Like most medical professions, and all professions, really, physical therapy has come a long way over the years. In other words, physical therapy isn’t what it used to be, and that’s a good thing.
Changes in physical therapy modalities are an excellent example of how things have evolved. It used to be heat, cold, and water, and maybe electricity (not with the water, of course) were the primary PT modalities that a physical therapist would utilize when working with a patient. But in recent years, physical therapy modalities have undergone a dramatic transformation. Physical therapy modalities don’t have to involve pain or unpleasantness for a patient, which naturally leads to better patient outcomes.
Which begs the question: Has your physical therapy practice kept up with the changing times?
In case you fear you’re behind the curve, you may want to ask yourself if your practice is utilizing these physical therapy modalities. And if you aren’t using them, you should really ask yourself — why not?
Some of the physical therapy modalities your practice should be using
Musculoskeletal Ultrasound. This is an imaging modality that uses sounds waves to produce pictures of muscles, tendons, joints, and ligaments throughout the body. It’s approved by the FDA to help evaluate and diagnose sprains, strains, tears, and other soft tissue conditions. If a patient has a joint disorder, the musculoskeletal ultrasound will help the PT find it. It’s safe, non-invasive, and does not use ionizing radiation.
Videonystagmography (VNG) testing. A VNG test is used to help diagnose whether a vestibular (inner ear) disease may be causing a balance or dizziness problem. It’s also one of the only tests available that can distinguish between unilateral (one ear) and bilateral (both ears) vestibular loss.
As you probably know, but patients are often bemused to find out, VNG testing is done not by looking into ears but by recording eye movements. The patient follows visual objects with their eyes, and the testing monitors how well the eyes respond to information from the vestibular system.
Fortunately, VNG testing is also non-invasive.
Somatosensory evoked potential (SSEP) tests. These are tests that study the nerve pathway from the peripheral nerve through the spine to the somatosensory region of the brain.
(If your patient happens to say, “Somatosensory? This sounds Greek to me,” you can say, “Well, there’s a reason for that. Somato is a word of Greek origins, and it means ‘body.’”)
Anyway, SSEP tests are utilized to determine whether a patient has a spinal cord injury or disease as well as neuromuscular disease or demyelinating diseases such as multiple sclerosis and others. It’s another simple, non-invasive test, one that involves a series of minor stimuli in the median and/or tibial nerves and a recording of the response as it reaches the brain.
VEP Testing. VEP stands for “visual evoked potentials.” Visual evoked potential tests check the nerves that go from the eye to the visual cortex. Why do some patients need VEP testing? So the physical therapist can identify impaired transmission along the optic nerve pathways. It’s a very simple test, and similar to an SSEP test, it involves a series of visual stimuli via a television monitor and a recording of the response as it reaches the brain.
BAER testing. BAER stands for “brainstem auditory evoked potentials.” Brainstem auditory evoked potential tests the ear and the brain for auditory and brainstem disorders. It’s a non-invasive test that involves a series of sounds heard via a set of headphones and a recording of the response as it reaches the brain.
It’s a test that is often used in newborns and young children — or anyone who isn’t able to participate in a conventional hearing test. In fact, just as a fun fact to pass onto your patients, BAER tests are often given to dogs. It’s really the only scientific way to test a dog’s ability to hear — since a standard hearing test could never be administered to a dog.
Electromyography (EMG) Testing. Patients get really excited when you tell them that you’re going to hook them up with electrodes on their skin. But in all seriousness, as you know, it’s a very low-risk procedure.
Electromyography is a diagnostic procedure that assesses the health of muscles and the nerve cells that control them, also known as motor neurons.
When a patient receives EMG testing, the physical therapist is looking for possible nerve issues, muscle dysfunction, or something going wrong with the nerve-to-muscle signal transmission. If a patient has muscular dystrophy or polymyositis or perhaps a disease such as myasthenia gravis, electromyography testing is probably going to discover that.
There are other disorders that EMG testing can unearth as well, such as disorders that affect the motor neurons in the brain or spinal cord, such as amyotrophic lateral sclerosis, also known as ALS or Lou Gehrig’s disease.
How physical therapy modalities improve patient care and patient retention
It probably goes without saying, but when you can diagnose patients’ problems correctly, that has a major impact on their health. Go figure.
When you can diagnose health problems fast and without invasive surgery, that can also help a patient’s physical health and morale.
And when you diagnose a patient’s health issues correctly, fast, and without invasive surgery, patients tend to trust you even more — and stick with their treatment programs, which, of course, improves their health.
How physical therapy modalities improve profits at your physical therapy clinic
If your patients complete their treatments, that’s an obvious positive outcome for your PT practice’s bottom line. More visits to your practice mean more billings to the patient’s insurance company. But there’s also the simple fact that the billing codes that you send to insurers are far higher when you bill for diagnostic services and physical therapy modalities over conventional PT practices.
Those higher billing codes are especially needed now, with Medicare announcing an additional 9 percent reduction in all physical therapy rates that started on January 1, 2021.
So if you don’t have the newest physical therapy modalities in your PT practice, we hope you’ll consider becoming a Hands-On Diagnostics member and that you’ll give us a call or send us an email. If you think your own PT practice could be a little healthier than it currently is, we’re here to help.