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The Rise of Physical Therapy: A History in Footsteps

  • College of Applied Medical Sciences (CAMS), Majmaah University
  • Sreechand Speciality Hospital
ISSN: 2321-4848
Volume 2 | Issue 2 | July-December 2014
The Official Journal of Yenepoya University
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Invited Editorial
Archives of Medicine and Health Sciences / Jul-Dec 2014 / Vol 2 | Issue 2 257
Medical History
Abdul Rahim Shaik, Arakkal Maniyat Shemjaz
Department of Neuro Physiotherapy, Yenepoya Physiotherapy College, Yenepoya University, Deralakatte, Mangalore, Karnataka, India
The Rise of Physical Therapy: A History in Footsteps
Physical therapy originated as a professional group that
dated back to Per Henrik Ling, who is known as the “father of
Swedish gymnastics.” He founded the royal Central Institute
of Gymnastics in the year 1813 for massage, manipulation
and exercise. In 1851, the term “Physiotherapy” first
appeared in its German form “Physiotherapie” in an article
written by Dr. Lorenz Gleich, a military physician from
Bavaria.[1] In an English article published in Montreal Medical
Journal in the year 1894, Dr. Edward Playter used the word
“Physiotherapy.”[2,3] With time, the word “Physiotherapie”
changed to “Physiotherapy” and then to “Physical therapy.”
Physical therapists (PT) who were once known as
reconstruction aides evolved through a series of changes to
become the present ever-growing confident and accomplished
professionals in the health care system. They play a very
important role of providing rehabilitation and habilitation
services as well as prevention and risk reduction training.
In Sweden, PTs were called “sjukgymnast,” which translates
to “someone involved in gymnastics for those who are ill”.
The world in the year 1916 witnessed the devastating polio
epidemic. It was in this period that young women began
treating polio patients with residual paralysis by using
passive movements. Realizing the need of the hour, PTs
developed Manual Muscle Testing for assessing the strength
of the muscle and thereby implementing muscle re-education
techniques for weaker muscles. In the United States (US),
the polio epidemic continued to ravage to such an extent
that it even afflicted a man who would become the future
President of the US- Franklin D. Roosevelt. He went through
various therapies, including hydrotherapy for which in 1926
he purchased a resort at Warm Springs Georgia, which was
used as a Hydrotherapy Center for polio patients. This center
presently operates as Roosevelt Warm Springs Institute for
The First World War marked the start of the profession.
Throughout the world, 16 million people were engaged in
the battlefield. In 1917, the US entered the war and the need
to rehabilitate injured soldiers was recognized by the army.
This led to the formation of a special unit of the army medical
department. They also developed 15 ‘reconstruction aide’
training programs in 1917 to meet the demand of medical
workers who were specially trained in rehabilitation.[5] In the
1920s, a partnership grew between PTs and the medical and
surgical community, which boosted public recognition and
validation. In 1930s, the polio epidemic was still continuing,
and in the year 1937 the National Foundation for Infantile
Paralysis was established, which gave major support to the
growth of Physical Therapy as a profession.
The world entered the Second World War and the Physical
Therapy continued to show its dominance by treating the
individuals who sustained injuries during the war. In the first
half of 1940s with World War II at its peak, the world required
the attention of PTs for wounded soldiers who returned home
with amputations, burns, cold injuries, wounds, fractures,
and nerve and spinal cord injuries.[5,6] The investigation about
the application of electrical stimulation gave a new direction
to the Physical Therapy treatment. They realized it’s not just
Corresponding Author:
Dr. Shaik Abdul Rahim, Yenepoya Physiotherapy College, Yenepoya University, Deralakatte, Mangalore - 575 018, Karnataka, India.
