物理治療職能治療語言治療

其實除了物理治療 (physical therapy, PT) 和職能治療 (occupational therapy, OT) 以外，復健團隊中還有一個很重要的職類，叫做語言治療 (speech therapy, ST) ，三者合稱為復健3T。他們之間有什麼不同呢？讓我們繼續看下去吧！

物理治療 (physical therapy)

物理治療為患者處理「身體結構(physical)」的問題，諸如神經、肌肉、骨骼、關節等的不適感。有「四大主科」的專長，分別是：骨科、神經、心肺、小兒。

物理治療師透過所謂的「3M」協助患者復健，分別為物理因子儀器(modality)、徒手治療(manual)、運動治療(movement)。物理因子常見的有光、電、水、熱等儀器治療；徒手治療顧名思義是透過雙手進行如筋膜放鬆、神經鬆動等技術；運動治療則包含矯正運動、肌力訓練等。物理治療的最終目標是解決患者身體上的不適。

物理治療師透過動作分析及各種評估技術，找出患者身體不適的原因，並加以處理、治療。

職能治療 (occupational therapy)

職能治療為患者處理「職能(occupation)」的問題。有「三大領域」的專長，分別是：生理、精神、小兒。

職能治療師透過有目的活動訓練患者，提升職能參與能力，或透過環境、活動調整、輔具等，讓參與職能的條件降低，來適配患者目前的狀況。職能治療的最終目的即是讓患者可以順利參與職能，提升主觀安適感。

職能治療師透過活動分析剖析一項職能或活動所需的條件（包含人的條件及環境條件），並透過評估技術與量表了解患者現況（包含身體結構能力及認知功能等），找出與患者現況不適配的部分並予以介入。

語言治療 (speech therapy)

語言治療為患者處理「言語及語言(speech & language)」的問題，核心知識有：言語、語言、吞嚥。

其中言語包含了構音及流暢度，語言包含聽說讀寫的理解及表達（涉及認知功能），吞嚥則涉及了從口腔自咽喉部的肌肉協調。因此可看出語言治療師和職能治療師同樣專注於患者能力與活動條件之間的適配程度。

語言治療師透過矯治的方法訓練患者身體結構的能力或認知功能，進而達成與人溝通及吞嚥的目標，或透過輔具的使用協助復健潛能較低的患者達到最大程度溝通及吞嚥等功能表現。

物理治療、職能治療、語言治療同屬復健團隊的一員，以各自的專業協助患者排除或克服障礙及減少不適感，透過不同職類專業互相協調溝通復健計劃，讓患者在傷或術後順利回歸生活並達到最大程度獨立。

治療師們的專業技術或多或少有重疊之處，（例如職能及物理治療師都會幫中風病人進行被動關節活動運動），因此在醫療場域中有時會較粗略地將職類的業務用部位分別，例如最常見的即是：職能治療做手，物理治療做腳。

但實際上在復健執行時並無法分得如此清楚，治療師們必須保持溝通，了解患者最新的進展狀況，並隨時調整復健計畫。例如當物理治療師開始訓練中風患者站立後，職能治療師可在有目的活動中加入維持站立平衡的活動目標；又或者語言治療師訓練患者語言能力時，職能治療師在活動中也可以加入言語認知相關的元素。

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.

最簡單的方法描述PT和OT的區別那就是物理治療師看重的是如何治療疾病本身，而作業(職能)治療師看重的是如何把疾病或者殘疾與生活互相協調！

PT試圖通過增加移動性，矯正骨骼和關節或減輕疼痛來改善損傷本身。

OT幫助身患損傷的患者完成必要的日常任務。這樣做可能會使用新的工具和技術來幫忙完成。

物理治療

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.

物理治療師更專注於評估和診斷運動功能障礙以及治療人疾病本身。

雖然作業(職能)治療師也會有對應的評估，但是物理治療師將更有可能診斷和治療問題的物理性來源，比如受傷的身體組織和結構。

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 others.

