Dr Alex B. Miguel asked:


Amputation is a major blow to anyone, both physically and psychologically. To help a person deal with the loss of a limb a team of trained professionals is engaged – a doctor, a prosthetist, a psychologist, and nurses. To rehabilitate an amputee, a physiotherapist is also required.

When a person is adjusting to life without a limb, a physiotherapist is almost indispensable in the patient’s healing process. An amputee has to deal with several physical and physiological issues the. Among these are phantom pains, which are painful sensations that seem to emanate from the limb that has already been removed, as if it still exists. These are nervous responses and require physiotherapy to overcome and treat it.

A prosthetic limb is a must-have for most amputees. Though it is a common notion that learning how to wear it is enough, most don’t realize how difficult it can be to adjust to an alien appendage. There are many amputees who have been wearing prosthetic limbs for years, but can still not function normally. Such situations only underline the need for amputee rehabilitation.

The use of a prosthetic limb can be made easier with physiotherapy. Therapy allows a person to get used to the new limb. The routine followed by the patient for this adaptation depends on individual needs and abilities.

Often amputees lose their sense of balance and have to be taught how to walk or stand without support. This is seen more often in the case of a leg or foot amputation. That, however, does not mean that a person who loses an arm will not have a problem with his balance. The redistribution of weight due to the loss of an arm can also result in balancing problems for the amputee.

Many amputees do not realize that it is possible to completely mask a limp, even with the use of a prosthetic limb, if the person learns to walk in the best suitable manner. Physiotherapist are able to train amputees during the rehabilitation program and once this limp is camouflaged, the battle is half won.

It is best to begin physiotherapy immediately after the surgery, to avoid the weakening or unequal strengthening of muscles. An amputee subconsciously uses only one set of muscles as far as possible to avoid strain on the weakened set, thus weakening them further. The sooner the physiotherapy starts, the easier it will be to address such issues.

Physiotherapy for amputees is never a generalized program. It depends on individual needs and will always be a program tailor-made to suit the patient. Exercise routines are customized according to the kind of rehabilitation required in the case of each amputee.

Massages, otherwise called manual therapies, are also included in the physiotherapy program. Exercise stresses the muscles and manual therapy helps to ease out the tension and pain from the muscles that are being taxed to adjust to their difficult situation. Other manual therapies include acupuncture, heat compresses, ultrasound massages and electrical stimulation.

In amputee rehabilitation programs, physiotherapy is an indispensable treatment. A person having lost a limb needs such therapy and help without any question. Yet there are amputees who think it is not necessary, or are too shocked to consider recovery a possibility. It is imperative that such patients be convinced to start physiotherapy to get back to their normal daily lives without feeling at a loss.

Groshan Fabiola asked:


Finding physical therapy jobs in the United States can be very complicated, especially if you are a foreigner. There are certain steps that you have to take in order to become a physical therapist and the path towards working in the physical therapy profession in the United States can be very confusing in the absence of accurate information and assistance. The requirements you have to meet as an aspiring physical therapist in the U. S. are not very different from the ones in your country, but the path to getting a physical therapy license in the U.S. can be very confusing without proper help.

There are certain websites that shed a light on physical therapy jobs for foreigners and give a big hand to those who want to practice physical therapy in the United States.  Not only do these websites represent a good guide to getting your license, but they also have job offers from different important employers.

The first step of you, as a foreign physical therapist, who wants to practice physical therapy in the United States is to apply to the U.S. State Board of your choice. The expenses that you must incur in order to get your physical therapy license are often calculated for you by special programs put at your disposal by the web site you are visiting. Moreover, you can also pick the best state where to practice, due to a program that compares states according to several requirements and living costs.

Next step in getting your license in physical therapy is completing the state requirements. There are three major such requirements that have to be met in order for the candidate to be able to practice physical therapy in the United States. First, foreign physical therapists must apply for credentialing. As every state has different requirements and credentialing agencies that they work with, it is advisable that you search diligently, so that you can be certain you’ve made the right choice.

The next requirement is to take a proficiency exam. Depending on the state in which you want to find physical therapy jobs, you can take either a TOEFL exam or TSE or TWE. If you take your information off a reliable web site, then you will know exactly which exam to take depending on the specific requirements in the state of your choice.

