3:46PM Apr 16, 2021
Welcome to Health queries a podcast where your health questions are answered by faculty and experts in the mcqueary College of Health and Human Services at Missouri State University. I'm your host Larn Stock. And today we are sitting down with Dr. Tracy garrison from Missouri state's occupational therapy department, and Dr. Jason Shar from Missouri state's physical therapy department. They're going to tell us about the ways that occupational therapy and physical therapy are different but also how they work together.
Right. It's good to be here for this podcast. I am Jason Shaw, physical therapist at Missouri State University. I'm an assistant professor. I had been with the university since 2004. I started as a PR course instructor, and in 2015, was hired on as full time faculty at the University. My career as a physical therapist started in 1997. I graduated with a bachelor's degree in physical therapy in 1997, from New York University a couple of years later on a colleague and I decided to study for the specialist board exam in neurologic physical therapy. And so I became certified as a board certified specialist in neurologic physical therapy in 2001. And that's a recertification that I've done every 10 years, I have to recertify with that, in 2015, I received a post professional doctorate through at still University out of Arizona. And here I am, I teach in the physical therapy program, as I mentioned, I teach the neurologic courses, the adult neuro courses, the motor control course, the integumentary course. And then of course, work with research advices.
Thank you for having me. I'm Traci Garrison. I'm a clinical assistant professor in the Department of occupational therapy. And I actually got my Bachelors at Drury here in town in biology and psychology, got my master's in occupational therapy from Washington University in St. Louis. And then a couple years ago, got my Doctorate of health science from the University of Indianapolis. And so I graduated with my ot degree in 2000, and have spent the bulk of my career in acute rehab, acute rehab and acute care. Acute Care is really my love, and came to MSU and 2014, as they were creating an occupational therapy program. So I loved having students with the hospital and decided, Hey, I could do it all the time. So I have been there, got to help create the program and have been here ever since. So I also teach neuroscience in our curriculum and the adult rehab content in kind of the pathophysiology course, and also have research invitees. And what's fun is that Dr. Shaw and I share a team. So we have OT and PT students working together on a research project.
Can you kind of describe just what an occupational therapist does?
Sure, yeah, that's a common question because our just our name is confusing. So a lot of people associate occupation with vocation. And for the occupational therapist, occupation is kind of a simple way to think of it it is whatever occupies your time. So it's what you do in a day. So everything from brushing your teeth, to cooking a meal, driving a car. So anytime a disability or an injury, or disease process gets in the way of the things that some what people want and need to do, then that's when the occupational therapist would be seeing them. So OTS work everywhere from the nichia, with the T, tiny babies, all the way up through the lifespan to end of life care. So, you know, occupations vary by age. But our specialty is in kind of analyzing those tasks and figuring out how we can help individuals either rehabilitate so that they can resume the things that they were doing, or also possibly, if needed, adapt what they need to do.
And then Jason, can you do the same thing for physical therapy?
Sure, as physical therapists, we like to think of ourselves as specialists in movement. Certainly a lot of other professions specialize and work with people in movement as well, too. We also have a strong background in helping people who have pain issues, to manage their pain. Of course, there is lots of different causes for movement, disability. Those could be related to trauma, injury, certain types of pathology overuse syndromes. So similar to occupational therapy, we work with people in a number of different settings, including hospital settings, all the way excuse me to nursing home type settings, home health settings, even in the workplace with ergonomics. That's kind of the gist of what we do.
So yeah, They are very similar, but also very different.
There's certainly a lot of overlap. And it's probably similar, perhaps between OT and PT more than any other discipline. But we also have overlaps between other disciplines. Some pts tend to specialize in sports medicine. And of course, that would overlap with physicians who specialize in sports medicine and athletic trainers. And so there certainly is our areas of overlap. For sure.