物理治療師可以專注於許多不同的領域，包括運動醫學，兒童健康（兒科）和婦女的健康，在這些領域內有三個不同的實踐。這些是：

• 肌肉骨骼物理治療 – 也稱為矯形物理療法，用於治療諸如扭傷，背痛，關節炎，拉傷，失禁，滑囊炎，姿勢問題，運動和工作場所損傷以及行動不便的狀況。手術後的康復(復健)也包括在此類別中。
• 神經系統物理治療 – 用於治療神經系統疾病，包括中風，脊髓損傷，獲得性腦損傷，多發性硬化和帕金森病。它也可以用於腦手術後的康復(復健)。
• 心肺物理治療 – 指是用於治療使用的哮喘，慢性支氣管炎，肺氣腫和其他心臟呼吸障礙的名稱。

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 spinal mobilisation), 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.

治療類型: 每個人的治療都是根據自己的具體要求量身定制的，物理治療師將選擇廣泛的治療方法，包括：

• 手動(徒手)治療 – 這些可包括，聯合操縱和脊柱訓練，手動阻力訓練和拉伸。
• 運動 – 如肌肉加強，姿勢再訓練，心血管伸展和訓練.
• 電療技術 – 包括經皮神經刺激（TENS），鐳射治療，透熱療法和超音波。

職能治療

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.

與物理治療相比，職業(職能)治療往往更注重評估和改善人生活的能力。

職業(職能)治療師通常不使用諸如物理治療師的手動治療或針灸的技術直接治療損傷，而更通常地幫助人在損傷或身體損傷的情況下優化其獨立性和完成日常活動的能力。

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.

職業(職能)治療師通常也會直接治療損傷，但更常見的是職業(職能)治療更多地側重於改善生活技能，並在治療師定制治療方案的時候採用適應性的工具。

比如在世界的一些地方，職業(職能)治療師利用諸如在損傷康復中使用超聲波的做法，非常像物理治療師那樣。

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.

幫助人們提高他們執行日常任務的能力是職業治療師的主要目標。

OT更有可能對家庭環境和工作環境進行現場評估，並就每個專案的適當調整提出建議，以提高生活品質。

職業(職能)治療師接受訓練，以改變物理環境，以及訓練人使用輔助設備以增加獨立性。雖然物理治療師進行現場評估，但這往往不太常見。

我在職能治療是什麼? 身為OT最常被問的Q&A這篇文章中有更詳細的描述職能治療怎麼幫助患者恢復功能的唷！

職能治療與物理治療相互覆蓋的部分

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.

物理治療師和職業(職能)治療師都在解剖學和肌肉骨骼系統學中訓練有素，所以與一般醫生醫生相比，他們對肌肉骨骼損傷和康復非常瞭解。

雖然兩個醫療專業在有很多差異，但是OT和PT之間也有很交集。

例如，職業(職能)治療師經常參與教育人們如何預防和避免傷害，以及教育人們關於癒合過程，就像物理治療師。

而物理治療師反過來通常通過教育和培訓幫助人們提高他們做日常活動的能力。

雖然專業之間存在著這種交集，但它們都發揮著各自非常重要的作用，並且各有所擅長的事情。在許多情況下，兩類的專業人員都參與復健治療。

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.

考慮一名患者需要膝關節置換手術後恢復。

他的PT可能會分配各種運動訓練，以改善新的人工膝關節的移動性，並舒緩手術後的疼痛和僵硬。

他的OT可能會教他如何在恢復的早期階段使用輪椅，然後幫助他用新的膝蓋練習上下樓梯。

或者，在療養院中，物理治療師可以説明患者站在輪椅上並保持站立平衡，而職業(職能)治療師協助她在如何刷牙。通常，PT和OT 密切合作，幫助患者實現完全康復。

下面臨時插上一個不得不提的話題，什麼是按摩師呢？

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.