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258 Archives of Medicine and Health Sciences / Jul-Dec 2014 / Vol 2 | Issue 2
to retard and prevent atrophy but to restore muscle mass
and strength. The “galvanic exercise” was given by the PTs
on the atrophied hands of patients who had an ulnar nerve
lesion from surgery upon a wound.[7]
By the year 1942, the therapists started getting their relative
military rankings. Hospital-based practice for PTs was
increased by 1946. The main reason for this was the Hill
Burton Act passed during 79th US Congress, to build hospitals
across the country. It increased the public access to hospitals
and health care facilities and the demand for Physical
Therapy services increased.[5]
After the war, the need for PTs declined and the training
of new PTs was suspended. The PTs already on active duty
were included in the newly established Women’s Medical
Specialist Corps (WMSC) in 1947. Male therapists were
accepted into the Corps in 1955 and the name of the Corps
was changed to the Army Medical Specialist Corps (AMSC).
The post war era brought an increased awareness of the
need for rehabilitation. During this time ‘proprioceptive
neuromuscular facilitation’ (PNF) emerged as a part of the
armamentarium of skills of the PTs. Dr. Bobath, neurologist
and Mrs. Bobath, physiotherapist together developed the
Bobath concept for the treatment of children with cerebral
palsy and adults with neurological conditions. In their
lifetime they travelled extensively, in teaching and training
tutors around the world. They both received many honors
for their pioneering and innovative work.[8]
In 1950s gaining independence, autonomy and
professionalism was the need of the hour for the
profession when PTs progressed from technicians to
professional practitioners. Two events that took place
in 1950s contributed to this; in 1954, American Physical
Therapy Association (APTA) developed a 7-hour-long
professional competency examination in conjunction with
the Professional Examination Service, which was made
available to the state licensing boards. The Self-Employed
Section formed as a component of APTA in 1955 as private
practice expanded.[9]
The role of PTs in Cardiac Rehabilitation started expanding.
In 1952, Levine and Lown openly questioned the need for
enforced bed rest and prolonged inactivity after a myocardial
infarction, which was put forward in 1930s by two physicians,
Mallory and White. Based on the work performed in a
Boston hospital during the 1940s, they concluded that the
long, continued bed rest “decreases functional capacity,
saps morale and provokes complications.”[10] Their highly
published report caught the attention of many and raised
numerous clinical questions about the management of
Figure 2: Lois “Burnsie” Stevens, a Physical Therapist who has been
involved with polio patients
Figure 1: ‘Reconstruction Aide’ treating the amputated soldier
Figure 3: Duchenne, the founder of modern electrotherapy, faradizing
the frontalis muscle (1847)
Source: le-duchenne-
cardiovascular diseases. At the 13th Scientific Session of
the American Heart Association (AHA) in Chicago in 1953,
Shaik and Shemjaz: The rise of physical therapy
Archives of Medicine and Health Sciences / Jul-Dec 2014 / Vol 2 | Issue 2 259
noted physician Louis Katz told the medical community that
“physicians must be ready to discard old dogma when they
are proven false and accept new knowledge.”[11] The need
to continue research on physical activity and to assimilate
this new information into the practice scheme for cardiac
patients was emphasized.[12]
Just like in the previous World Wars, the Korean War also
produced a large number of war causalities for which the
services of Physical Therapy once again proved vital. During
the Vietnam War, a female PT was first among the members
of AMSC to volunteer for Vietnam duty posting at Fort Belvoir,
Virginia. She arrived with the 17th Field Hospital, Saigon, in
March 1966. In South Vietnam, 43 army PTs, 33 of whom
were women, served between 1966 and February 1973.