The final requirement is to take the National Physical Therapy Exam. As this exam can only be taken in the United States, you have to be very careful about your visa. You can either look for a sponsor or apply for your tourist visa. Physical therapy jobs can be easily found once you have obtained your license.

The final step towards working as a physical therapist in the United States is to find your sponsor. This sponsor will take care of all the remaining requirements, so that you can practice as a newly licensed physical therapist.

There are special web sites dedicated to physical therapy jobs and how to become a licensed physical therapist in the United States. These sites are perfect guides to getting your license, finding physical therapy jobs and getting an answer to any question you might have about physical therapy in the United States.

Nathan Wei asked:


Patients with arthritis in our practice are often referred to physical therapists during the course of their management. One question I often hear from patients when I suggest physical therapy is, “But, why can’t I do exercises at home?”

So the big misconception here is that physical therapy is just a bunch of glorified exercise instruction. Nothing could be further from the truth. Physical therapy plays an extremely important role in the management of the patient with arthritis.

Before we go into the treatment modalities that physical therapists use, let’s start with exercises since they are an integral part of treatment.

Exercises consist of stretching, strengthening, and range of motion. In addition, as patients get older they need different types of training such as with balance and gait. Finally, the physical therapist in conjunction with the occupational therapist may look into activities of daily living and suggest some modifications that may be helpful.

But where physical therapy plays a major role is in using different modalities to relieve pain and speed the healing process.

Diathermy is a treatment method which delivers deep heat. It is useful for chronic pain conditions such as deep muscle injury or arthritis.

Precautions in regard to skin and subcutaneous tissue depth should be attended to. For example, a person who is skinny will require much less diathermy than an obese person. Also patients with damage to sensory nerves probably should not receive diathermy.

Iontophoresis (IP) is a procedure where an electric current pushes ionically charged chemicals (ie., glucocorticoids or steroids) through the skin to reach deeper tissues. IP can be used for calcific tendonitis and inflammatory conditions such as arthritis. Contraindications to use of iontophoresis include allergy to the chemical being applied, open wounds, or neurologic deficits that impair a person’s ability to feel.

Iontophoresis also should not be used near metallic implants, wires, or staples.

Ultrasound (US) is a type of treatment in which high-frequency sound waves are used to “heat up” superficial soft tissues and to help with tissue healing. Ultrasound can be used for tendon injuries or for short-term pain relief related to muscle strain or spasm. Contraindications of ultrasound include the use of US directly over recently surgically manipulated nerves such as a recent laminectomy, directly over malignant tumors, and over joint replacements and permanent pacemakers. US should also not be used in areas of thrombophlebitis (blood clots), near the eyes, over the uterus, ovaries, and *********. US also should not be used in areas of acute inflammation, over the epiphyseal plates of growing children, and over ****** implants of any type.

Phonophoresis (P) is the use of ultrasound to transport therapeutic medications to subcutaneous tissues. P can be used for inflammatory conditions such as tendonitis, arthritis, and bursitis. The same cautions and contraindications exist as for US.

Electrical stimulation (ES) is the process of using electrical current to deliver a therapeutic effect by generating an action potential in nerve tissue. This action potential leads to two potential results. The first is a change in sensory input, ie. a reduction in the ability to perceive pain. The second is a muscle contraction. Low grade muscle contractions can often relieve the severe muscle spasms that occur in association with arthritis. ES can be used for chronic pain related to arthritis, bursitis, or tendonitis. It is also useful for muscle spasm as well as neuropathic or radicular pain (pain from pinched nerves in the spine).

It has the same contraindications as US.

Low-level laser therapy- also known as cold laser- acts through the absorption of photon radiation. This leads to changes in cellular oxidative metabolism. Evidence indicates that levels of inflammatory and pain mediators such as prostaglandin E2 can be reduced with this modality. Cold laser can be used for minor musculoskeletal pain, osteoarthritis, chronic neck and low back conditions, and fibromyalgia.

It should be used with caution in patients with malignant tumors or in those being treated with anticoagulants, corticosteroids, or immunosuppressive drugs and should not be used over the thyroid gland or over reproductive organs.

Patients and those providing the cold laser treatment should use safety goggles to limit eye exposure to laser light.

