time parameters. Along with using their time wisely to document correctly with legible and accurate writing.

A major difference between my experience in the clinic and my education was the use of the Tinetti with patients with PD. In class we have been taught that this outcome measure did not have good evidence for use with these patients and should not be used with them. However, the therapist chose the Tinetti to test balance and gait for a patient with PD. Therefore, I asked the therapist before leaving why she did this and she said that she felt that the patient has a high enough level that the outcome measure is appropriate. Which relates back to the branch of clinician experience in Evidence Based