職能治療|物理治療|最大的差別? 史上最狂解說!

成在OT

成在OT

我們是集國外康復乾貨,英語學習,出國留學資訊於一體的澳洲小分隊,打開視野,提高水平,每天進步一點點,做一個國際化的康復工作者
成在OT

職能治療與物理治療最大的差別?那就是物理治療師看重的是如何治療疾病本身,而職能治療師看重的是如何把疾病或者殘疾與生活互相協調!PT試圖通過增加移動性,矯正骨骼和關節或減輕疼痛來改善損傷本身。 OT幫助身患損傷的患者完成必要的日常任務。這樣做可能涉及應用新的工具和技術。

哈囉~今天非常榮幸到张罗成,來和各位介紹職能治療與物理治療的差別,他是一位在澳洲念職能治療的中國留學生,希望和大家分享在國外的留學經歷,一邊念書一邊在微信經營成在OT的公眾號,超認真的~這篇就是他在公眾號的文章唷~將職能治療與物理治療關注的焦點分析得很好!
前言

由於國內大部分的高等院校只開設了康復治療學,所以很多人並不是很能分清物理治療和作業(職能)治療的區別,而國外都是物理治療和作業(職能)治療完全分開的。所以希望大家能夠不僅僅局限于康復(復健)治療這個詞,這個詞其實並不有助於物理治療和作業(職能)治療的發展。因為這兩個的方向基本上有太多的不同,也完全沒有誰高於誰的說法。希望大家看完今天的推送能澄清以前的關於PT和OT的某些誤區。老規矩,咱們還是借助地地道道的英文來學習這些不同!

職能治療與物理治療最大的差別

The Basic Difference between OT and PT
The easiest way to describe the difference between physical therapy and occupational therapy is that a physical therapist treats the patient’s actual impairment, while an occupational therapist treats that impairment in action. The PT tries to improve the impairment itself by increasing mobility, aligning bones and joints or lessening pain. The OT helps the patient complete necessary everyday tasks with the impairment.  Doing so may involve applying new tools and techniques.

最簡單的方法描述PT和OT的區別那就是物理治療師看重的是如何治療疾病本身,而作業(職能)治療師看重的是如何把疾病或者殘疾與生活互相協調!PT試圖通過增加移動性,矯正骨骼和關節或減輕疼痛來改善損傷本身。 OT幫助身患損傷的患者完成必要的日常任務。這樣做可能涉及應用新的工具和技術。
~分開來看~

物理治療

The PT tends to be more focused on evaluating and diagnosing movement dysfunctions as well as treating a person’s injury itself. While an occupational therapist will often also do diagnosis, the physical therapist will be more likely to diagnose and treat the physical source of the problem; the injured tissues and structures.

物理治療師更專注於評估和診斷運動功能障礙以及治療人疾病本身。雖然作業(職能)治療師也會有對應的評估,但是物理治療師將更有可能診斷和治療問題的物理性來源,比如受傷的身體組織和結構。

Physiotherapists can specialise in a number of different areas including sports medicine, children’s health (paediatrics), and women’s health and within these parameters there are three different areas of practise. These are:
Musculoskeletal which is also called orthopaedic physiotherapy and is used to treat conditions such as sprains, back pain, arthritis, strains, incontinence, bursitis, posture problems, sport and workplace injuries, plus reduced mobility. Rehabilitation following surgery is also included within this category.
Neurological- This is used to treat disorders of the nervous system including strokes, spinal cord injuries, acquired brain injuries, multiple sclerosis and Parkinson’s disease. It can also be used for rehabilitation following brain surgery.
Cardiothoracic is the name given to the treatment of used asthma, chronic bronchitis, emphysema and others.