Physical Therapy restored the use of damaged arms and legs,
rehabilitated surgical wounds, increased range of motion, and
restored flexibility and strength following serious burns, and it
speeded patient recovery and repaired the wounded soldier.[13]
A major change occurred after the Vietnam conflict. The huge
army population with neuro-musculoskeletal problems was
managed by very few orthopedic surgeons. The performance
record and the scope of practice required in Korea and Vietnam
led to the identification of PTs as “Physician Extenders,” who
were credentialed to evaluate and treat neuro-musculoskeletal
patients without physician referral.[13,14]
During times of peace, PTs worked in a prescriptive
environment prior to the early 1970s. Due to the increased
need for PTs and the discontinuation of the army-based schools
after the war, APTA recognized the need to educate more
PTs. The Schools Section of APTA made recommendations
about admissions, curricula, education and administration
of Physical Therapy programs. Also, APTA embarked on an
effort to encourage more universities and medical schools
to create programs and expand existing programs, including
creating opportunities for graduate-level education.[9]
The decade 1967-1976 saw the expansion of the profession
into the management of orthopedics and cardiopulmonary
disorders. With the advent of open heart surgery, Physical
Therapy began to be practiced in preoperative and
postoperative units. The care to individuals with severe
joint restrictions altered with the increasing practice of joint
Associations for the promotion of the practice of animal
Physical Therapy by PTs have been in existence since 1984
and are continuing to expand. Small numbers of PTs are
currently engaged in animal Physical Therapy especially for
racing horses.[15]
In the 21st century, the profession has continued to grow
substantially. Patients are able to refer themselves to a
PT without being told to refer themselves by a health
professional.[16] New generation PTs consider movement
as an essential element of health and well-being, which is
dependent upon the integrated, coordinated function of the
human body at a number of levels. Movement is purposeful
and is affected by internal and external factors. So today’s
Physical Therapy is directed toward the movement needs
and potential of individuals and populations. Though we
are in a more scientific and research-dependent era of our
evolution, let us not forget those practitioners of the past,
from all professions and doctrines, who have given so much
throughout the centuries of history in Physical Therapy.
1. Terlouw TJ. The origin of the term “physiotherapy.”
Physiother Res Int 2006;11:56-7.
Figure 4: The Patient Gymnasticon, an early exercise machine
resembling a stationary bicycle, invented in 1796 by Francis Lowndes
Figure 5: The Physical Therapist with wheelchair-bound patients
Shaik and Shemjaz: The rise of physical therapy
260 Archives of Medicine and Health Sciences / Jul-Dec 2014 / Vol 2 | Issue 2
2. Korobov SA. Towards the origin of the term physiotherapy:
Dr. Edward Playter’s contribution of 1894. Physiother Res
Int 2005;10:123-4.
3. Playter E. Physiotherapy first: Nature’s medicaments
before drug remedies; particularly relating to hydrotherapy.
Montreal Med J 1894;xxii:811-27.
4. Burns JM. Roosevelt: The Lion and the Fox: Vol. 1; 1882-1940.
5. Moffat M. The history of physical therapy practice in the
United States. J Phys Ther Educ Winter 2003;17:15-25.
6. Murphy W. With vision, faith, and courage, 1920-1929. In:
Healing the generations: A History of Physical Therapy
and the American Physical Therapy Association. Lyme:
Greenwich Publishing Group Inc; 1995. p. 70-103.
7. Licht SH. “History of Electrotherapy”. Therapeutic Electricity
and Ultraviolet Radiation, 2nd ed. New Haven, Conn.: Licht;
8. History of Bobath. Available from: http://www.bobathwales.
org/our-history/. [Last accessed on 2014 July 6].
9. Murphy W. “Progress Is a Relay Race,” 1946-1959. In: Healing
the Generations: A History of Physical Therapy and the
American Physical Therapy Association. Lyme: Greenwich
Publishing Group Inc; 1995. p. 136-77.
10. Levine SA, Lown B. Armchair treatment of acute coronary
thrombosis. J Am Med Assoc 1952;148:1365-9.
11. Katz LN, Burch GE, Dorfman A, Ernstene C, Hecht HH,
Parker RL. Symposium: Unsettled clinical questions in
the management of cardiovascular disease. Circulation
12. Certo CM. History of cardiac rehabilitation. Phys Ther
13. In: Anderson RS, Lee HS, McDaniel ML, editors. Army
Medical Specialist Corps. Washington: Office of the Surgeon
General, Department of the Army; 1968.
14. Neel, Spurgeon. Medical Support of the U.S. Army in Vietnam,
1965-1970. Washington, D.C.: Department of the Army; 1973.
15. Laurie Edge-Hughes, BScPT, MAnimSt (Animal
Physiotherapy), CAFCI, CCRT Presented as an oral abstract
at the 2008 Congress of the Canadian Physiotherapy
Association, Ottawa, Ontario. International Trends in the
Practice of Animal Physiotherapy & Rehabilitation.
