Differences Between Occupational Therapy and Physiotherapy

In healthcare there is a large overlap between many professions. In this discussion, we shall learn the similarities and differences between a physiotherapist and an occupational therapist.

What is occupational therapy?

Occupational therapy (OT) is a regulated healthcare profession that looks at how one is functioning and the best ways to improve or maintain their independence. OT itself is a broad field that focuses on all activities that one can engage in ranging from self care, productive work, recreational activities, and much more. Occupational therapists work in a variety of settings and can include schools, hospitals, rehabilitation centers, outpatient clinics and within a patient’s own homes. Here are some examples that highlight the scope of practice of OT:

Occupational therapists can recommend safety aids to reduce fall risks and improve one's ability to safely transfer from one surface to another.
Occupational therapists can recommend safety aids to reduce fall risks and improve one’s ability to safely transfer from one surface to another.
  • Helping one maintain and improve their ability to engage in personal hygiene tasks like toileting through use of assistive aids and rehabilitation
  • Developing modified work duties as part of a vocational rehab program to transition someone back to work following injury or illness
  • Conduct cognitive assessments and administer interventions to address memory deficits and impaired higher level thinking
  • Assess home safety needs with a particular focus on safety equipment to help with transfers and falls prevention
  • Address issues of accessibility for services or places related to decreased vision, communication impairments, cognitive deficits, and much more
  • Modifying and providing adaptive strategies when difficulties are present with laundry, cooking and other housekeeping duties
  • Assess one’s mobility needs and prescribe a wheelchair, rollator walker or other gait aids as appropriate
  • Provide education on pressure redistribution and ways to minimize the risk of developing a pressure sore
  • Facilitate safe discharges from hospitals after an acute illness or after an inpatient rehab stay
  • Assess and treat upper body coordination, sensory or strength deficits
  • Provide education on energy conservation strategies and principles to help those with shortness of breath or fatigue
  • Provide recommendations with respect to home modification to increase safety and access for all parts of the residence
  • Maximize patient recovery by guiding occupational therapy assistants as they provide goal oriented care to patients
  • Coordinate equipment trials and teaching on appropriate equipment use
  • Help marginalized populations with financial aid applications that address safety concerns with home renovations and assistive aids
  • Develop a customized sensory diet for individuals that are overly sensitive or desensitized to input via touch, taste, smell, and more
  • Assess and treat patient with mental health crises to facilitate safe community integration

What is physical therapy?

Physiotherapists (PT) are a college regulated healthcare profession that assess and treat physical dysfunctions. PT can work in a variety of settings from schools, hospitals, rehabilitation centers, outpatient clinics and within a patient’s own home. Here are some examples that highlight the scope of practice of PT:

  • Strength re-training following injury, illness or deconditioning from a lengthy hospital stay
  • Prescribe home exercise programs for patients to continue their rehab on their own time
  • Assess for mobility aids like a wheelchair, wheeled walker or cane
  • Assess and and treat impaired balance and equilibrium issues
  • Assess home safety and recommend safety equipment to help with transfers
  • Provide falls prevention recommendations
  • Guide physiotherapy assistants to help patients work towards accomplishing their rehab goals
  • Focus on improving muscle strength within the upper extremities when an occupational therapist is not involved
  • Slowly progress injuries through a graded exercise regime to lead to improved recovery and function
  • Can teach and provide what is known as chest physio to help with clearing of lung secretions for conditions like cystic fibrosis
  • Link patients to additional community resources such as outpatient physio or physical rehab clinics
  • Can help with trialing and selecting a back or neck brace
  • Use different modalities like electrical stimulation of the muscles to facilitate motor recovery and treat pain

Skill overlap between an occupational therapist and physiotherapist

OT and PT share a lot of similar skill sets. In fact some educational institutions even train them together in joint anatomy classes and labs. As a result they are keenly aware of the body’s muscles, structure and mechanism of action. On top of this they also share similar work environments, so it is not uncommon for them to have the same experiences, deal with similar patient populations, medical conditions and provide the same intervention. As an example, when found in the community, they both focus on home safety, transfers education, falls prevention, mobility assessments and much more. When theses professions act alone, and there is no referral for the other provider, their roles and purpose will overlap, making it difficult to distinguish between the two. In a sense this is beneficial as it may not always be appropriate or possible to have both services active at the same time. For example many publicly run community support agencies are gravely underfunded and may only be able to put in one of the two services.

Differences between occupational therapy and physical therapy

When both of these services are active in the patient’s care, their roles tend to differentiate to minimize overlap and double dipping of care. This commonly happens in areas such as rehabilitation centers where both providers work and are required for different reasons. As an example, in rehab settings the scope of practice of physiotherapists is generally focused on strength training of the lower body and balance. In this environment, occupational therapy is geared towards upper body recovery, cognition and returning one to optimal functioning and independence with toileting and higher level activities. That said, there tends to be great fluctuation in roles across different settings related to established workplace culture and organizational expectations. When in doubt, ask your care provider what specific role they will be addressing or fulfilling.