Can you guys think of a scenario basically with a patient where they would need to attend both OT and PT,
so I would just say that's extremely common. So I'm across all the settings. And so I think like, we didn't mention schools, we both work. OTS and pts also work in school systems. We work everywhere, and we can help everyone. But, um, so I would say, an easy one to describe will be someone who is post stroke or a post brain injury, post traumatic injury. So they've got, they've got movement issues, they've got cognitive issues, they also probably have psychosocial issues. And so there's a lot that goes into the rehabilitation process for those individuals. And I will just say that most of even though there's some overlap, in my career, at least, there's always plenty to work on. So I don't find that there's like any, it's very rare that there's like a rub between like, well, I want to do that. It's much more collaborative of, you know, it's fantastic that my PT colleague may be focusing on balance and specific transfers, and the move very specific movement, you know, ends of things with individual, whereas I'm maybe focusing on getting the individual back to where they can dress themselves, bathe themselves, cook their own meal, you know, wherever they are kind of on the spectrum of recovery. And so, you know, we're always bouncing ideas off of each other, like, Hey, I see this going on, what are you using, and so we're just all the time, I'm collaborating about how to, you know, help that person become more independent. That's great.
I'm interested now to know what the differences are like, what would be a scenario where someone would only have OT or someone would only have PT
I think one way to kind of help. The understanding of that might be that when you look at our training, so when Jason and I were describing what we teach, for instance, we both teach neuroscience to our students. So we have a lot of the same foundational coursework. But then as you look at, for instance, our accreditation standards about which means that's what the big accrediting body says your school has to teach, you'll see some differences. So you know, there's some probably a heavier focus on cognition and psychosocial issues for the OT. But like as therapists enter practice, they also can specialize. So like I know, PT is that if Adam had gone on and gotten more training and vision, or cognition, that type of thing, and you'll have PT or OTS that will go on and get more training and vestibular. So because we have that foundational level, we can go on and get more training, it can vary depending on the setting, and depending on the therapists that are there and the skill base that they have. So there are places where OTS can treat the same, you know, orthopedic, shoulder injury or neuro upper extremity injury as a PT could treat it as well, from my experience, when, for instance, an individual does have a perceptual deficit or a visual deficit that they're trying to compensate for, and it's really not affecting their mobility, or they have a cognitive deficit that's not affecting their mobility, then that would be more OT,
I would agree. Another area that came to mind for me was perhaps pts tend to specialize a little bit more in wound care. However, you know, the integumentary system is not owned by one discipline and OTS are very good at recognizing and managing issues related to pressure sores, things of that nature. So it may be perhaps more tradition and how we view it. So we tend to emphasize wound care a lot. OTS and pts both do lymphedema care, which is closely very intimately related with wound care. And so there certainly is a lot of overlapping areas well to another area, perhaps that maybe more specific to PT is the treatment of perhaps specific pain issues that don't necessarily require an OT to train retrain the person on functional tasks associated with that. So let's say someone hurts their back doing a particular activity they may go see the PT and the PT finds that this person has a spinal instability at a particular level, and working on particular exercises and relating that to how they move and modifying how they do things on a daily basis may be sufficient may not require specifically an OT in that case. But there are other situations where short Would the person would benefit from both disciplines?
How do the education tracks differ for OT and PT?
I think there's a lot of similarity. In fact, oftentimes, people who become OTS and pts aren't quite sure which one they're going to become in the process of doing their, their training and their preparation. There certainly is a lot of emphasis for the PT prerequisites with the basic foundational sciences. And I'm sure this is similar to ot as well too. But the biology courses, typically, General psychology, abnormal psychology, some programs require developmental psychology as well, too. I think I mentioned anatomy, physiology, strong emphasis in physics. That's an area that we tend to focus a lot on biomechanics, and kinesiology. And then once in the program, I think there's a strong emphasis in PT, perhaps right now, because in most states, pts have direct access to patients, they don't necessarily need a physician referral. And so in those circumstances, we have to prepare our students to be ready to recognize perhaps not come to a definitive diagnosis, because a lot of those areas would be dependent upon the physician, but to be able to recognize a large breadth of medical conditions that could be occurring, and to decide whether it's appropriate to refer to a physician or to go ahead and provide treatment as the US kind of that gatekeeper in the health care system.