These are only a very small portion of the many therapeutic modalities a physical therapist has in their arsenal. In the care of patients with arthritis, physical therapists are an indispensable member of the team.

Amy Nutt asked:


Physiotherapy, also known as physical therapy, is a health related field that strives to enable individuals who were physically injured or whose bodies have degenerated due to aging or disease to function as much as they can without assistance. This often involves an interaction with the medical practitioner and patient that incorporates physical therapy equipment or training exercises for muscles that may have been harmed for a number of medical reasons.

The medical professionals who work within this field are often identified as physical therapists. Many of these practitioners receive years of education before obtaining a license to practice. PT disciplines are also multifaceted and diverse, ranging from geriatric to orthodontic. Certified therapists are reregistered with the American Physical Therapy Association, and undergo vigorous scrutiny prior to be accepting into the board.

Physical therapy fields

Some physical therapists work within hospitals or centers while others are contractors who work independent of a facility. The kind of physical therapist you work with will greatly depend on what kind of injury or ailment you are addressing.

Orthopedic therapist

This type of therapists deals with injury or disease of the musculoskeletal system. With the use of physical therapy equipment, a therapist may retrain a client on the fundamentals of walking after multiple leg fractures or enable them to regain the use of their hands after invasive surgeries. Simple physical training supplies, like hot cold compresses may be used for sprains or mild fractures.

Geriatric/Pediatric therapist

Geriatric physical therapists work with the elderly while pediatric physical therapist work with babies and children. Both specialists are familiar with diseases that afflict their particular group and their training is geared to help target problems associated with those illnesses. For example, a pediatric therapist may help a child with a curvature of the spine to learn to walk with a brace while a geriatric therapist helps senior citizens cope with arthritis or aggravations from various replacement surgeries.

Neurological therapist

A neurological patient often relies on the expertise of a physic therapist in this field to combat issues associated with neurological damage. Brain or spinal cord injury and in born issues like MS or Parkinson’s are often dealt with by these specialists. Often these types of practitioners work with people who have been paralyzed and are unable to walk. Physical therapy supplies like electronic muscle stimulators may be used by these therapist to stimulate blood flow and keep the muscles from atrophying.

Massage therapist

Practitioners of this particular health discipline must keep massage therapy equipment current and up to date. More often than not, individual masseuses work as independent contractors and have to buy their own massage therapy supplies. Again, these individuals have to be fully licensed and board certified even if they are not affiliated with a specific center. A masseuse who works within a medical establishment will have access to state of the art massage therapy equipment, although they still may have to pay for a few of their own massage therapy supplies.

The Role of family

A good portion of physical therapy success is based on the mental attitude of the patient. This is where family can come in. The physical therapist will show the patient what steps they need to take to ensure a positive outcome. In turn, the family has to be there for the patient and help keep their spirits up so that they fight to get back to a place of wholeness after a tremendous physical set back.

Remember, when looking for physical therapist, be sure to check and see if they went to an accredited school and are board certified. Even a masseuse should be well trained, whether they have to provide their own massage therapy supplies or not.

In the end, the over all goal of physical therapy is to increase the fitness and well being of the patient post surgery or after an accident or prolonged, debilitating illness.

Igor S asked:


Pediatric physical therapy services are meant for treating congenital disorders, non congenital disorders and even developmental delays of children. Pediatric physical therapy is helpful in detecting the health problems of children in the earlier stages itself. Pediatric physical therapists are specialized in diagnosing, treating and managing infants and children having developmental, congenital, skeletal, and neuromuscular diseases.

Physical therapy treatment focuses mainly on improving coordination and balance, motor skills, endurance and strength. It also aims at improving processing/integration at the cognitive and sensory levels. This includes developmental milestones such as standing, sitting, walking and crawling. Reputable healthcare centers ensure that they have the best, experienced and licensed physical therapists to provide pediatric physical therapy services.  

The duration for physical therapy treatment varies in children. Children who are reluctant walkers or those having injuries may need only short term physical therapy treatment. In some cases, if the child has a developmental delay, the treatment may have to be given for a longer duration of time.

