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PTA Blog Talk

Other Territory

Published May 29, 2012 8:13 PM by Jason Marketti

I was treating a patient and we were alternating between LE and UE exercises. So we rested the legs and worked the arms. I instructed the patient to do "21"s (a fallback to my body-building days) and we really blasted those biceps. Then I was thinking about the poor OTs who had to treat this guy after I am done with him. The guy's arms looked like a couple of wet spaghetti noodles and they were going to want him to don and doff stuff like compression stockings. The patient didn't mind the workout and actually liked the different routine we did but he could barely lift his SPC as we walked (like Lee Haney) back to the room.

Over the years, I have discussed the whole UE/LE thing with the OTs and most don't mind if PT steps in with some UE exercises as long as we don't fatigue the patient too much and they still have energy for functional dressing and ADLs. I doubt the guy I saw will be doing many ADLs but at least his bicep actin and myosin potential will be greater the next day.

Now let's change it up. What if we in PT saw an OT instructing a patient in gait and doing LE exercises with him. Would we say something like, "Hey you can't do that, you don't know what you are doing?" They can though. For activity tolerance and lower-body strengthening for ADLs, OTs could do leg exercises and walk with a patient. Would PTs become even more territorial if OTs did this more? But there are PTs who see nothing wrong with doing UE exercises with a patient who also sees an OT. Can someone explain this?


I think we have to be careful not to duplicate services.  It's not that either field can't cross over, it's that we need specific reasons & goals for completing our services.  For example, I may have a person stand & reach for cones to work on dynamic balance, the OT may do the same but is working on AROM of the shoulder.  I would recheck my PT goals.  Does the PT have a specific goal for UE strengthening to progress something functional for the pt that is PT related?  If not, it shouldn't be the PTA's focus.  If OT doesn't have a strength goal & you feel one should be added, talk to your PT or OT about it.  

Sandy Baldwin, PTA October 19, 2012 6:23 AM

Hey Jason,

 My advice to you would be to check out the OT's evaluation and look at their goals, as they may have an upper extremity strength goal...

-Rachel, MS, OTR/L

Rachel June 6, 2012 5:39 PM

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About this Blog

    Jason J. Marketti
    Occupation: Physical Therapist Assistant
    Setting: San Jacinto, CA
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