16. Department of Health. Self-referral pilots to musculoskeletal
physiotherapy and the implications for improving access to
other AHP services. London: Department of Health; 2008.
How to cite this article: Shaik AR, Shemjaz AM. The Rise of Physical Therapy:
A History in Footsteps. Arch Med Health Sci 2014;2:257-60.
Source of Support: Nil, Con ict of Interest: None declared.
... Near the end of the 19th century, the physical therapy profession emerged because of several health crises, presenting a need for additional health care services. 1 Physical therapy has expanded to serve new populations and conditions, evolving to become a central component of health care. 1 For decades, physical therapists have been treating children with various movement disorders, but it was not until 1973 2 and sometimes in the 1980s that the APTA Academy of Pediatric Physical Therapy (then called the Section on Pediatrics) and the Pediatric Division of the Canadian Physical Therapy Association were formed, respectively (Canadian Physical therapy Association, e-mail communication, November 15, 2019). The scope of practice of pediatric physical therapy has continued to expand since its inception to promote healthy and active lifestyles for children with disabilities, as well as managing many different neuromuscular, developmental, and musculoskeletal conditions. ...
... 1 Physical therapy has expanded to serve new populations and conditions, evolving to become a central component of health care. 1 For decades, physical therapists have been treating children with various movement disorders, but it was not until 1973 2 and sometimes in the 1980s that the APTA Academy of Pediatric Physical Therapy (then called the Section on Pediatrics) and the Pediatric Division of the Canadian Physical Therapy Association were formed, respectively (Canadian Physical therapy Association, e-mail communication, November 15, 2019). The scope of practice of pediatric physical therapy has continued to expand since its inception to promote healthy and active lifestyles for children with disabilities, as well as managing many different neuromuscular, developmental, and musculoskeletal conditions. ...
Purpose: To observe research and practice trends in the journal, Pediatric Physical Therapy, as a proxy for the field. Methods: All issues of Pediatric Physical Therapy published from 1989 to 2019 were chronicled and summarized. Data were extracted regarding variables related to the issues and individual articles. Results: The most common diagnosis studied was cerebral palsy. The proportion of studies involving middle childhood and adolescent-aged participants increased over time. Cohort studies and exercise were the most common study type and intervention studied, respectively. The proportion of scientific content in the journal increased. Conclusion: It is evident that pediatric physical therapy research has evolved over the past 30 years, both in rigor of articles published and in breadth of populations studied. What this adds to the evidence: This review adds an in-depth evaluation of trends in the literature, facilitating the profession's continued growth.
... Globally, there has been an increasing demand for physiotherapy services at a much higher rate than was observed in the last decade. In Nigeria, the demand for physiotherapy services became high after the civil war, prompting a demand for training more people in the profession [1]. According to Balogun et al. [2], there are currently only 2,000 physiotherapists in Nigeria, which amounts to one physiotherapist for every 86,800 citizens. ...
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Background: Nigeria needs more physiotherapists to be able to meet Nigeria's growing demand. However, as much as there is a need to increase the number of practicing physiotherapists in Nigeria, more important issue to be tackled is the quality of care offered by these professionals. The ripple effect of these deficiencies and misconceptions about physiotherapy specialization in Nigeria is expected to have a negative impact on professional development, clinical and academic practice, as well as patient care and satisfaction.
... Darüber hinaus wurden sie mit der Aufgabe betraut, Physiotherapieausbildung in Nigeria einzuführen, damals ein dreijähriger Diplomlehrgang (University of Lagos Association of Physiotherapy Students, 2010). Am Höhepunkt des 2. Weltkrieges, in der ersten Hälfte der 1940er Jahre, begannen Physiotherapeut*innen weltweit, verwundete Soldaten zu behandeln, die an den Folgen von Amputationen, Verbrennungen, Erfrierungen, Wunden, Frakturen sowie Nerven-und Rückenmarksverletzungen nach Hause kehrten (Shaik and Shemjaz, 2014 (Shimpi et al., 2014). Innerhalb der Medizin veränderte sich die Beziehung zu den Patient*innen in den USA durch die Einführung der "informierten Zustimmung (informed consent)" in den 1950er Jahren, welche auch in den darauf folgenden Jahren in anderen Disziplinen Einzug hielt (Purtilo, 2000). ...