Torticollis, cerebral palsy and spina bifida which are diseases found in children, are effectively treated by physical therapy. Torticollis is a condition in which the sternocleidomastoid muscle of the neck is shortened. This condition will result in limited neck motion. There are effective exercises and techniques in physical therapy for treating this condition. Spina bifida, a neural tube defect affecting children, also has effective treatment in physical therapy. Cerebral palsy is a neurological disorder seen in infants. This disorder can permanently affect muscle coordination and body movement.  Physical therapy is one of the proven methods for treating this condition.

Some of the major services provided by pediatric physical therapy service centers are training in neuro development, early intervention, sensory integration, myofascial release, fabrication of splints and casts, functional mobility, treatment for urinary incontinence, management of pain, aquatic physical therapy, electrical stimulation, and hippo therapy.

Nishanth Reddy asked:


Lower back pain is one of the most common causes of job-related disability and why some people miss work. It is also the second most common neurological ailment in the United States, second only to headache. In fact, approximately 80% of adults in Western countries have, at some point, experienced lower back pain.

For some fortunate people, pain in the lower back may be resolved by itself or with the aid of medication within two to four weeks. However, there are some cases of lower back pain that may last for more than a few weeks, during which case the condition is termed as “chronic” and “progressive,” meaning it can only grow worse over time.

Moreover, 60-80% of those patients who suffer their first episode of lower back pain may experience recurring pain within one year.

According to current research, there are certain muscles in the back that work to stabilize the spine. When the spine or the back suffers an injury, these muscles are reflexively inhibited or shutdown. Worse still, these muscles do not spontaneously recover, and this is true even if patients do not feel pain and are able to return to normal activity levels.

As a result of the inhibition of these muscles, called lumbar multifidi and the transversus abdominus, lower back pain occurs. However, there are steps you can take to prevent the same thing from happening to you.

Lower Back Pain and Physical Therapy

One way to prevent the inhibition of the lumbar multifidi and transversus abdominus is through a series of physical therapy exercises.

Designed to strengthen the muscles of the lower back and keep the spine healthy, these physical therapy exercises may range from back stabilization exercises to muscle strength development and several wide variety of techniques.

In addition, a physical therapist may also recommend such methods as heat therapy, ultrasound, massage, mobilization, and education about posture and body mechanics in order to prevent lower back pain from recurring.

Some of these methods will be discussed later on. You will also find some practical self-help tips provided by experts to help you avoid lower back pain or prevent the condition from worsening.

However, before we head on to learning how lower back pain is treated through physical therapy, it is important that we first understand what causes lower back pain.

Lower Back Pain: CAUSES

There are actually many types of back pain, but the most common is pain in the lower back. Why? You might ask. The reason is simple: you carry most of your weight in the lower back. Thus, it is highly likely that a person would suffer pain in that area.

There is no definitive cause of lower back pain. Sometimes, the causes of the condition are so complex that it is difficult to pinpoint just a single one.

However, physical therapists and other healthcare professionals have observed that lower back pain is often a result of strained back muscles and ligaments due to any of the following activities:

Improper posture

Heavy lifting

Sudden awkward movement

Muscle spasm

Stress

We could all be guilty of the above activities. We may not suffer any back pains now, but it is likely that as we get older and the degree of inhibition of the back muscles as a result of these activities increases, back pain becomes a very distinct possibility.

In addition to these common activities, lower back pain may also result from specific conditions, such as:

Herniated disk (when the disk material presses on a nerve)

Sciatica (when a herniated disk presses on the sciatic nerve. The condition causes sharp, shooting pain through the buttocks and the back of the leg.)

Spinal stenosis (when the space around the spinal cord and nerve roots becomes narrow. This is caused by arthritis and bone overgrowth, the pain resulting from when a nerve gets pinched in the narrow space.)

Spondylosis (a type of arthritis affecting the spine due to degenerative changes brought on by aging)

Spondylolisthesis (when one vertebra in the spinal column slips forward over another)

Lower Back Pain: TREATMENT

The treatment of lower back pain depends on several factors, including the specific type of lower back pain (whether it is chronic or acute) and the purported cause.

For instance, acute lower back pain is commonly treated with pain relieving drugs, such as analgesics, or some forms of exercises that can help relax the muscles.

