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Physical therapy as a profession has its roots to earliest of time, when the techniques were used for treatment much earlier than that of origin of the very term “physiotherapy” itself. This professional discussion paper is a review of the past, present and future of physical therapy as a profession in its three roles- educator, clinician and researcher. The ensuing paradigm shift in favor of advanced teaching methodologies and pedagogues evolved the present situation of physical therapy education. The shift from evidence-based practice to an evidence-informed one witnessed clinical therapists to pursue continuing educational programmes and professional development. The growing evidence in terms of increasing randomized controlled trials in physical therapy indicated development of quality clinical practice guidelines to translate evidence into practice. Professionalization in physical therapy needs a shift towards professionalism to move physical therapy forward in all three core areas of the profession.
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J Phys Ther.
2010;1:
58
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Professional
discussion
Physical
Therapy-
Past,
Present,
Future
Distributed in Open Access Policy under Creative Commons
®
Attributi on License 3.0
Physical therapy: past, present and
future- a paradigm shift
Senthil P Kumar PT, (PhD)*
ABSTRACT
Physical therapy as a profession has its roots to earliest
of time, when the techniques were used for treatment much
earlier than that of origin of the very term “physiotherapy” itself.
This professional discussion paper is a review of the past,
present and future of physical therapy as a profession in its
three roles- educator, clinician and researcher. The ensuing
paradigm shift in favor of advanced teaching methodologies and
pedagogies evolved the present situation of physical therapy
education. The shift from evidence-based practice to an
evidence-informed one witnessed clinical therapists to pursue
continuing educational programmes and professional
development. The growing evidence in terms of increasing
randomized controlled trials in physical therapy indicated
development of quality clinical practice guidelines to translate
evidence into practice. Professionalization in physical therapy
needs a shift towards professionalism to move physical therapy
forward in all three core areas of the profession.
Key words:
Professionalism, physical therapy, history,
paradigm shift
Author’s information:
*- Corresponding author. Associate professor, Dept of Physiotherapy,
Kasturba Medical College (Manipal University), Mangalore, India.
senthil.kumar@manipal.edu
INTRODUCTION
“Learn from yesterday; live for
today; hope for tomorrow; the
important thing is not to stop
questioning.”
- Albert Einstein.
Welcome to the
second issue of Journal of
Physical Therapy. The aim of
this editorial in this issue of
Journal of Physical Therapy is
to enlighten our readers about
history of our profession, its
development from past to the
present whilst presenting
global challenges and rising
opportunities for the future.
The description of editorial will
include the historical note on
origin of the term
“Physiotherapy” and then the
paradigm shift that ensued
along the three well-
recognized roles of a Physical
Therapist; as an educator, a
clinician and a researcher.
Historical perspective-
Physiotherapy/ Physical
Therapy?
Development of a
discipline owes to its ability for
a clear vision to “look back to
its roots” and to answer simple
questions directed on the very
name of the discipline.
Questions such as, “how did
the name originate?”, “who
invented the term?” and “when
was it first used?” etc
1
would
facilitate though-provoking
efforts, the answers of which
indicate high levels of
professional integrity and
professionalism.
The word
“physiotherapy” in English
owes its origin to Dr Edward
Playter (1834-1909), way back
in 1894, when he reported in
Montreal Medical Journal, on
page 816; (figure-1).
1,2
A military physician Dr
Lorenz Gleich (1798–1865)
from Bavaria was the first to
use the term physiotherapy in
its earlier German language
version, “physiotherapie” in his
article in the year 1851.
3
As
we step into 160
th
year of our
profession, the original French
term “physiotherapie” got
changed in English into
“physiotherapy” and then to
physical therapy.
Key points and pre-publication history of this article is available at the end of the paper.
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Figure 1- Cut out from the article by Dr Edward Playter in 1894.
2
There are a number of
definitions of the
physiotherapy profession. The
definitions vary across the
globe with associations and
professional bodies adopting
their own way of describing
what WCPT defined below in a
comprehensive manner.
Definition of Physiotherapy/
Physical Therapy:
The World
Confederation for Physical
Therapy (WCPT), the
renowned global organization
for physical therapy for
instance, defines
physiotherapy as:… ‘providing
services to people and
populations to develop,
maintain and restore
maximum movement and
functional ability throughout
the life-span. Physiotherapy
includes the provision of
services in circumstances
where movement and function
are threatened by the process
of ageing or that of injury or
disease. Full and functional
movement are at the heart of
what it means to be healthy
…Physiotherapy is concerned
with identifying and
maximising movement
potential, within the spheres of
promotion, prevention,
treatment and rehabilitation.