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Das Ziel dieser Dissertation ist es, ethische Situationen in der internationalen Physiotherapie in Art, Umfang und Häufigkeit ihres Auftretens zu untersuchen, ebenso wie Faktoren, die in ethischen Entscheidungen von Physiotherapeut*innen international eine Rolle spielen, um solide Wissensgrundlagen für praxisnahen Ethikunterricht in Grundstudium und kontinuierlicher professioneller Entwicklung zu schaffen. Es wird auch untersucht, ob Physiotherapeut*innen im Grundstudium/ in der Grundausbildung, und auf welche Art, Physiotherapeut*innen weltweit über ethische Kodizes und Rahmenkonzepte für ethische Entscheidungsfindung lernen. Ein solches Wissen kann physiotherapeutischen Berufsvertretungen in der Leitlinienentwicklung dienen, Bereiche für weiterführende Forschung identifizieren, sowie Physiotherapeut*innen in allen Weltphysiotherapie-Regionen in ihrer ethischen Praxis unterstützen. Die Dissertation basiert auf zwei internationalen Online-Umfragen, deren unterschiedliche Aspekte in sechs Veröffentlichungen berichtet werden. Die erste Umfrage untersucht Art, Umfang und Häufigkeit von ethischen Situationen in allen fünf Weltphysiotherapie-Regionen, und ethische Lerninhalte des Grundstudiums/ der Grundausbildung. Die zweite Umfrage untersucht die Sichtweisen von Physiotherapeut*innen auf verschiedene individuelle, organisationale, situationelle und gesellschaftliche Faktoren, die in ethischen Entscheidungen eine Rolle spielen, und erforscht weitere Faktoren, die in ethischen Entscheidungen des beruflichen Alltags der Teilnehmer*innen eine Rolle spielen, sowie die Wege des Lernens über berufsethische Aspekte. Veröffentlichung I beschreibt die Häufigkeit des Auftretens 46 verschiedener ethischer Situationen im Alltag von Physiotherapeut*innen, die der internationalen Literatur entnommen, und die in vier Kategorien gegliedert wurden: (A) Interaktion zwischen Physiotherapeut*in und Patient*in (19 Items); (B) Physiotherapeut*innen und andere Angehörige von Gesundheitsberufen einschließlich anderer Physiotherapeut*innen (10 Items); (C) Physiotherapeut*innen und das System (5 Items); und (D) Berufliche und wirtschaftsethische Situationen (12 Items). Ein Mangel an Ressourcen, der die Qualität der physiotherapeutischen Behandlung beeinflusst, und Ungerechtigkeit im Zugang zu Physiotherapie für Menschen, die diese Behandlung benötigen, werden als am häufigsten auftretende ethische Situationen weltweit erlebt und kommen durchschnittlich öfter als monatlich vor. Ethische Situationen innerhalb des Systems (Kategorie C) werden von Physiotherapeut*innen international am häufigsten erlebt. Rund drei Viertel der internationalen Stichprobe lernte in ihrem Grundstudium/ ihrer Basisausbildung über ethische Kodizes, rund die Hälfte der Stichprobe lernte über Rahmenkonzepte für ethische Entscheidungsfindung. Lernen über ethische Kodizes ist mit dem selteneren Erleben ethischer Situationen assoziiert. Veröffentlichung II berichtet über die große Bandbreite und Komplexität der gelebten ethischen Erfahrungen der Teilnehmer*innen. Rund 40% der in den Daten identifizierten Problemstellungen bezogen sich auf die Interaktion mit Angehörigen anderer Gesundheitsberufe inklusive anderer Physiotherapeut*innen (Kategorie B), die übrigen Daten verteilten sich mit je rund 20% auf die Kategorien (A), (C) und (D). Über ein Viertel der Antworten der Teilnehmer*innen bezog sich auf drei ethische Situationen: Fehlverhalten Angehöriger anderer Gesundheitsberufe (inklusive anderer Physiotherapeut*innen); Mobbing oder Belästigung von Physiotherapeut*innen; und Konflikt mit anderen Angehörigen der Gesundheitsberufe über das Patient*innen-Management. Vier neue Themenbereiche von ethischen Problemstellungen wurden identifiziert: Mangelnde Anerkennung der Rolle und Position von Physiotherapeut*innen im