aides were physical education teachers or graduates of
HISTORY OF PT
ORIGINS OF PHYSICAL THERAPY
● Massage was used by the Chinese in 3000 BC,
described by Hippocrates in 460 BC, modified by the
Romans, and accepted as a scientific procedure in the
early 1800s.
● Techniques of muscle reeducation developed from this
evolution.
● Hydrotherapy was practiced by the Greeks and
Romans through the use of baths and river worship.
● The development of electrotherapy began in the 1600s
with the introduction of electricity and electrical
devices.
● More modern techniques of physical therapy were
practiced extensively in Europe, particularly England
and France, before being used in the United States.
● It took the outbreak of polio epidemics and World War I
to bring these techniques to the United States.
IMPACT OF WORLD WAR I AND POLIO
● The epidemic of polio in 1894, 1914 and 1916, and
world war I came that left children and injured soldiers
in need of "physical therapy"
● In 1917, the Division of Special Hospitals and Physical
Reconstruction was created to train and manage
reconstruction aides (exclusively women) for those
injured in the war.
● During this period, the Vermont Plan was created to
study the cause and effect of the ongoing polio
epidemic which includes health care teams to conduct
field visits to provide care for children with polio
including physiotherapists (physicians’ assistants).
● The physiotherapists became involved in taking
accurate measurements to determine muscle strength
and providing therapy through exercise and massage
POST-WORLD WAR I PERIOD
● Even after the war, the need for physical therapy
continued. Humanitarian interests and the labor
requirements of an industrial society resulted in a focus
on “crippled children.”
● On January 15, 1921, at Keen’s Chop House in New
York City, the first ever meeting of "physical
therapeutics" was attended by 30 reconstruction aides
and five physicians which also gave birth to the
creation of the American Women’s Physical
Therapeutic Association.
● The American Women’s Physical Therapeutic
Association elected Mary Mcmillan as its first president
who used to train in England, who is credited with
becoming the first “physical therapist” in the United
States.
● In 1921, an official journal, the P.T. Review was
established and published.
● In 1922, the American Women’s Physical Therapeutic
Association changed its name to American
Physiotherapy Association (APA).
● In 1926, the journal was retitled into Physiotherapy
Review.
● During the 1940s, physicians established physical
medicine as a medical specialty. These physicians
were known as physiatrists, and the term physical
therapist (without adding technician or aide) became
acceptable thereafter.
● In 1928, the APA developed a suggested curriculum of
a 9-month program (1200 total clock hours). Entrance
requirements included graduation from a school of
physical education or nursing. In contrast, most of the
students in the 14 training programs for reconstruction
physical education schools.
● Greater recognition of education programs and
standards was required, so the APA sought assistance
from the AMA in 1933. Consequently, the Council on
Medical Education and Hospitals of the AMA inspected
35 schools of physiotherapy. Based on this inspection,
as well as input from the APA and 1 other related
organizations, the AMA adopted the Essentials of an
Acceptable School for Physical Therapy Technicians in
1936.
IMPACT OF WORLD WAR II AND POLIO
● The National Foundation for Infantile Paralysis (often
referred to as “the Foundation”) was established in
1938 for research, education, and patient services.
● Catherine Worthingham, a past president of the APA,
accepted the position of Director of Professional
Education on the staff of the Foundation in 1944.
● In 1944, the first national office of the APA was
established in New York City and the first executive
director was hired. A permanent headquarters and staff
for the APA enabled the organization to create the
House of Delegates to serve as a policymaking body.
POST-WORLD WAR II PERIOD
● The U.S. Army recognized the need to retain PTs in an
organized unit to provide service to military personnel.
As a result, the Women’s Medical Specialist Corps was
established in 1947. It consisted of PTs, occupational
therapists, and dietitians. A PT, Emma Vogel, became
the first chief of the Corps and was accorded the rank
of colonel.
● In 1955 the Corps became the Army Medical Specialist
Corps to allow men and women to serve with
commissions in the military.
● A major breakthrough in the treatment of polio occurred
during this period with the introduction of gamma
globulin and the Salk vaccine. Finally the disease could
be controlled. PTs played prominent roles during field
trials of these medications, which began in 1951.
● Physical therapists (PTs) could now practice physical
therapy. This role clarification was reflected in the new
name for the national organization, the American
Physical Therapy Association, in 1947 and a new title
for the journal, Physical Therapy, in 1962.
● The Essentials of an Acceptable School of Physical
Therapy, no longer referred to technicians. This
document was adopted by the AMA in 1955 and was
used to approve new and existing educational
programs for over 20 years. The new Essentials
established minimum curricular standards, including a
program length of 12 months
1960S THROUGH 1980S
● The APTA adopted policy statements in the 1960s to
clarify the preparation and use of PTAs and aides.
These positions were necessary to meet the growing
demand for services.
● This period opened with an APTA policy in 1960
declaring the baccalaureate degree to be the minimum
educational requirement for a PT. By the late 1970s it
became clear that a post-baccalaureate degree would
be necessary to master the knowledge and skills
required for competent practice.
● Consequently, a critical policy adopted by the APTA in
1979 (amended in 1980) stated that new and existing
programs in physical therapy must award a
post-baccalaureate degree by December 31, 1990.
● In 1974, the APTA adopted the Essentials of an
Accredited Educational Program for the Physical
 Therapist, which represented a dramatic departure reiterate the importance of autonomy of judgment as
from the prescriptions in the 1955 Essentials. In 1977 one of the highest, if not the highest, characteristic of a
the Commission on Accreditation in Education (a body profession.
separate from, but administratively supported by, the
APTA) became recognized by the U.S. Office of
Education and Council on Postsecondary Education as
an accrediting agency.
● Standards for Accreditation of Physical Therapy
Educational Programs was adopted by the APTA in
1979.
● In 1983, after contesting the value of the AMA in the
accreditation process, the Commission on
Accreditation in Education became the sole agency for
accrediting education programs for PTs and PTAs. This
recognition marked the maturity of the profession.
● The American Board of Physical Therapy Specialties
was created by the APTA in 1978. This provided a
mechanism for PTs to become certified and recognized
as clinical specialists in certain practice areas.
● The Foundation for Physical Therapy was initiated in
1979 to promote and support research in physical
therapy.

