What is the difference between OT and PT?
This is a question I get asked a lot, and for good reason. What I’ve noticed is that, unless you have a child that received services, or a parent you have supported while at a rehabilitation center, it’s difficult to understand the difference. In many settings, the OT and PT will be working together on a case very closely because there may be some overlap in treatment. Academically, both professions require similar schooling- OT/PT students shared the same classrooms for Anatomy and Physiology. However, our differences come into play with the theories that define the outlook and goals for our treatment.
Theories refer to the outlook on treatment – think of it like choosing your political view. Physical therapy only uses a Biomechanical Model of improving performance. PTs focus on Strength, Range of Motion, and balance for improved gait (walking), and transfers (moving from one position to another). Occupational Therapists are trained in the Biomechanical Model, but also a range of other theories that reflects training in psychology, sociology, communication and the way we perform functional activities. A simple analogy - Physical Therapy are like body builders performing reps to build muscle, and Occupational Therapy are the Yogi’s or Dancers. Both groups are athletes and may look similar and work on the same muscle groups, but they have a different approach. The setting also determines the way Occupational Therapists perform treatment.
In Acute settings OT focuses on Activities of Daily Living (ADL’s). ADL’s are defined as daily occupations performed at home that are required to get back to your routine, typically it includes tasks in Toileting, Dressing, Hygiene, Bathing. Insurance companies and the Interdisciplinary team (nursing, social work, MD, etc) want to see that you can perform these tasks safely and independently before discharging to the home. Your Occupational Therapist is the person that will ensure your independent mobility with exercise and functional activities in treatment. Let’s say an 80 year old woman breaks her hip and gets a hip replacement, after a couple days in the hospital the doctor deems her unsafe to return home because she can’t go to the bathroom on her own or walk. Instead, they send her to a Sub-Acute Rehabilitation where an OT will work on her ability to perform ADL’s on her own, and PT will work on her ability to stand, walk and climb the stairs needed at home.
In Outpatient settings, or a Hand Therapy Clinic, there are specialists called Certified Hand Therapists (CHT) for injuries of the Upper Extremities. This is for those that may have had a work related injury like Carpal Tunnel (refer to the Ergonomics Blog Post!), and need surgery, or someone who fell on ice and broke their wrist. Believe it or not, 70% of Certified Hand Therapists are Occupational Therapists, 30% are Physical Therapists. In this setting, splints or devices to help the joint heal properly are made or fitted by your therapist. This is in combination with exercises specific to your needs to ensure safe return to daily activities. In this setting, the two are very similar. In some settings, people define OT as upper body specialists, and PT for lower body injuries, but there is a clear difference in the assessments we perform and the way we document treatment.
In Pediatric settings, Occupational Therapists have the best job in the world - to play with babies! This comes with strategic play. Just as in the other settings, we evaluate where a child is struggling or has a developmental delay, and plan an activity to focus on improving those areas of difficulty. The children seen in occupational therapy may have a diagnosis of Autism Spectrum Disorder, Down Syndrome, ADHD, or a Learning Disability, but many times they may go undiagnosed. That's where our specialty is our strength, we assess all different areas of the way your child processes their world from attention, the way they hold a pencil, how they process sound or vision, social communication, and we can differentiate behavior difficulties from sensory processing difficulties. OT’s in this setting will report on behaviors, abilities to perform fine motor and gross motor tasks, communication, visual attention and ability to perform ADL’s, PT’s will focus on strength, posture, and mobility. The two disciplines may overlap, especially in this setting, but the differences are more clear in the documentation and goals for treatment.
Occupational and Physical Therapists are the twins that keep getting confused with each other, not to mention our third sibling Speech Therapy. We’re all healthcare professions that are needed in similar settings, and get grouped together for insurance reimbursement. However, we each belong to different national associations and have different specialties.
I hope that helps those of you that were confused! If you have questions, please feel free to reach out to me at smplytherapy@gmail.com