On the other hand, chronic back pain or one that lasts for more than two weeks and is progressive may be caused by some underlying condition, during which case the treatment plan may consist of resolving the underlying condition to treat the back pain.

Lower Back Pain and Physical Therapy Exercise

Physical therapy exercise is one of the most common methods of treating lower back pain. In fact, many home remedies for lower back pain consist of exercise, because the general theory is that if you remain active, you remain healthy. This is true in most cases.

However, for purposes of this article, the exercises featured here will be those that are practiced by physical therapists to treat patients with lower back pain.

Generally, in physical therapy exercises, the exercise program for back pain should encompass a set of stretching exercises, strengthening exercises, and low impact aerobics. Read below for more on these exercises:

-Stretching

The back of a person is composed of the spinal column and contiguous muscles, ligaments and tendons. All these are designed to move in consonance with each other so that any limitation in the range of motion in any of these components of the back result in back pain.

Stretching for lower back pain specifically targets soft tissues, such as muscles, ligaments and tendons, found in the back and around the spine. By stretching, the spine and soft tissues are mobilized, increasing motion and thus, relieving pain.

There are many kinds of stretching exercises employed by physical therapists. One is the Hamstring Stretching Exercise which works to relax tight hamstrings, a common symptom of lower back pain. This exercise is said to help decrease the intensity of lower back pain among sufferers.

-Strengthening

Physical therapists generally use two forms of strengthening and back pain relief exercises, usually depending on the specific condition of the patient. These are the McKenzie exercises and dynamic lumbar stabilization exercises. However, the two forms of strengthening exercises may also be combined should the therapist find it appropriate to do so.

-McKenzie Exercises

Named after a physical therapist in New Zealand, McKenzie exercises are primarily extension exercises that could help reduce pain generated from the disc space and also may help reduce the symptoms of herniated disc by reducing pressure on a nerve root.

For acute pain, the McKenzie exercises should be done frequently, at least once every two hours. In addition, patients are advised to avoid flexing their spine when exercising.

-Dynamic Lumbar Stabilization Exercises

Using this back exercise technique, the first thing that a physical therapist does is to look for the patient’s “neutral” spine. This refers to the position that allows the patient to feel the most comfortable.

Afterwards, when the patient is in that position, the back muscles are then exercised in order to “teach” the spine how to stay in this position.

Performing these exercises on a regular basis can help strengthen the back muscles and keep the spine well-positioned.

Low Impact Aerobic Exercises

The purpose of low impact aerobic exercise is to recondition the back. Patients who undergo reconditioning of the back through low impact aerobic exercise will have fewer episodes of lower back pain.

In addition, whenever an episode of lower back pain does occur, the pain is less intense and lasts only for a short period.

Another benefit of low impact aerobic exercise is that patients tend to stay functional that is, they can continue with their regular work and carry on with recreational activities. In contrast, patients who do not undergo low impact aerobic exercises typically experience the gradual loss of their functional abilities.

For low impact aerobic exercises to achieve their desired results, they should be continuous. This will increase the heart rate and keep it elevated as well as increase the production of endorphins, which are pain fighting hormones released by the body.

Here are some examples of low impact aerobic exercises that you may want to try in order to lessen or reduce lower back pain:

-Walking

One of the simplest forms of aerobic exercises, walking is generally considered as very gentle on the back. To get the maximum benefit from walking as a form of low impact aerobic exercise, walk two to three miles three times per week.

-Stationary Bicycling

This form of aerobic exercise is less painful on the back since there is lower impact produced. This is beneficial for patients with lower back pain who may find walking too painful.

-Water Therapy

Sometimes referred to as aquatherapy, water therapy is simply doing exercise in the water. The buoyancy works to provide effective conditioning at the same time stress on the back is reduced.

Dr Alex B. Miguel asked:


Americans have lower back problems to such an extent that at least 80% of the population have complained of it at one point of the other. It is the most common reason for a visit to the doctor. Although for some it is a temporary issue, most require physiotherapy to restore their fitness.

 

There are different techniques in use to address lower back trouble. One of the popular methods of treatment is acupuncture. The patient is made to lie face-down while the doctor inserts acupuncture needles on the back. The doctor subsequently finished the required procedure. A series of treatments like this usually provide relief for several months afterwards.