Gesundheitswesen; Wirtschaftliche Faktoren, welche die therapeutische Praxis bestimmen; Mangel an Regulierungs- und/oder Akkreditierungspolitik und –infrastruktur; und Politische Bedrohungen. Veröffentlichung III beleuchtet Unterschiede der Ethikausbildung in Grundstudium/ in der Grundausbildung und der Häufigkeit ethischer Situationen innerhalb Europas und im internationalen Vergleich. Ethische Situationen im professionellen und wirtschaftlichen Kontext (Kategorie D) werden in Europa signifikant weniger häufig erlebt als im internationalen Vergleich. Veröffentlichung IV vertieft den Blick auf ethische Situationen und das Lernen über berufsethische Aspekte innerhalb der europäischen Region mit einem Vergleich der deutschsprachigen Länder mit dem Rest Europas. Physiotherapeut*innen aus den deutschsprachigen Ländern lernen signifikant weniger oft über ethische Kodizes und Rahmenkonzepte für ethische Entscheidungen, als Physiotherapeut*innen in Rest-Europa. Veröffentlichung V analysiert die Antworten der Teilnehmer*innen auf eine optionale offene Frage der Umfrage 2, welche Faktoren in ihren ethischen Entscheidungen eine Rolle spielen. Ein Spektrum von 43 verschiedenen Faktoren innerhalb fünf übergeordneter Themen (Individuelle, relationale, organisationale, situationelle und gesellschaftliche Faktoren) konnte identifiziert/konstruiert werden. Komplexität und Diversität ethischer Situationen und den verschiedenen Prozessen ethischer Entscheidungsfindung spiegeln sich deutlich in den Ergebnissen dieser Studie wieder. Veröffentlichung VI befragt Physiotherapeut*innen in allen fünf Weltphysiotherapie-Regionen zu ihrer Sicht auf Faktoren, die in ethischen Entscheidungen eine Rolle spielen, und zu Wegen des Lernens über berufsethische Aspekte. Die höchsten Zustimmungswerte erhielten die Aussagen, dass ethische Entscheidungsfindung mehr Fähigkeiten erfordert, als nur einem Ethikkodex zu folgen, und jene hinsichtlich der hohen ethischen Anforderungen der sozialen Rolle von Physiotherapeut*innen. Verschiedene Faktoren, die in ethischen Entscheidungen eine Rolle spielen, werden von Physiotherapeut*innen verschiedener Weltregionen hinsichtlich Zustimmung und Ablehnung signifikant unterschiedlich bewertet. Die vielfältigen Arten und Weisen berufsethischen Lernens der Teilnehmer*innen umfassen formelle und informelle Bildungswege, welche sich in Qualität und Quantität zwischen den einzelnen Weltphysiotherapie-Regionen signifikant unterscheiden. Physiotherapeutische ethische Theorien und Praxis müssen an den lokalen Kontext angepasst werden, und sowohl im Grundstudium/ in der Grundausbildung als auch im Laufe der kontinuierlichen professionellen Entwicklung vermittelt werden. Berufsethische Bildung ist ein individueller Faktor, der in ethischen Entscheidungen von Physiotherapeut*innen eine Rolle spielt, und der die Häufigkeit des Erlebens ethischer Situationen beeinflusst. Nichtsdestotrotz darf der individuelle Einfluss von Physiotherapeut*innen auf ethische Situationen und deren Lösungen nicht überschätzt werden, da organisationale, relationale, situationelle und gesellschaftliche Faktoren in ihrem Entstehen und bei ihrer Lösung eine nicht unbedeutende Rolle spielen. Es bedarf auf diesen Ebenen zusätzlicher Handlungen befähigter Entscheidungsträger*innen. (Weiter)Entwicklungen von ethischen Kodizes und Rahmenkonzepte für ethische Entscheidungen müssen den internationalen Gegebenheiten und Erfahrungen von Physiotherapeut*innen angepassten werden, damit Inhalte formellen Lernens als praxisrelevant anerkannt werden. Kollaborative Lernumgebungen, die wechselseitiges Lernen und (internationalen) Erfahrungsaustausch und Reflexionsmöglichkeiten bieten, sind informelle Lernoptionen für kontinuierliche berufsethische Entwicklung, genauso wie niederschwellige Bildungsangebote, wie zum Beispiel frei zugängige Forschungsberichte und Online-Datenbasen und –Kurse.