1990S

● During the 1990s, skyrocketing costs of health care

resulted in significant cost control measures in the
private and government sectors. New methods of
financing and reimbursing health care, created by the
proliferation of managed care and the Balanced Budget
Act of 1997, had a direct impact on the delivery of
health care services, including physical therapy.
● The shift to post-baccalaureate education gave rise to
several national conferences, which resulted in
documents that described the values and preferences
in PT and PTA education programs. A Normative
Model of Physical Therapist Professional Level
Education: Version 2004 was originally developed in
1994-95 to provide guidance to these programs.
● In 1995, the Guide to Physical Therapist Practice was
created to provide a comprehensive and detailed
description of physical therapy services, but research
was needed to substantiate these services.
● The developing concept of evidence-based practice
(practice based on proof) was promoted through the
new Hooked on Evidence program. This provided a
user-friendly database of current literature pertinent to
the practice of physical therapy. In the same year the Board of Directors approved another
● In 1998 a separate deliberative body for PTAs, the document related to the Vision Statement, “Professionalism in
Representative Body of the National Assembly, was Physical Therapy: Core Values, ” developed by a consensus
approved. The decade closed with a bright outlook for conference method. The purpose of identifying and describing
improvements in the future. these Core Values was to assist the transition to a doctoring
profession by articulating what a PT practitioner would do in
TWENTY-FIRST CENTURY her or his daily practice to demonstrate professional behavior.
This document has focused greater attention on professional
● The twenty-first century opened with an evolutionary behaviors and how to teach and emulate them. In 2005, after
action by the APTA House of Delegates when, in the an extensive review of the limited effectiveness of the
year 2000, it adopted the APTA Vision Statement for Representative Body of the National Assembly, the APTA
Physical Therapy 2020. House of Delegates replaced it with the PTA Caucus, which
● Commonly cited as Vision 2020, it has become a had its first meeting in 2006.
beacon for the profession and has provided a distinct
direction for current and future action. Its six key
components address the areas of practice, education,
and research: (1) autonomous practice, (2) direct
access, (3) practitioner of choice, (4) Doctor of Physical
Therapy (DPT), (5) evidence-based practice, and (6)
professionalism.
● In 2003 the APTA Board of Directors issued a position
listing and describing the elements of autonomous
practice. This position indicates that PTs have the
capability to exercise professional judgment to practice
under direct access within their scope of practice and
refer patients and clients to other health care
professionals when necessary. These attributes
 2008, and is currently the guide to the Association’s
growth, giving direction to its officers and members.

