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Administers physical therapy on a consultant basis to crippled children in local health clinics in an area of the State.

The duties involve administering muscle tests to determine the physical limitations, and designating therapeutic exercises for crippled children both as an evaluation of the patient's progress and as demonstration and instruction to the child's parents or relatives who carry out the daily exercises between clinic visits. Evaluations include the effectiveness of restorative exercises, the need for additional or changes in exercises based upon the patient's condition, the adequacy and acceptability of braces or prostheses, the determination of need for apparatus repairs or replacement, and recommendations to patient's families on procedures and activities which will aid in the restoration of the affected body area. The many diverse clinic areas assigned restricts the availability of physical therapy equipment which necessarily limits the modalities employed in treatment and also requires considerable travel. More than the usual discretion is required in consultation with patient's relatives to avoid recommendations which may conflict with the orthopedist's objectives and treatment, to maintain the confidence and cooperation of both the patient and his family, and in the evaluation of the adequacy of apparatus to avoid unnecessary expenditures by the Crippled Children's Bureau of the State Department of Health. Medical supervision is rarely available in the daily clinic consultations, and responsibility is assumed for decisions requiring judgment and awareness of the consequence of errors. The work requires attendance at orthopedic clinics to advise the orthopedist on the patient's progress and to receive direction in treatment changes and restoration objectives. Patient's orthopedic clinic appointments are so scheduled that frequently the physical therapist is the only contact between patients, their families, and the treatment program for extended periods of time. The work is performed independently but direction is obtained through periodic contacts with the orthopedist, and administrative supervision is received from the Physical Therapy Field Director who evaluates the work through a review of clinic schedules a through consultation with the various orthopedists in the State.

Examples of duties characteristic of positions in this class:

1. Visits local health units as a consultant for physical therapy clinics in an area of the State; performs muscle tests on new patients to determine physical limitations; evaluates progress of return patients to determine continuation of prescribed exercises or designation of new ones for muscle restoration; examines braces and/or prostheses, shoes or other appliances to determine their condition and proper fit.

2. Discusses patient's progress with family of patient; demonstrates exercises to be administered daily by family; inquires into any problems arising between clinic visits; observes family's technique is administering muscle restoration exercises to correct faults; instructs Public Health Nurses in such exercises so they may administer or observe administration of patient's exercises in the home between clinic visits.

Evaluates the need for changes in appliances; makes minor adjustments or suggests sending appliance to the manufacturer for major repairs or changes; advises families on the need for new or repairs to corrective shoes; suggests home appliances that may assist the patient in progress improvement and the source of such appliances when the family can afford to make purchases.

4. Attends orthopedic clinics to receive special instructions for physical therapy to be administered to patients between visits go orthopedic clinics (which may be several months, or as much as a year, apart); advises orthopedist on conditions involving patients observed during physical therapy clinics; confers with orthopedist on appliance adjustments as they relate to physical therapy methods.

5. Inspects new or repaired appliances returned from manufacturer; approves their acceptability and certifies their acceptance for payment by Crippled Children's Bureau; prepares acceptance report, and progress reports on patient's treatment.

6. May visit patients in their homes on special request of Public Health Nurses; if conditions permit, may evaluate condition of adult patients and suggest therapeutic exercises to Public Health Nurses on a consultant basis.

Graduation from an accredited school of physical therapy and eligibility for licensure to practice physical therapy in Virginia.

Thorough knowledge of skeletal and neuro-anatomy; thorough knowledge of fundamentals and theories of physical therapy techniques and their proper application; considerable knowledge of the effects of exercise and muscle use in restorative processes; ability to administer muscle tests and required physica1 therapy modalities with little direction; ability to work effectively with children of all types and to maintain confidential and cooperative working relationships with their families.