【走进康复科】一分钟了解作业治疗和物理治疗的区别

【走进康复科】一分钟了解作业治疗和物理治疗的区别

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前言

由于国内大部分的高等院校只开设了康复治疗学，所以很多人并不是很能分清物理治疗和作业治疗的区别，而国外都是物理治疗和作业治疗完全分开的。所以希望大家能够不仅仅局限于康复治疗这个词，这个词其实并不有助于物理治疗和作业治疗的发展。因为这两个的方向基本上有太多的不同，也完全没有谁高于谁的说法。希望大家看完今天的推送能澄清以前的关于PT和OT的某些误区。老规矩，咱们还是借助地地道道的英文来学习这些不同！

总论

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.

PT和OT最基本的不同

最简单的方法描述PT和OT的区别那就是物理治疗师看重的是如何治疗疾病本身，而作业治疗师看重的是如何把疾病或者残疾与生活相协调！PT试图通过增加移动性，矫正骨骼和关节或减轻疼痛来改善损伤本身。 OT帮助身患损伤的患者完成必要的日常任务。这样做可能涉及应用新的工具和技术。

Breaking them down！

分开来看

物理治疗

物理治疗

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.

物理治疗师更专注于评估和诊断运动功能障碍以及治疗人疾病本身。虽然职业治疗师也会有对应的评估，但是物理治疗师将更有可能诊断和治疗问题的物理性来源，比如受伤的身体组织和结构。

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 othe

物理治疗师可以专注于许多不同的领域，包括运动医学，儿童健康（儿科）和妇女的健康，在这些领域内有三个不同的实践。这些是：

肌肉骨骼物理治疗，也称为矫形物理疗法，用于治疗诸如扭伤，背痛，关节炎，拉伤，失禁，滑囊炎，姿势问题，运动和工作场所损伤以及行动不便的状况。手术后的康复也包括在此类别中。

神经系统物理治疗 - 用于治疗神经系统疾病，包括中风，脊髓损伤，获得性脑损伤，多发性硬化和帕金森病。它也可以用于脑手术后的康复。

心肺物理治疗指是用于治疗使用的哮喘，慢性支气管炎，肺气肿和其他心脏呼吸障碍的名称。

Types of therapies

Each 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 spinalmobilisation), 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.

治疗类型: 每个人的治疗都是根据自己的具体要求量身定制的，物理治疗师将选择广泛的治疗方法，包括： 手动治疗 - 这些可包括，联合操纵和脊柱训练，手动阻力训练和拉伸。 运动程序 - 如肌肉加强，姿势再训练，心血管伸展和训练. 电疗技术 - 包括经皮神经刺激（TENS），激光治疗，透热疗法和超声波。

作业治疗

作业OT

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.

与物理治疗相比，职业治疗往往更注重评估和改善人生活的能力。职业治疗师通常不使用诸如物理治疗师的手动治疗或针灸的技术直接治疗损伤，而更通常地帮助人在损伤或身体损伤的情况下优化其独立性和完成日常活动的能力。

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.

职业治疗师通常也会直接治疗损伤，但更常见的是职业治疗更多地侧重于改善生活技能，并在治疗师定制治疗方案的时候采用适应性的工具。比如在世界的一些地方，职业治疗师利用诸如在损伤康复中使用超声波的做法，非常像物理治疗师那样。

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.

帮助人们提高他们执行日常任务的能力是职业治疗师的主要目标。 OT更有可能对家庭环境和工作环境进行现场评估，并就每个项目的适当调整提出建议，以提高生活质量。职业治疗师接受训练，以改变物理环境，以及训练人使用辅助设备以增加独立性。虽然物理治疗师进行现场评估，但这往往不太常见。

两者相互覆盖的部分

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.

物理治疗师和职业治疗师都在解剖学和肌肉骨骼系统学中训练有素，所以与一般医生医生相比，他们对肌肉骨骼损伤和康复非常了解。

虽然两个医疗专业在有很多差异，但是OT和PT之间也有很多交叉。例如，职业治疗师经常参与教育人们如何预防和避免伤害，以及教育人们关于愈合过程，就像物理治疗师。而物理治疗师反过来通常通过教育和培训帮助人们提高他们做日常活动的能力。虽然职业之间存在着这种交叉，但它们都发挥着各自非常重要的作用，并且各有所擅长的事情。在许多情况下，两类的专业人员都参与损伤恢复。

举个例子

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.