 

Massages are also useful when treating lower back pain. However only someone who has intimate knowledge of lower back pain should carry out this procedure. An untrained masseur can harm the patient more than no treatment at all.

 

Such therapies are known as modalities or passive therapy. Here the patient is the passive receiver of the treatment and not an active participant in exercise. Hot and cold compresses are also popular forms of passive therapy. These can be used as separate compresses, but for some one with an acute problem they can be used in conjunction as alternate compresses.

 

Another modality used for lumbar pain is known as a transcutaneous electrical nerve stimulator (TENS). With the use of this unit, the patient doesn’t feel any pain but only the sensations that the stimulator induces in his nerves. If this treatment produces positive results, the patient is given a unit to use as his needs dictate in the convenience of his home.

 

Another passive therapy of some use to a patient with acute lumbar pain is ultrasound stimulation. This process generates heat in the lower back region which along with lessening the pain also quickens the healing process.

 

Exercises assigned by a physiotherapist are also useful. If done correctly and regularly they alleviate lumbar pain speedily. However, in case of a back condition which involves acute pain or the possibility of surgery exercises are not advisable.

 

A physiotherapist is the best person to assign exercises and supervise the progress of a patient. Although exercises may be done at home, it is imperative to be faithful to the instructions given and come in for regular progress checks.

 

Exercises are given to both strengthen the lower back as well as to stretch the back in cases of patients suffering from lower back pain. Stationary swimming-like movements are a common exercise. While this exercise works the back muscles, it protects the lumbar region from further injury.

 

Flexion exercises are given to strengthen the middle region of the back so that it can support the back better. If the pain is aggravated by standing up or walking around, such exercises are necessary. One such exercise is a knee-chest exercise.

 

Aerobic exercises are also excellent for alleviating and preventing pain in the lumbar region. These are exercises such as walking or running. Massages and acupuncture procedures also relieve the patient of acute pain. Physiotherapy, all in all, helps millions of people around the world reduce and prevent their lower back problems.

 

Terry OBrien asked:

Terry O’Brien General Manager of Back Trouble UK says that, “Physical therapy has a significant benefit for mechanical back pain. Studies show that, for patients presenting with acute back pain, spinal mobilisation and/or manipulation is more effective than placebo in the short term and thus reduces the period of morbidity, allowing an earlier return to work.

The timing of the treatment is important. If the medical practitioner is unskilled with physical therapy, referral is appropriate. Spinal manipulation is contraindicated or ineffective in patients with acute low back pain with spasm, fixed lateral scoliosis or sciatica.

The gentler technique of mobilisation may be effective in providing relief and shortening the period of disability. Once the severe pain and spasm phase subsides (average 3-7 days), then it is usually possible to apply the more vigorous spinal manipulation technique. However, it is possible to perform manipulation safely from the outset in many patients. These are the patients who often feel that something in their back has `jammed’ and feel the need for physical therapy. Such patients who have received relief, sometimes instantaneously, in the past for a similar disorder will seek out therapists who provide this treatment.

Manipulation’s bad name, particularly among surgeons who have to deal with subsequent disrupted discs is related to inappropriate spinal manipulation that aggravates the problem or fails to help over a long period of time.

The management of back pain is incorrectly portrayed as a difficult problem shrouded in medical ignorance. The physician has to provide optimal circumstances for the dysfunction problem to heal itself. The key to successful management is for the practitioner to be well informed, confident and believable, and be prepared to give or organise safe effective physical therapy for back problems which are slow to respond to conservative methods.”

Terry O’Brien

www.backtrouble.co.uk

Dr Alex B. Miguel asked:


About fifteen million Americans require asthma management through physiotherapy programs. There are several medical and physiotherapy treatments which have been successfully employed to manage asthma issues. Recently, there have been concerns raised over the use of some questionable treatment.

Some physiotherapy clinics insist asthma can be controlled through physiotherapy programs. Syptoms like breathlessness and wheezing can apparently be alleviated by physiotherapy. Massages are also said to relieve the same symptoms in both young and old patients.

Acupuncture has also been used as an alternative treatment method to alleviate asthma symptoms. Interestingly, this technique has actually been beneficial for asthmatics.

