What is the difference between Occupational Therapy (OT)
& Physiotherapy (PT). This is a question often asked by parents. What is
Physical Therapy?
Physiotherapy is the same as Physical Therapy (used in the
USA).
Although being 2 different areas of rehabilitation, PT and OT
overlap in every rehabilitation setting, more so in pediatric therapy. In the
USA, there is a scope of practice for each of them, delineated by boards,
organizations, and insurance companies. The PT and OT roles vary state wise,
practice wise, and may slightly change periodically.
Having said this, PT & OT are not watertight
compartments. PT is foundational to improving mobility and function; OT is
foundational to functional occupation of the patient. Broadly speaking, PTs
deal with the lower body, gross motor, mobility, transfers, breathing exercises,
and endurance. OTs work on the upper body, fine motor, writing, dressing and
other activities of daily living (ADL). Addressing cognition and feeding overlaps
between OT and speech therapists.
Speaking about the overlap in adult rehabilitation, PT &
OT both work towards improving transfer mobility of patients i.e. transfers out
of bed, transfers from bed to chair, transfers sit to stand, and transfers from
wheelchair to toilet seat. While working in the USA, I have worked on transfers
on a regular basis, either along with an OT, or each of us has done the same
with an aide (based on staff availability).
When it comes to children, there were many tasks that
overlapped between PT and OT. For eg. rolling, sit-stand transfers, sitting and
standing balance tasks would be done by each therapist during different
sessions. Or during a co-session, PT would address postural control, while the
OT would work on fine motor, cognition, visual skills at the same time. If the
PT sat a child / adult on a therapy ball, the OT would work on eye-hand
coordination at the same time.
While in the USA, as a PT, I would still offer a vision-perception
or a fine motor task (e.g assembling a puzzle, fixing pegs on a foam board) during
PT sessions but working on visual skills would not be my stated goal. An OT
would work on vision-perception tasks.
PTs deal with muscle tone, core stability, and postural
deviations that contribute to other areas such as vision, proprioception, and
ultimately learning. The foundations of core strength and endurance that are
addressed through play can contribute to improved handwriting. When we look
closely at children with ASD, a large majority will have issues with muscle tone,
core strength, balance, and endurance.
While nations like USA can afford to have PT & OT both due to economics and availability of therapists, the situation differs significantly in India, where there is a shortage of pediatric PTs as well as OTs. in proportion to the population. India is a vast country, with many small cities and towns where PT and OT is just starting to grow in the last decade.
Parents of young children are referred to Activ Kaarya with concerns about their child such as motor, sensory, feeding, behaviors, lack of sitting tolerance, difficulty with coping in the classroom. I am a pediatric PT, with a long experience of working in the USA alongside OTs. My training in Sensory Integration, as well as teaching hand and chewing-swallowing biomechanics as a faculty, my practice comprises a holistic approach of addressing both – motor & sensory components in therapy sessions. What I cannot do and if the child needs it, I will refer out to another professional as per ethical practice, eg. Oral Placement Therapy.
I would like to convey to all therapists in India, whether you are a PT or an OT, try to look at the child as a ‘whole’ entity. Consider all domains of development - motor, sensory, feeding, communication, cognitive, and socioemotional.
