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Physical therapist finds rehab a good fit

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Cindy Atoji Keene/Boston.com

Cara Brickley works on a patient at Spaulding Rehabilitation Hospital in Boston.

Cara Brickley decided to become a physical therapist after hearing stories from her father, a Vietnam vet. He described how physical therapy helped him return to active duty after combat wounds kept him from walking. “He’d tell me how he was pushed to do exercises and get as strong as he possibly could, and how much he appreciated this help.”

Today Brickley is a physical therapist at Spaulding Rehabilitation Hospital in Boston, where she works in the orthopedic, amputation, and burn unit, helping patients get back on their feet again after an accident or injury, much as her father did so many years ago. “I see patients make progress and do things they weren’t able to do before, and it’s very rewarding,” says Brickley, who has been at the rehab facility for 12 years.

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The typical patient comes in after a car accident, surgery, or fall, like a young man who fractured his pelvic and was unable to put weight on his right leg. He needed help with everyday tasks like getting out of bed, transferring to a wheel chair, and eventually had to be able to maneuver up the three flights of stairs in his home.

“When a new patient like this comes in, they’re evaluated on range of motion, strength and balance, whether they need any devices, and other factors. A team of physicians, nurses, occupational and physical therapists, and others develop a program in conjunction with their family, to help them return to their home environment,” says Brickley. The average stay is two weeks, and this particular patient progressed from a walker to a pair of crutches, and after 10 days, was even able to manage the third-floor walk-up to his home. “Today’s physical therapist looks not just at the injury, but how everything is working together, from the cardiac and pulmonary system, to neuromuscular functions,” says Brickley.

This emphasis on assessment and diagnostic skills has pushed the educational requirements for physical therapists from a master’s degree requirement to doctorate level, with clinicians like Brickley also holding a state license to practice the discipline. With this high level of training, employment of physical therapists is expected to grow 27 percent to 2016, with the increasing elderly population driving demand for services.

Q: What’s the most common misconception about physical therapists?
A:
That we’re torturers. That’s the big one. I had a very nice lady who came in after a knee replacement, and she said to me, “Please don’t make me scream.” But after doing this for so long, I don’t think I’ve made anyone scream.

Q: Do you use video games like the Nintendo Wii to help motivate patients?
A:
We do, we call it Wii-hab. We use the bowling and boxing games as well as the Wii Fit Board to work on balance and strength.

Q: What’s the most miraculous comeback you’ve seen?
A:
We had a woman who had amputations in all four extremities. She was limited in what she could do, but she was fit for prosthetics and as soon as she got her legs, right away she got and up took some steps.

Q: Have you ever been injured yourself and needed to use a physical therapist?
A:
No, but many of the other staffers I work with went through that scenario, and that’s how they became interested in physical therapy.

Q: Part of the problem with so many people who go to see a physical therapist is that they don’t do their exercises.
A:
Patients may not be used to doing exercises so incorporating exercises into their daily routine can be a challenge. Breaking up the exercises throughout the day can be helpful.

Q: Being a physical therapist, you must be more aware of fitness and exercise. What do you do for fitness?
A:
I run, practice yoga, and I’m always working on my golf game. As physical therapists, yes, we are definitely aware of how to take care of ourselves.


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