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.
~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.
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.
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.
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.
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.
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.
我在職能治療是什麼? 身為OT最常被問的Q&A這篇文章中有更詳細的描述職能治療怎麼幫助患者恢復功能的唷!
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.
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.
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.
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
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
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!
想要更了解職能治療?
訂閱!

參考資料:
- Occupational Therapy Vs Physical Therapy: Differences Worth Knowing
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/
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
2 Comments
Edison
2019-10-15 at 14:20:44thank you so much
MARIANA LEE
2017-08-14 at 16:37:00Amazing 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