PROFESSIONAL ROLES AND

CHARACTERISTICS OF PHYSICAL
THERAPISTS
ROLES IN THE PROVISION OF PHYSICAL THERAPY

The primary role of a PT involves direct patient care. Although

PTs engage in many other activities and in some cases no
longer participate in clinical practice, patient care remains the
predominant employment activity

ETHICAL OR LEGAL CONSIDERATIONS ETHICAL OR

LEGAL CONSIDERATIONS

A. Ethical Considerations

a. The physical therapist & physical therapist

PHYSICAL THERAPY IN THE PHILIPPINES
assistant practices according to the APTA Code
of Ethics for the Physical Therapist.
● The earliest recorded information of historical
significance to the development of physical therapy in
B. Legal Considerations
the Philippines was the formation of a Section of
Electrotherapeutics, under the Department of Medicine
a. The physical therapist complies with all the
of the Faculty of Medicine and Surgery of the
legal requirements of jurisdictions regulating the
University of Santo Tomas, in the school year
practice of physical therapy.
1908-1909.
b. The physical therapist assistant complies with
● In 1916, Physiotherapy was included in the curriculum
all the legal requirements of jurisdictions
of the UST Faculty of Medicine and Surgery along with
regulating the work of the physical therapist
Radiography.
assistant.
● The first hospital to have a Physical Therapy
Department in the Philippines was established at San
ADMINISTRATION OF THE PHYSICAL THERAPY SERVICE
Juan de Dios Hospital. Military Hospitals, like Veteran's
Memorial Hospital and the V. Luna General Hospital,
● Mission, Purposes, Goals, Objectives, and Scope of
were likewise pioneers in this field especially during
Services
WW2. It was however at the Mandaluyong General
Hospital, which later became the National Orthopedic
○ The physical therapy service has a statement of
Hospital in 1948, where progress in this field was
mission, purposes, goals, objectives, and scope
hastened.
of services that is reviewed annually and
● On December 8, 1964 the Philippine Physical Therapy
reflects the needs and interests of the patients
Association was established by the first BSPT
and clients served, the physical therapy
graduates from the University of the Philippines School
personnel affiliated with the service, and the
of Allied Medical Professions (UP SAMP), the first
community.
academic institution to offer a Bachelor’s Degree in
Physical Therapy in the Philippines.
● Organizational Plan
● The Association was incorporated on December 26,
1964. One of the early fruits of labor of the Association
○ Ensures that a physical therapist provides the
was the enactment of the Republic Act 5680 (Philippine
clinical direction of physical therapist services
Physical and Occupational Therapy Law) on January
○ Defines supervisory structures within the
21, 1969.
service
● PPTA was accredited by the Professional Regulation
○ Reflects current personnel functions
Commission as a national organization for physical
therapists on May 31, 1978 (with accreditation number
● Policies and Procedures
29). The PPTA acquired membership in the World
Confederation for Physical Therapy on May 24, 1967
○ The physical therapy service has written
and became a founding member of the Asian
policies and procedures that are reviewed
Confederation for Physical Therapy.
regularly and revised as necessary; reflect the
● The first licensure examination was held on July 23,
operation, mission, purposes, goals, objectives,
1973, for 26 physical therapists and 18 occupational
and scope of the service; are legally compliant
therapists. In 1994 the licensure examinations became
