Nelson Marquez, PT, EdD, Physical Therapy Editor

Nelson Marquez, PT, EdD, Physical Therapy Editor

“Physical therapy is the art and science of treatment using various therapeutic modalities to alleviate patients’ symptoms, address physical dysfunctions, and to assist patients in achieving their highest rehabilitation potential.”

I still remember memorizing this statement in preparation for my interview for PT school in the mid-80s. I thought that I should use this opener in case I get to be asked to define PT or to discuss what I know about the profession.

After many years of clinical practice, I had come to fully appreciate the science part of PT. Teaching anatomy and kinesiology made me appreciate it even more. However, the art part of my definition had eluded me over the years. I admit that I included it in my definition of PT back then as it sounded cool; besides, the senior students at the school where I applied told me that PT is an art. However, they failed to explain to me why, and I blindly subscribed to it.

In my search for validation of the art part of my definition, I came across at least two pieces of evidence that PT is an art. The first one was when I went for my NDT training and a series of advanced NDT courses under Susan Woll, PT, and Jan Utley, PTR/L. I recall Woll saying that implementing NDT-based treatment plans is a drama. Using a novel approach in treatments demands creativity. Each treatment was supposed to be carefully planned and crafted from beginning to end, including the props that will be used for the session.

Teaching a course on patient interaction in our PTA program at Polk State College guided me toward my second piece of evidence. Referencing Purtilo and Haddad in the course, my students and I discussed the similarity of our patient interactions with a play or drama. We concluded that both patient interactions and a play or drama have similar components: actors with their specific roles and some kind of a script for each role. In addition, both have a beginning, middle and end. However, one difference exists: in a play or drama, we know how it will end. For patient interactions, we do not know how these will end. Each interaction is also full of improvisations.

These pieces of evidence seem not to hold water as I have observed many therapists over the years. It is not easy to ignore the fact that I have observed these therapists perform the following exercises, regardless of their patients’ diagnoses: ankle pumps, heel slides, windshield wipers, short arc quads or its variant: with ankle weights! This observation made me ask the question: “How can you follow the same script over and over?” I know that when these therapists graduated from PT or PTA school, they had a repertoire of treatment approach that they had learned. But how can they forget them so quickly? Is it because they are now tainted? Having seen others get away with the same mundane treatments, do they now believe that somehow it is the norm?

Because of these observations, I set on a course to not allow my students become tainted. Through many hands-on practice, case studies and problem-based activities in my classes, I was hoping that my students would appreciate the artistry in PT and avoid becoming tainted. But I was still doubtful until I came across an article from a North Carolina newspaper, the Andrews Journal. The article entitled, “Art and Therapy Come Together,” described how patients who are wheelchair-bound made tire marks on a blank fabric canvas by rolling their wheelchairs through paint. Jennifer Jack, PTA, created the wheelchair art exercise as a way to make physical therapy for patients fun and exciting, while teaching them wheelchair mobility skills. As patients roll their wheelchairs through the paint, they created various patterns and color combinations that resulted in their collaborative masterpiece. The PT team planned to display the painted canvas in the facility’s entrance to showcase the patients’ artwork.

Who would have thought that I would find a possible answer to my quest in a small town in North Carolina?

Thank you, Jennifer Jack, for providing me a third piece of evidence of artistry in PT and for helping validate my memorized definition of PT. Most of all, as a former student, I salute you for not allowing yourself to become tainted.

As we celebrate National PT Month in October, I would like for all of us to make a pact: “Banish becoming tainted in our profession!”

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