From an OT standpoint, most schools don't really have a specific designation at all about what major you need to be an undergrad but as Jason referred to, because of the prerequisites we require. Often people do end up in, you know, biology, biomedical science, from an OT standpoint, we do have a lot of students that have their undergrad is in psychology. So the early foundations of occupational therapy are actually based in mental health. And so there's an emphasis on that throughout our education. So after you get into grad school, so one difference currently is that the entry level degree for physical therapist is a doctorate. So it's the DPT for the occupational therapist, you can do either a master's level entry level degree, so an mot or ms OT, or you can do a doctorate in OT, which isn't OTD. So right now we have what's considered dual entry. So it just depends on your preference. Essentially, there's more research in the education if you choose to go the OTD route.
Okay, so now I want to ask you guys about this research project, what is the project describe kind of how it came to be what the purpose of it is, all that
Tracy contacted me about a patient that we were both treating, seeing being seen for PT and OT, and a gentleman by the name of Brett Baker had devised a an adapted guitar, this guitar that could be used to be played with someone who has limited use of an upper extremity limited use of an arm was actually designed for his grandfather, because his grandfather loved to play the guitar and had a stroke and was unable to play the guitar. So Tracy had contacted me, she'd been in contact with Brett, and knew that I was working with this particular patient who had had a stroke and thought that it might be something helpful for him to do. And so we kind of took an interest in in this and started with this particular patient. And then it just kind of grew from there to where we thought, boy, maybe we could do research on this and do something collaborative, because that's something that we we do in the clinic anyway. I mean, when we're in most of the settings that we work in, we work together, pts, and OTS work side by side. And so we thought this would be a really good project.
Yeah, so um, basically, we worked and got a grant to play to pay for some additional guitars. And so the plan is that we'll be recruiting individuals after having a stroke, and basically providing known evidence based therapies to them, and then also for our experimental group, adding in the guitar to see how that might impact the recovery, really looking also at how it motivates individuals. So as you're in rehab for a long time, it can get tiring, you can get discouraged. And so having novel means to work on the rehab process is important. I think Jason and I both really value the interprofessional end of therapy disciplines, I think now are really trying to take a focus on Enter professionalism, because I always tell my students right now is when you'll be with the most OTS because when you get out in practice, that's, you know, you work on a team of different professions. And that's what you want, right? You want everybody coming in with their different lens to offer that patient different things so that they can reach the best level of independence that they can. I think we're both very passionate about giving the students the opportunity now to work together. So in our research project, it will be teams of OT and PT students, that we'll be offering the rehab to these participants. So we want them you know, benefits, obviously the participants, but we also really believe it'll benefit the students as they learn.
What do you think are some misconceptions about your specific field? So Tracy, about ot Jason about pT?
Oh, that the very automatic one is people will say, I don't need a job. So if you if you come in and say, Hi, I'm your occupational therapist, and the individuals retired, that's kind of their automatic assumption, again, that they associate it with vocation. And so we do a lot of explaining about what we're what we do and why we're there, and also about how we are different from the other disciplines.
I think with PT, perhaps some of the misconceptions are that we just focus on exercise and exercise is going to be the cure all doesn't, regardless of what type of exercise. So if someone's exercising, then they're going to, they're going to get better, they've had a stroke, just exercise them, they're magically going to walk again, be able to get back to work again. So it's interesting, because when people will come to a physical therapy clinic to look for the equipment, they have this type of exercise, bike, or whatever. And oftentimes, those are the least helpful things to help someone recover. Who has neurologic deficits, for example, I think that's a major part of the misconceptions out there, perhaps just that any type of movement is good movement. And we know from research, and we try to instill this in our students that it has to be very task specific, there's a lot that goes into the choice of how you help someone regain from movement disabilities, or recover from movement disability.