考虑一名患者需要膝关节置换手术后恢复。他的PT可能会分配各种锻炼，以改善新的人工膝关节的移动性，并舒缓手术后的疼痛和僵硬。他的OT可能教他如何在恢复的早期阶段使用轮椅，然后帮助他用新的膝盖练习上下楼梯。或者，在疗养院中，物理治疗师可以帮助患者站在轮椅上并保持站立平衡，而职业治疗师协助她在如何刷牙。通常，PT和OT 密切合作，帮助患者实现完全康复。

下面临时插上一个不得不提的话题，什么是按摩师呢？

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.

按摩是由从业人员利用技术，并涉及移动身体的肌肉和软组织。按摩治疗技术可以包括但不限于摩擦，揉捏，滑行，打击，振动，压缩和在正常解剖运动范围内的被动或主动拉伸。“按摩治疗师施加的最常见的按摩形式是瑞典式按摩，深层组织按摩以及触发点按摩。

所以物理治疗和作业治疗都是临床疗法，涉及到复杂的临床诊断和评估！！！！！！而按摩只是一种肌肉的放松，完完全全不同！

写到这，还并没有结束，因为草草结束不是我的风格。为了对得起标题，我找来了悉尼大学PT和OT两年制研究生的课程名称，大家赶快看看有什么区别吧。想来国外读书的孩纸也借此机会看看国外大学课程大纲吧！

先看作业治疗

第一年第一学期

Assessing Evidence for OT Practice  OT循征学

OT Assessment and Planning           OT评估和制定计划

Introduction to OT Theory and Practice  OT理论和实习

下面三个课中选择一门

Oriented Musculoskeletal Anatomy A   骨骼肌肉解剖学A

Psychology for Graduate Students     研究心理学

Clinically Based Neuroscience         临床神经科学

e-Health for Health Professionals    健康信息化医学

标注：关于e-health，有一段解释：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.

健康信息化是利用信息和通信技术（ICT）促进健康。例子包括治疗患者，进行研究，教育卫生人力，跟踪疾病和监测公共卫生。

第一年第二学期

Biomechanical and Sensorimotor Strategies 生物力学和感觉运动策略

OT in Home and Community Environments 作业治疗改造家庭和社区环境

OT in School and Work Environments         作业治疗改造学校和工作环境

Developing OT Prof. Skills in Practice  OT理论和实习

第二年第一学期

Psychosocial and Cognitive Strategies         心理社会学和认知策略

Enabling Occupation with Communities 发挥作业治疗在社区中作用

Community-Based OT Fieldwork                基于社区的实习

或者选择

Research Project Elective        研究项目

第二年第二学期

Implementing Skills in OT Prof Practice  如何把OT技术和OT专业化的实习结合

Reflexivity and OT Professional Practice 反思化学习以及OT实习

Evaluation of OT Practice   评估化实习

或者选择

Research Elective Dissertation 研究项目

下面看看物理治疗

第一年第一学期：

Cardiopulmonary Physiotherapy     心肺物理治疗

Musculoskeletal Physiotherapy IA   肌肉骨骼物理治疗IA

Musculoskeletal Physiotherapy IB     肌肉骨骼物理治疗IB

Neurological Physiotherapy     神经物理治疗

第一年第二学期：

Neurological and Cardiopulmonary Physio    神经和心肺物理治疗

Musculoskeletal Physiotherapy II 肌肉骨骼物理治疗II

Musculoskeletal Physiotherapy III 肌肉骨骼物理治疗III

Physiotherapy across the Lifespan 物理治疗贯穿生命

第二年第二学期

Physiotherapy Practicum 1     物理治疗实习1

Physiotherapy Practicum 2     物理治疗实习2

Musculoskeletal Physiotherapy IV    肌肉骨骼物理治疗

Physiotherapy Health Care and Society    物理治疗和社会的关系

第二年第二学期

Physiotherapy Practicum 3        物理治疗实习3

Physiotherapy Practicum 4        物理治疗实习4

Advanced Physiotherapy Practice        高级物理治疗实习

Advanced Clinical Reasoning           高级临床推理

总结一下

相信大家从悉尼大学的教学大纲中可以看出来物理治疗和作业治疗的整体区别。这里和大家普及一下，澳洲的PT和OT研究生都是2年，会包含临床1000个小时的实习。一般一年2学期，每学期都会学4门课，这种叫做授课型研究生，也就是说研究生阶段侧重于基本知识的学习而不是研究。会有论文，演讲，考试等等考核方式。

（来源：康复资讯）

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