... It is admitted that the use of hands, with or without the addition of any adjuvant substance, with the aim of healing, is probably older than any other healing tradition, and the origin of physiotherapy goes back to the beginnings of civilisation, when man used, empirically, exposure to the sun, thermal waters, and massage, to relieve or cure his ailments (Lucena, 2011). However, the start of the profession was mainly boosted by the First and Second World Wars and the need to rehabilitate the injured soldiers, requiring physiotherapists' attention because of wounds, amputations, burns, cold injuries, fractures, and nerve and spinal cord injuries (Shaik and Shemjaz, 2014). ...
The physiotherapy profession and education have evolved aligned with over a century of worldwide historic moments, sociodemographic challenges, and advances in science and technology. The goal of this chapter is to describe future challenges in physiotherapy education, recognizing physiotherapists as allied health professionals with specific core competences, whose educational outcomes can be enhanced through active learning strategies integrated in a real context for practice, in a never ending continuous professional development leveraged by a lifelong learning experience.
Background Despite the prevalence of mental health disorders rising worldwide, physio-therapists’ perceptions of their role and ability to holistically treat people with anxiety and depression remain unclear. Purpose This research aimed to understand the physiotherapists’ perception of their role in treating and managing people with anxiety and depression while revealing barriers and facilitators in practice. Methods PubMed, PsycInfo, CINAHL, EMBASE, Web of Science, and Google Scholar were searched systematically for mixed-method, quantitative, or qualitative designs. Using the Joanna Briggs Institute (JBI) Methodology for Systematic Reviews, data was extracted, critically appraised, assigned quality grades, and synthesized through meta-aggregation. Results A total of 2991 records were initially sourced, with eleven studies included in the systematic review. The studies were published worldwide between 2016 and 2021, with the majority (n = 8) published in 2020–2021. Participating physiotherapists most frequently had a Bachelor’s degree (35.7–62.6%), followed by a Master’s degree (28.4–37.4%). Meta-aggregation revealed the synthesized finding that physiotherapists perceived their role to include treating people with anxiety and depression despite feeling underprepared. Physiotherapists perceive many barriers and facilitators, such as education, when treating people with anxiety and depression. Conclusion Physiotherapists have positive perceptions toward anxiety and depression, despite feeling underprepared in their ability to implement psychosocial strategies.
This chapter reviews non pharmacologic and non surgical treatments for spine pain. Evidence based treatments are emphasized and discussed. Non pharmacological treatments are recommended as first line care, reducing the need for more aggressive interventions.KeywordsNon pharmacological treatment Back pain ExerciseEvidence based treatment
The world has been familiar with the diagnosis of stroke since the year 500 BC, as well as with the therapeutic value of physical exercise (early physical therapy). However, exercises were incorporated to promote recovery after stroke in the late 1920s, and matured into an orderly practice in the late 1940s. The synthesis of the reviewed literature suggests that this late date of emergence was, to a great extent, because of the development of relevant knowledge, specific (post-war) timing and the emergence of health professional pioneers that led this practice. This article documents the unique historical trajectory of these preconditions. This brief review demonstrates how war pushed physical rehabilitation to the threshold of being able to provide neurological rehabilitation. It also discusses the contribution of the health professional pioneers to post-stroke rehabilitation, in light of today's more accepted approach of evidence-based practice.