It has been proven that acupuncture boosts the immune system to fight diseases better. This is an important criteria for asthma management. Common colds or influenza only worsen an asthmatic’s condition. Acupuncture, if it reduces the chances of catching a cold, is definitely advantageous in such situations. However, acupuncture has yet not been accepted as a stand-alone treatment and is used only in conjunction with other established methods of asthma management.

There are other methods used by acupuncturists in asthma management such as burning herbs over the acupuncture points, giving the patient specific massages, or using breathing exercises. These treatments, again, have not been proven useful.

Asthma treatments are also carried out by chiropractors who rely on spine manipulative methods. This treatment method has received mixed responses. A study was carried out with two groups of asthma patients. One group was given fake manipulations, while the other group was given actual spinal manipulations. The results showed hardly any difference between both groups. According to these results, chiropractors cannot really help asthma patients with their treatments.

Another study on chiropractic treatments was also carried out. The progress of 81 asthmatic children at a chiropractic clinic was followed. The study showed that children undergoing the treatment had 45% fewer attacks and 30% of the children could reduce the amount of medication they had to take to control their asthma. Because of these two conflicting studies, it is undetermined if chiropractic treatments are actually useful.

For physiotherapists who want to continue in asthma management, there is a specialty certification. They can be trained to become Certified Asthma Educators and deal with patients. There services are paid for by Medicare and Medicaid.

It has been propounded that asthma patients who have been hospitalized should undergo physiotherapy. Asthma patients who were made to do motion exercises during their hospital stay, on average remained hospitalized three days fewer than patients who were not given exercises.

Traditional physiotherapy however faces a problem of dehydrating asthma patients. Asthmatics can be seriously affected by dehydration, which occurs faster for them. Sometimes it may even induce an attack. As a result, physiotherapists must keep this in mind when giving exercises.

There are several methods available to treat asthma, and they may be valuable, but physiotherapy also has a toe-hold in the field of asthma management. However, as long as they can’t be proved useful, it is better to use alternative methods in conjunction with traditional management methods.

Groshan Fabiola asked:


To be able to practice physical therapy in the United States, you have to meet a series of requirements. The most important requisite of all is taking the physical therapy exam. Prior to this, you also have to take several steps, but the passing of the exam is essential if you want to be able to practice. However, beside taking and passing the exam, you also have to find a physical therapy sponsor. Finding your sponsor is very important because otherwise you cannot practice.

The physical therapy exam can be taken in the United States only. So your first concern should be to make sure that your visa is still valid when you take the exam. As has been said before, there are several requirements that have to be met before you can take the exam, but the most important one is to have a visa.

In order to see to this, you can apply for a tourist visa or you can find yourself a physical therapy sponsor to sponsor you for your Green Card or H1b. However, most agencies will not sponsor you until you have passed the exam. So a tourist visa is the perfect option in the beginning. After you have taken the exam, your sponsor will make sure that your stay in the United States is legal.

In order to apply for the physical therapist exam, there are important steps you have to take. You have to obtain certain materials, fill them out, make some payments and schedule an appointment to determine your eligibility. There are special web sites dedicated to foreign physical therapists detailing exactly what you must do in order to apply for the physical therapy exam.

If you are lucky and have already found a physical therapy sponsor before taking the exam, then the agency will probably help you with your application. However, you can also find this information on the Internet.

After you have applied for your physical therapy exam, next comes the most important part, which is taking the exam. The Internet is once again a good source of information on what to do and what to expect from your exam. Special web sites dedicated to foreign physical therapists can be a great guide for you. On these web sites you can find the necessary information about your physical therapy exam and what you have to do after you have passed it.

Once you are a licensed foreign physical therapist, your next step is finding a physical therapy sponsor. Your sponsor will help you get your Green Card or H1b. Your sponsor will send you the offer detailing the costs and salary, benefits and health insurance. The lawyer and immigration fees are fairly high, but part of them may be paid by your physical therapy sponsor. Moreover, the salary, holidays, benefits and health insurance are going to be the same as those of other U.S. employees.

After you have taken your physical therapy exam and found a physical therapy sponsor, you can legally practice in the United States. However, you should know that your visa is only valid three years for an H1b visa, upon which you have to apply for an extension or permanent residency. All these should be discussed with your physical therapy sponsor.