Okay, so then what makes you guys passionate about working in your specific field,
I just absolutely love helping people become independent, stay independent, though. For me, I'm in particular, I love working with older adults. And so helping them remain in their homes, helping them remain safe. And in acute care. So acute care is working in the hospitals like ICU right after illness, injury diagnosis often. And so for me there, I love the fact that I kind of meet them at baseline, you know, I will say, for both of us, we're often you know, we don't meet people on their best day of their life, or often meeting them in a very difficult time of their life, a very time when something has really changed or very hard. And so, as a therapy team, again, I'm just coming in and saying, Hey, this is the way forward here, here's the next step, in order for you to, you know, return to the things that you want me to do. So I think really just offering hope and helping people see, you know, each day is a new day, and that there are things that we can do to deal with whatever it is that they're facing.
I think a lot of us, most of us go into physical therapy, because we are fascinated and passionate about the human body, and the human body's ability to heal given the right circumstances. We're also very social, we love to interact with others with colleagues, we love to see people overcome something that's challenging. In fact, if I look at my three favorite patient populations to work with, I would say pusher syndrome, where someone does not have a sense of what is upright their body that cannot align their body upright with gravity. And you can imagine how difficult that would be to move around in your world. See six spinal cord injury, because they feel helpless, they can hardly move anything. And by the time they leave rehab and continue on, they can do amazing things that they never believe that they could do. And then perhaps subarachnoid hemorrhage, where the deficits unfortunately are quite severe early on, affecting pretty much all neurologic systems. Yet, unfortunately, most of the damage is not necessarily within the brain tissue. And so there's a lot of potential for recovery. For me that that's kind of a passion for me to see someone who really doesn't have the vision of what they can do, but as a clinician to help to guide them. And of course, we have that vision and try to instill that in them and then use the right tools to help them make significant progress in meaningful progress in their lives.
That's awesome. So kind of kind of going off of that. And this is the last official question I have for you guys. Um, where can somebody go if they're interested in ot or PT on the Missouri State website, or just in general, to get some more information or just look into it a little bit?
Sure. Um, we provide tours at Missouri State and I'm sure the Occupational Therapy Department does that as well too. So if students or high school students or college students are interested in the field of physical therapy, they are more than welcome to set up a tour with us. We will give them a personalized tour tour of the department talk to them about our program. The American Physical Therapy Association has a lot of resources. And then most physical therapy programs require that a student do a certain number of job shadowing hours prior to applying to the program, because you want to make sure that it's something that you're interested in is a lifetime investment. And perhaps some people think, Oh, I didn't realize that I would be helping take someone to the restroom or something like that, or that I'd be doing wound care that that kind of bothers me or whatever. And so it's always advised to job shadow in a number of different settings. And I did that before I went to PT school. I did that in pediatric type settings, in adult neuro rehab settings, outpatient orthopedics, sports medicine type settings, to kind of get a real good idea of all these different areas that I potentially could work in.
Yes, very similar here. So they're more than welcome to contact us, you can look for OT and PT, you can look on the MSU website, you know, just go to the alphabet at the top, pick the O or p. And you'll find us. And there's ways to contact us for tours, we actually, we also have a Facebook page that we try to keep updated. And currently it has a virtual tour on it for ot because of COVID. We did, we did that. And then also the American Occupational Therapy Association, that website has some nice resources where you can even live videos, we can watch OTS, at different settings, working with different populations and kind of learn about the variety there. And just as Jason said, we also require observation hours. So I mean, we always highly encourage that students, undergrad students, high school students go observe. For most students, once they go observe, they start to feel like you know what, I'm a better fit with x. And again, like, as we just talked about it, it can sound like we're super similar. But I think when you actually see the sessions, you start to see kind of the different lenses that we use to look at a patient as they're going through recovery process. And again, that's not a negative being on the rehab team with multiple disciplines. And it's just a fantastic experience as a professional. And then also, as Jason talked about, it's what's best for the patient. I love that
I love that it's so collaborative.
You know what I think is? So Jason, you've been practicing? What do you say? 23 years?
23 years? Yes.
And I'm at 21 years and I you know, I hope at least you can still hear in our voices like how we still love it. Right? They are great profession is to help people every day. If you love a face and talk about like, if you're amazed by the human body and you want to help people. Both of our professions are fantastic places to look.
I love I can I can definitely tell that you both are passionate. Thank you for coming on and talking to me. I really appreciate it.
Thank you very much, Lauren, we appreciate it.
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