History of Physical Therapy Practice in the United States, The

Journal of Physical Therapy Education, Winter 2003 by Moffat, Marilyn

The first Social Security Act, which later had a major impact on the provision of physical therapy services to the elderly in the United States, was passed by Congress in 1935 and was initially the old-age retirement system, which employees and employers financed through taxes.

In the mid 1920s, a group of physical therapy physicians had founded the American College of Physical Therapy, which then became the American Congress of Physical Therapy. By the mid 1930s, a group of these physicians had established the American Registry of Physical Therapy Technicians for the purpose of conferring a registered title to physiotherapists who passed the test. Registered physiotherapists remained technicians under the supervision of physicians.6

By 1937, physical therapy physicians had achieved recognition as a medical specialty. In an effort to further distinguish themselves from physiotherapists and in order to gain respect within the medical profession, physical therapy physicians began to call themselves "physiatrists."

APA hired its first paid staff member in 1934; membership grew to 710. A year later, the APA adopted its first "Code of Ethics and Discipline." The Association's active member category required members to have graduated from an approved school of nursing, passed an approved course in physical therapy for physical education and nursing graduates, and completed 1 year of practice within 2 years of graduation.

In reviewing the purposes of the APA in 1937, it is obvious that the technician mentality continued to dominate practice. The purposes of the Association were to:

* form a nation-wide organ which would establish and maintain a professional and scientific standard for those engaged in Physical Therapy;

* promote the science of Physical Therapy;

* aid in the establishment of educational standards and in scientific research in Physical Therapy;

* cooperate with, and to work only under the prescription of members of the medical profession;

* provide available Information for those interested in Physical Therapy;

* provide a central registry which will make available to the medical profession, efficiently trained assistants in Physical Therapy; and

* bind the several Chapters together.

In 1938, the APA established its first permanent office with the rental of space for The Physiotherapy Review in Chicago, Ill.

THE 1940s

Most of the developed world became embroiled in World War II between 1940 and 1945. Unlike World War I, World War II employed advanced technological developments enabling land, sea, and air maneuvers to be carried out in ways inconceivable before. Sixteen million people were engaged in battlefields throughout the world. As the United States prepared to enter the war, the US Army Medical Department once again became involved in plans for the reconditioning of those who would inevitably be wounded; the reconditioning was to include physical retraining, vocational rehabilitation, and psychological support.8 Drastic changes in the medical management of war wounds with penicillin and sulfa drugs and improvements in surgical techniques led to increasing numbers of individuals returning to the United States with disabling war wounds. Physical therapy practice at home and abroad was again dominated by the treatment of wounded veterans, including those with amputations, burns, cold injuries, wounds, fractures, and nerve and spinal cord injuries.6