物理治療師可以專注於許多不同的領域,包括運動醫學,兒童健康(兒科)和婦女的健康,在這些領域內有三個不同的實踐。這些是:
肌肉骨骼物理治療 – 也稱為矯形物理療法,用於治療諸如扭傷,背痛,關節炎,拉傷,失禁,滑囊炎,姿勢問題,運動和工作場所損傷以及行動不便的狀況。手術後的康復(復健)也包括在此類別中。
神經系統物理治療 – 用於治療神經系統疾病,包括中風,脊髓損傷,獲得性腦損傷,多發性硬化和帕金森病。它也可以用於腦手術後的康復(復健)。
心肺物理治療 – 指是用於治療使用的哮喘,慢性支氣管炎,肺氣腫和其他心臟呼吸障礙的名稱。

Types of therapiesEach individual’s treatment is tailored to suit their specific requirements and a physiotherapist will choose from a wide range of therapies, including:Manual therapies – These can include, joint manipulation and mobilisation (which includes spinal mobilisation), manual resistance training, and stretching.
Exercise programmes – such as muscle strengthening, posture re-training, cardiovascular stretching and training.
Electrotherapy techniques – which consists of Transcutaneous Electrical Nerve Stimulation (TENS), laser therapy, diathermy, and ultrasound.

治療類型: 每個人的治療都是根據自己的具體要求量身定制的,物理治療師將選擇廣泛的治療方法,包括:
手動(徒手)治療 – 這些可包括,聯合操縱和脊柱訓練,手動阻力訓練和拉伸。
運動 – 如肌肉加強,姿勢再訓練,心血管伸展和訓練.
電療技術 – 包括經皮神經刺激(TENS),鐳射治療,透熱療法和超音波。

作業治療

As compared with Physical Therapy, occupational therapy tends to focus more on evaluating and improving a persons functional abilities. An occupational therapist often does not directly treat a person’s injury using techniques such as manual therapy or acupuncture-like a physical therapist would but more commonly helps a person optimize their independence and their ability to accomplish their daily activities following an injury or in situations of physical impairment.

與物理治療相比,職業(職能)治療往往更注重評估和改善人生活的能力。職業(職能)治療師通常不使用諸如物理治療師的手動治療或針灸的技術直接治療損傷,而更通常地幫助人在損傷或身體損傷的情況下優化其獨立性和完成日常活動的能力。

Occupational therapists often will directly treat injuries, but more even often occupational therapy focuses more on improving life skills and incorporating adaptive tools at times customized by the therapist. In some parts of the world occupational therapists utilize practices such as use of ultrasound in injury rehabilitation, much like a physical therapist does.

職業(職能)治療師通常也會直接治療損傷,但更常見的是職業(職能)治療更多地側重於改善生活技能,並在治療師定制治療方案的時候採用適應性的工具。比如在世界的一些地方,職業(職能)治療師利用諸如在損傷康復中使用超聲波的做法,非常像物理治療師那樣。

Helping people improve their ability to carry out their daily tasks is a prime goal of the occupational therapist. An OT is more likely to perform on-site assessments of both the home environment and work environment and give recommendations on suitable adaptations of each to allow for a better quality of life. The occupational therapist is trained to modifying the physical environment as well as training the person to use assistive equipment to increase independence. While physical therapists do on-site assessments as well this tends to be less common.

幫助人們提高他們執行日常任務的能力是職業治療師的主要目標。 OT更有可能對家庭環境和工作環境進行現場評估,並就每個專案的適當調整提出建議,以提高生活品質。職業(職能)治療師接受訓練,以改變物理環境,以及訓練人使用輔助設備以增加獨立性。雖然物理治療師進行現場評估,但這往往不太常見。

職能治療與物理治療相互覆蓋的部分

Both physical and occupational therapists are trained extensively in anatomy and the musculoskeletal system resulting in both being very knowledgeable about musculoskeletal injuries and rehabilitation than a general practitioner medical doctor.
Although the two health care professions have differences in their focus there is much crossover between OT and PT. For an example of the crossover, an occupational therapist is often involved in educating people on how to prevent and avoid injuries, as well as educating people about the healing process, just like a physical therapist. Physical therapists in turn often help people improve their ability to do their daily activities through education and training. While there is this crossover between professions both play very important roles and are specialized in their areas of expertise. In many situations, both types of health-care professional are involved in injury recovery.

