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Physical Therapy, Occupational Therapy & Speech Therapy: What's the Difference?

By: Leslie Mantrone

Have you ever wondered what physical therapy, occupational therapy or speech therapy was? You’re not alone – many people are confused about their purposes. Often, your primary care physician will be the gatekeeper for these services, usually writing a prescription for one or more types of therapy based on their assessment of your needs.

For many older adults, however, the entry route for these services is frequently due to a sudden event, such as a stroke, fall or heart attack. In those cases, the older adult will be taken to a hospital, treated, and then discharged to a rehabilitation facility, where these services can be performed on a daily, or other regular basis. Some therapies are prescribed based on a person’s medical diagnosis. For example, people with Lewy body dementia may be prescribed physical therapy to improve their gait, and people with Parkinson’s disease are prescribed speech therapy to improve their speech and ability to swallow, as those specific functions are often affected by their disease process.

Depending on a person’s disabilities and needs, the same person may receive only physical therapy (also called PT), only occupational therapy (also called OT), only speech therapy (formally known as speech language pathology or PLP) OR any combination.

Physical, occupational and speech therapy can be performed in hospitals, rehabilitation centers based in nursing homes or community locations, as well as in the home setting. Most private insurance pays for these therapies, but usually for a time-limited basis.

Additionally, when someone gets discharged from a hospital or facility-based rehabilitation center, Medicare will pay for a limited amount of therapy – usually two weeks – to help people transition safely back to their home environment. Private insurance often kicks in to pay for additional therapy after Medicare’s limit has been reached.

Physical therapists

  • Focus on gross motor skills such as relearning how to walk or relearning how to move a frozen shoulder or limb

  • Aim to relieve pain and discomfort through use of heat, massage as well as flexibility and strength training

  • Assess your functioning and provide a personalized set of exercises for you to do and specify how often they should be done. Therapists monitor your progress to ensure you are making steady progress and your care goals are being met

Occupational therapists

  • Teach injured people how to relearn everyday activities such as eating, dressing, bathing or writing, with the goal of regaining the function of a limb or other body part. When there is permanent damage and regaining function is deemed not possible, they will teach you “work arounds,” or ways to accomplish an activity in a new or different way.

  • Focus on fine motor skills including the use of your wrists and hands to accomplish specific tasks (such as buttoning a shirt or opening a jar, etc.)

  • Will assess someone for the proper selection and use of assistive devices like walkers or rollators and raised toilet seats. Occupational therapists will also assess your house for safety concerns, such as rugs that can be fall risks or kitchen shelves that are too high to safely utilize, and they will recommend the proper placement of grab bars in a person’s bathroom.

Speech therapists (also known as speech pathologists or speech language pathologists)

  • Assist people who have difficulties producing or understanding speech due to a stroke, head injury or other condition. They also help people who, because of dementia or other cognitive conditions, are unable to find the correct words to say what they wish to communicate.

  • Not everyone knows that speech therapists are called to re-train people who have problems chewing food or swallowing liquids due to a physical or cognitive issue such as a stroke or dementia. Speech therapists work with a patient and family to identify the proper consistency of food and liquid to prevent a person for gagging or choking.


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