with federal and state law; and are guided by
partially computerized. Fully computerized licensure
the association’s positions, standards,
examinations were conducted in 1995.
guidelines, policies, and procedures
● Cebu Doctors' University was the first school in the
Visayas and Mindanao to offer physical therapy in
1974. The year 1998 was very significant for the
profession in view of the signing of the Presidential
Proclamation No. 15, which declared every 8th day of
September as National Physical Therapy Day.
● In 2004, the PPTA drafted its Vision-Mission-Goals
2010 (VMG 2010). This was reviewed and revised in
● Administration
○ Guided and informed by APTA positions,
standards, guidelines, policies, and procedures,
the physical therapist responsible for the clinical
direction of physical therapist services ensures:
■ Compliance with local, state, and federal
requirements;
■ Services are provided in accordance
with established policies and
procedures;
■ The process for assignment and
reassignment of physical therapist staff
(handoff communication) supports
individual physical therapist
responsibility to their patients and clients
and meets the needs of the patients and
clients.
● Fiscal Management
○ Includes a budget that provides for optimal use
of resources
○ Ensures accurate recording and reporting of
financial information
○ Allows for cost-effective utilization of resources
○ Follows billing processes that are consistent
with federal regulations and payer policies,
charge reasonable fees for physical therapist
services, and encourage physical therapists to
be knowledgeable of service fee schedules,
contractual relationships, and payment
methodologies
○ Considers options for providing pro bono
services.
● Improvement of Quality of Care and Performance
○ The improvement plan:
■ Provides evidence of ongoing review
and evaluation of services; and
■ Provides a mechanism for documenting
improvement in quality of care and
performance and is consistent with
requirements of external agencies, as
applicable.
● Staffing
responsibility to their patients and clients
and meets the needs of the patients and
clients.
● Physical Setting
○ The physical setting, where applicable, is
designed to provide a safe and accessible
environment that facilitates fulfillment of the
mission, purposes, goals, objectives, and scope
of the physical therapy service. It is appropriate
for the number and type of patients and clients
served. The equipment is safe and sufficient to
achieve the purposes and goals of the physical
therapy service.
● Coordination
○ Physical therapy personnel collaborate with all
health services providers and with patients,
clients, caregivers, and others as appropriate;
and use a team and person-centered approach
in coordinating and providing physical therapist
services
PATIENT AND CLIENT MANAGEMENT
Physical Therapist of Record
- All patients and clients receiving physical therapist
services shall have a physical therapist of record who
is responsible for patient and client management
Patient and Client Collaboration
- Within the patient and client management process, the
physical therapist, the individual, and their caregiver(s)
establish and maintain an ongoing collaborative
process of decision-making that exists throughout the
provision of services and can extend over the lifespan.
Initial Examination/Evaluation/Diagnosis/Prognosis
- The physical therapist performs an initial examination
and evaluation to establish a diagnosis and prognosis
prior to intervention. Wellness and prevention
encounters may occur without the presence of disease,
illness, impairments, activity limitations, or participation
restrictions.