物理治療師和職業(職能)治療師都在解剖學和肌肉骨骼系統學中訓練有素,所以與一般醫生醫生相比,他們對肌肉骨骼損傷和康復非常瞭解。雖然兩個醫療專業在有很多差異,但是OT和PT之間也有很多交叉。例如,職業(職能)治療師經常參與教育人們如何預防和避免傷害,以及教育人們關於癒合過程,就像物理治療師。而物理治療師反過來通常通過教育和培訓幫助人們提高他們做日常活動的能力。雖然職業之間存在著這種交叉,但它們都發揮著各自非常重要的作用,並且各有所擅長的事情。在許多情況下,兩類的專業人員都參與損傷恢復。
舉個例子

Consider a patient recovering from knee replacement surgery. His PT would likely assign various exercises to improve mobility with the new artificial knee and to ease post-surgery pain and stiffness. His OT might teach him how to use a wheelchair in the early stages of recovery, then help him practice going up and down stairs on the new knee. Or, in a nursing home, the physical therapist may help a patient stand from a wheelchair and maintain standing balance, while the occupational therapist assists her in performing hygiene tasks at the sink. Often, PTs and OTs/OTAs collaborate closely to help the patient achieve a full recovery.

考慮一名患者需要膝關節置換手術後恢復。他的PT可能會分配各種鍛煉,以改善新的人工膝關節的移動性,並舒緩手術後的疼痛和僵硬。他的OT可能教他如何在恢復的早期階段使用輪椅,然後幫助他用新的膝蓋練習上下樓梯。或者,在療養院中,物理治療師可以説明患者站在輪椅上並保持站立平衡,而職業(職能)治療師協助她在如何刷牙。通常,PT和OT 密切合作,幫助患者實現完全康復。

下面臨時插上一個不得不提的話題,什麼是按摩師呢?

Massage therapy is a technique utilized by certified practitioners and involves techniques for moving muscles and soft tissues of the body. Massage therapy techniques may include, but are not limited to, friction, kneading, gliding, percussion, vibration, compression and passive or active stretching within the normal anatomical range of movement.” The most common forms of massage applied by massage therapists are Swedish massage, deep tissue massage as well as trigger point therapy.

按摩是由從業人員利用技術,並涉及移動身體的肌肉和軟組織。按摩治療技術可以包括但不限於摩擦,揉捏,滑行,打擊,振動,壓縮和在正常解剖運動範圍內的被動或主動拉伸。“按摩治療師施加的最常見的按摩形式是瑞典式按摩,深層組織按摩以及觸發點按摩。所以物理治療和作業治療都是臨床療法,涉及到複雜的臨床診斷和評估!!!!!!而按摩只是一種肌肉的放鬆,完完全全不同!

寫到這,還並沒有結束,因為草草結束不是我的風格。為了對得起標題,我找來了悉尼大學PT和OT兩年制研究生的課程名稱,大家趕快看看有什麼區別吧。想來國外讀書的孩紙也借此機會看看國外大學課程大綱吧!

悉尼大學職能治療學系

第一年第一學期
Assessing Evidence for OT Practice  OT循征學
OT Assessment and Planning           OT評估和制定計劃
Introduction to OT Theory and Practice  OT理論和實習
下面三個課中選擇一門
Oriented Musculoskeletal Anatomy A   骨骼肌肉解剖學A
Psychology for Graduate Students     研究心理學
Clinically Based Neuroscience         臨床神經科學
e-Health for Health Professionals    健康資訊化醫學
標注:關於e-health,有一段解釋:eHealth is the use of information and communication technologies (ICT) for health. Examples include treating patients, conducting research, educating the health workforce, tracking diseases and monitoring public health.
健康資訊化是利用資訊和通信技術(ICT)促進健康。例子包括治療患者,進行研究,教育衛生人力,跟蹤疾病和監測公共衛生。第一年第二學期
Biomechanical and Sensorimotor Strategies 生物力學和感覺運動策略
OT in Home and Community Environments   作業治療改造家庭和社區環境
OT in School and Work Environments    作業治療改造學校和工作環境
Developing OT Prof. Skills in Practice  OT理論和實習第二年第一學期
Psychosocial and Cognitive Strategies    心理社會學和認知策略
Enabling Occupation with Communities 發揮作業治療在社區中作用
Community-Based OT Fieldwork            基於社區的實習
或者選擇
Research Project Elective       研究專案
第二年第二學期
Implementing Skills in OT Prof Practice  如何把OT技術和OT專業化的實習結合
Reflexivity and OT Professional Practice 反思化學習以及OT實習
Evaluation of OT Practice   評估化實習
或者選擇
Research Elective Dissertation 研究專案