Over the past few decades, oncology rehabilitation has transformed from a niche clinical area to an established specialty practice with a defined scope of knowledge and skills. Since the passage of board certification in the APTA House of Delegates in 2016, the Description of Specialty Practice has defined the scope and parameters of this specialization and has set benchmarks for practitioner knowledge, skills, and behaviors. Concurrently, several institutions have established oncology residencies for physical therapists, with many others in the developing stages. Residencies are extensive postgraduate, on-the-job training opportunities whereby a resident is closely mentored by a team of clinical experts. Accreditation standards for oncology residencies are established by the American Board of Physical Therapy Residency and Fellowship Education. This article provides perspectives on the current role of and future opportunities for oncology physical therapy residency programs. The infrastructure, institutional support, and development of residents and faculty mentors show great potential to further the specialty area, enhance patient access, and elevate the quality of services available to persons living with and beyond cancer.
Recognition of the importance of a patient's perception of their status and experience has become central to medical care and its evaluation. This recognition has led to a growing reliance on the use of patient reported outcome measures (PROMs). Nevertheless, while awareness of PROMs and acceptance of their utility has increased markedly, few of us have a good insight into their development; their utility relative to clinician-rated and performance measures such as the FIM and 6-Minute Walk Test or how their “electronification” and incorporation into electronic health records (EHRs) may improve the individualization, value, and quality of medical care. In all, the goal of this commentary is to provide some insight into historical factors and technology developments that we believe have shaped modern clinical PROMs as they relate to medicine in general and to rehabilitation in particular. In addition, we speculate that while the growth of PROM use may have been triggered by an increased emphasis on the centrality of the patient in their care, future uptake will be shaped by their embedding in EHRs and use to improve clinical decision support though their integration with other sources of clinical and sociodemographic data.
Full understanding of medical operations in Vietnam requires some appreciation of the nature of the country and of the war that has been waged there. The Republic of Vietnam lies entirely within the Tropics. Saigon is halfway around the world from Washington, D.C. There is a 12-hour difference in time between the two cities. The nearest off-shore U.S. hospital is almost 1,000 miles away at Clark Air Force Base in the Philippines. The nearest logistical support base is about 1,800 miles away in Okinawa. The nearest complete hospital center is in Japan, some 2,700 miles distant. Patients being evacuated to the United States must travel some 7,800 miles to reach Travis Air Force Base in California, or almost 9,000 miles to reach Andrews Air Force Base, near Washington, D.C.
Coronary artery disease is one of the leading causes of death in the United States. The early decades of the nineteenth century witnessed small gains in the diagnosis and treatment of the coronary patient. The most remarkable advances in the management of coronary disease, however, have occurred over the last three decades. This article will review the evolution of cardiac rehabilitation as a formalized method of patient management and the emerging role of the physical therapist in providing a variety of health services to the coronary population.
A panel discussion on unsettled clinical questions in the management of cardiovascular disease was conducted at the Thirtieth Scientific Sessions of the American Heart Association held at the Sherman Hotel, Chicago, Friday afternoon, October 25, 1957. The panel was comprised of the following members: LOUIS N. KATZ, Chicago, Ill. , MODERATOR; GEORGE E. BURCH, New Orleans, La. ; ALBERT DORFMAN, Chicago, Ill. ; A. CARLTON ERNSTENE, Cleveland, Ohio; HANS H. HECHT, Salt Lake City, Utah; and ROBERT L. PARKER, Rochester, Minn.
Rest for a diseased organ, be it a fractured limb or a tuberculous lung, is a therapeutic principle validated by clinical experience. It is believed that activity, with its complex biochemical and physical demands, diverts from the reparative process the available energy essential for optimal healing. When the heart is diseased, the only feasible application of the principle of rest is the attempted diminution of the cardiac load. Rest in bed has been traditionally regarded as tantamount to optimal rest for the heart. This is the practice in congestive heart failure and finds its most rigid application in acute coronary thrombosis, when the patient is placed flat in bed for three to six weeks.¹ It has been our view that recumbency in bed affords less rest to the heart than the sedentary position in a chair with the feet down.² The recumbent position permits maximal venous return from
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