○ The physical therapy personnel affiliated with Management Plan and Plan of Care
the physical therapy service have demonstrated
competence, and are sufficient to achieve the - The management plan is the framework of physical
mission, purposes, goals, objectives, and scope therapist services provided to patients or clients,
of the service. Provides appropriate groups, or populations. The management plan includes
professional and support personnel to meet the a plan of care when physical therapist services are
needs of the patient and client population. indicated to address a health condition. The plan of
care is based on the best available evidence and
● Administration consists of statements that specify the goals of the
plan, predicted level of optimal improvement,
○ Guided and informed by APTA positions, interventions to be used, proposed duration and
standards, guidelines, policies, and procedures, frequency of the interventions that are required to
the physical therapist responsible for the clinical reach the goals and outcomes, and plans as
direction of physical therapist services ensures: appropriate for referral, consultation, or
co-management with other providers
■ Compliance with local, state, and federal
requirements; Intervention
■ Services are provided in accordance
with established policies and ● Is provided at a level that is consistent with best
procedures; available evidence and current physical therapist
■ The process for assignment and practice;
reassignment of physical therapist staff ● Is in direct alignment with the patient’s or client’s
(handoff communication) supports desired outcomes and goals;
individual physical therapist
 ● Is altered in accordance with changes in response or
status; and
● Is provided in such a way that directed and supervised
responsibilities are commensurate with the
qualifications and legal limitations of the physical
therapist assistant.
Lifelong and Long-Term Patient and Client Relationships
● Foster continuity of service over patients’ and clients’
lifespans by addressing changes in the movement
system, health status, or disabilities as they arise;
● Empower patients and clients to advocate for their own
health;
● Empower the physical therapist to advocate on behalf
of patients and clients within the health services
system; and
● Foster identification by patients and clients that they
have their own physical therapist among various health
professionals.
Reexamination
- The physical therapist reexamines the patient or client
as necessary to evaluate progress or change in status.
Reexamination may occur during an episode of care,
during follow-up encounters after an American Physical
Therapy Association / 5 episode of care, or periodically
in the case of the management of patients and clients
with chronic conditions. During reexamination the
physical therapist modifies the management plan
accordingly and refers the patient or client to another
health services provider for consultation as necessary.
Conclusion of an Episode of Care
- The physical therapist concludes an episode of care
when the goals and outcomes for the patient or client
have been achieved, when the patient or client is
unable to further progress toward goals, or when the
physical therapist determines that the patient or client
will no longer benefit from physical therapy.
Communication/Coordination/Documentation
- The physical therapist communicates, coordinates, and
documents all aspects of patient and client
management including the results of the initial
examination and evaluation, diagnosis, prognosis, plan
of care, intervention, responses to intervention,
changes in patient or client status relative to the
intervention, reexamination, and episode of care
summary.
Consultation:
- Upon the request of another clinician(s), the physical
therapist renders professional expert opinion or advice
by applying highly specialized knowledge and skills to
aid in the management of an individual’s health
condition. The physical therapist documents the
findings and any recommendations of the consultation
as part of the management plan.
Referral
● Refer an individual to another provider and either
conclude care or not develop a plan of care;
● Refer an individual to another provider and continue
the management plan at the same time;
● Receive an individual referred from another provider
who chooses not to continue services for the individual;
● Receive an individual from another provider who
continues to provide services to the individual (if the
physical therapy episode of care is ongoing, the
physical therapist shares responsibility for the
individual); or
● Receive an individual from another provider for
diagnostic and or physiologic testing.
EDUCATION
- The physical therapist is responsible for individual
professional development.
● Under the direction and supervision of the physical
therapist, participate in the education of peers, other
health services providers, and students.
● The physical therapist educates and provides
consultation to consumers and the general public
regarding the purposes and benefits of physical
therapy.
● The physical therapist educates and provides
consultation to consumers and the general public
regarding the roles of the physical therapist and the
physical therapist assistant.
ADVOCACY
- The physical therapist and the physical therapist
assistant will participate in advocacy for patients’ and
clients’ rights with respect to:
● Physical therapy being an entry-point for patients into
the health services system;
● Physical therapists serving in primary care roles;
● Appropriate access to needed health services including
physical therapist services; and
● Communities creating safe and accessible built
environments, where population health is a priority.
RESEARCH
- The physical therapist applies research findings to
practice and encourages, participates in, and promotes
activities that establish the outcomes of patient and
client management provided by the physical therapist.
The physical therapist:
● Remains current in their knowledge of literature related
to practice;
● Protects the rights of research subjects and maintains
the integrity of research;
● Participates in research as appropriate to individual
education, experience, and expertise;
● Educates physical therapists, physical therapist
assistants, students, other health professionals, and
the general public about new evidence from research
and the outcomes of physical therapist practice; and
● Accesses and translates knowledge in support of
clinical decisions, and uses literature based on its
quality and appropriateness
COMMUNITY RESPONSIBILITY
- The physical therapist demonstrates community
responsibility by participating in community and
community agency activities, educating the public,
formulating public policy, and providing pro bono
physical therapist services.