悉尼大學物理治療學系

第一年第一學期:
Cardiopulmonary Physiotherapy     心肺物理治療
Musculoskeletal Physiotherapy IA   肌肉骨骼物理治療IA
Musculoskeletal Physiotherapy IB     肌肉骨骼物理治療IB
Neurological Physiotherapy     神經物理治療第一年第二學期:
Neurological and Cardiopulmonary Physio    神經和心肺物理治療
Musculoskeletal Physiotherapy II 肌肉骨骼物理治療II
Musculoskeletal Physiotherapy III 肌肉骨骼物理治療III
Physiotherapy across the Lifespan 物理治療貫穿生命第二年第二學期
Physiotherapy Practicum 1     物理治療實習1
Physiotherapy Practicum 2     物理治療實習2
Musculoskeletal Physiotherapy IV    肌肉骨骼物理治療
Physiotherapy Health Care and Society    物理治療和社會的關係
第二年第二學期
Physiotherapy Practicum 3     物理治療實習3
Physiotherapy Practicum 4     物理治療實習4
Advanced Physiotherapy Practice  高級物理治療實習
Advanced Clinical Reasoning     高級臨床推理
總結一下

相信大家從悉尼大學的教學大綱中可以看出來物理治療和作業治療的整體區別。這裡和大家普及一下,澳洲的PT和OT研究生都是2年,會包含臨床1000個小時的實習。一般一年2學期,每學期都會學4門課,這種叫做授課型研究生,也就是說研究生階段側重于基本知識的學習而不是研究。會有論文,演講,考試等等考核方式。

看完滿滿的一篇乾貨,是不是對物理治療和作業(職能)治療更加清楚了呢?別只看中文哦,要記得英文的學習,這也是我的公眾號和別人的不同。另外,到這裡結束也不是我的風格,下面再為大家放上精選的Youtube視頻哦,看看作業(職能)治療師和物理治療師對於同一個患者採取了什麼不同的方案吧!視頻中的小男孩有呼吸障礙,所以在醫院接受物理治療和作業治療!一睹為快吧!

QQ視頻
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最後的最後~如果還想知道有甚麼其他相關的澳洲OT問題,只要訂閱成在OT,就可以收到第一收資訊喔!
參考資料:

圖片來源:

  • http://vtphysicaltherapy.com/2017/03/23/cdc-recommends-physical-therapy-and-other-non-drug-options-for-chronic-pain/
  • http://newporthospitalandhealth.org/service/rehabilitation-services/occupational-therapy/
  • https://atlanticptcenter.com/
  • http://www.ludhianaonline.in/city-guide/occupational-therapists-in-ludhiana
  • https://de.dreamstime.com/photos-images/rollstuhl-schattenbild.html
  • http://manufacturing.penton.com/infographic-new-osha-requirements-for-injury-and-illness-reporting/
  • http://www.soroptimistphil.org/2017/05/19/%E3%83%95%E3%82%A3%E3%83%AA%E3%83%94%E3%83%B3%E3%81%AE%E6%A0%BC%E5%AE%89%E3%83%9E%E3%83%83%E3%82%B5%E3%83%BC%E3%82%B8/

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臉書留言

一般留言

  1. Amazing comparative analyses of the essence of two allied Health professions, we are PT & OT somewhat like non- identical twins in the rehabilitation/ health spectrum…..Yes, read both the Chinese & English versions: spotted some words which may be better in either versions..
    Inspiring to many OTs experiencing identity crises in financially restraints macro environment.
    We have grey overlapping areas but this healthy overlapping enables clients transition smoothly in different sectors..
    Just differentiate what is supporting, like Putty is warm up only, versus what is core focus, functional movements and occupational tasks to work reconditioning/ return to community living…..
    Hold on tightly to the core, OCCUPATIONAL amidst adverse conditions…..
    Keep our OCCUPATIONAL roots heritage amidst chaos…..BRAVO…..Good fruitful sharing…..
    KEEP THE OCCUPATIONAL THERAPY SPIRITS ALIVE!

    Mariana.LEE
    Trained in England 1976-79, with Hong Kong, Canadian, Australian professional qualifications
    Retired Community Health Volunteer and Active Ageing Advocate
    Housewife, Mother, Daughter, Volunteer…..are all OCCUPATIONAL life-roles
    Special interest in Professional Identity and Collaborative Teamwork

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