Physiotherapy involves the
interaction between
physiotherapist, patients or
clients, families and care
givers, in a process of
assessing movement potential
and in establishing agreed
upon goals and objectives
using knowledge and skills
unique to physiotherapists.’
4
The WCPT definition
emphasizes the “action-
orientedness” in the definition
of the very term itself. For a
successful transformation and
progressive growth, enhanced
understanding of the
profession and its basis is thus
a need-of-the-hour in Physical
Therapy. The solution lies in
studying the professional
dimensions along lines of a
paradigm.
A paradigm is defined
a model that directs actions;
that is, an action-strategy or
approach that guides activities
in a specific field. A
professional paradigm means
that a person within a
particular profession has
adopted a certain way of
thinking. Physical Therapy
professional paradigm
includes four inherent
components through which the
identity of physiotherapy can
be defined- interest (what one
desires), competence (what
one knows/one can do-
cultural, communicative, socio-
cultural, linguistic, socio-
ethical), world view
(understanding of the field of
practice), and view of science
(comprehension of particular
strategies, methodologies and
ideals).
5
Physical Therapists
have three basic functions as
professionals in the
professional paradigm-
educator, clinician and
researcher. The three roles
coincidentally develop in
accordance with continuous
and progressive wholistic
development of knowledge,
experience and skill.
6
Now we
take a look at each of them in
detail, to observe and analyze
the trend through the years so
that we can learn from the
past and aptly apply them for
use in the future. As one
paradigm shifts backwards to
the past improving our present
understanding, there are the
other paradigms that shift
forwards into the future.
Physical Therapist as an
Educator- past, present and
future:
Fundamental to growth
of profession and its
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level of education. Though
ancient times witnessed
manipulators, lay practitioners
and bone-setters leading the
way and setting a trail for the
others to follow, the initial
knowledge-transfer happened
mostly on one-one basis and
practical life situations with
patients during their treatment
processes. Though the
method was less scientific and
rationale, ancient education
relied on manual handling
skills for evaluation and
treatment. Through the years,
earliest forms of treatment like
manual techniques,
hydrotherapy and movement
therapies gained importance in
the field of education.
To present
knowledge, the first
documented development of a
professional school for
Physical Therapy education
(as was required to be entry-
level program) was seen in
1913, with the School of
Physical Therapy at University
of Otago, New Zealand and in
1914 at Reed College at
Portland, Oregon, USA.
7
Now
there are approximately
schools in 80 countries
teaching Physical Therapy at
various entry-level
programmes recognized and
approved by their regional
governing bodies/associations
around the world. Wide
variation in the number of
Physical Therapy schools-per-
country ratio exists where
Slovenia has only one
Physical Therapy school and
USA having 202 schools
whereas a country like India
has 171 schools.
8
Presently, the World
Confederation of Physical
Therapy (WCPT) recognizes
there is considerable diversity
in the social, economic,
cultural, and political
environments in which
physical therapist education is
conducted throughout the
world. W CPT recommends
physical therapist entry-level
educational programs be
based on university or
university-level studies, of a
minimum of four years,
independently validated and
accredited as being at a
standard that accords
graduates full statutory and
professional recognition.
WCPT acknowledges there is
innovation and variation in
program delivery and in entry-
level qualifications, including
first university degrees
(Bachelors/ Baccalaureate/
Licensed or equivalent),
Masters and Doctorate entry
qualifications.
8
Professional
education prepares physical
therapists to be autonomous
practitioners in collaboration
with other members of the
health care team. Physical
therapist entry-level
educational programs
integrate theory, evidence and
practice along a continuum of
learning. This begins with
admission to an accredited
physical therapy program and
ending with retirement from
active practice. The shift
towards Doctoral programs
offered by many institutions in
USA witnessed greater journal
publication productivity
(measured by number of
publications and their citation
index) which was also
associated with number of full-
time faculty in those academic
institutions.
9
One of the highly
acclaimed education models in
the present day Physical
Therapy curriculum is
problem-based learning.
10
The future would be a
witness to curricular
developments and application
of an integrated curricular
model such as Client-Oriented
Research and Evaluation
(COR
X
E) best practice model
and COR
X
E clinical decision-
making model.
11
The model
was formed by integrating-
Hypothesis-Oriented Algorithm
for Clinicians (HOAC);
collaborative clinical
reasoning; inter-relationships
of theory, clinical models and
research; and the Evidence-
Based Practice circle.
Clinical practice- past,
present and future:
Greek physicians
including Hippocrates (460-
370BCE) are believed to have
been the first practitioners of
physical therapy, advocating
massage, manual therapy
techniques and hydrotherapy
to treat people.
7
During the second half
of the 19th century, a period of
increasing specialization in the
field of medicine, terms like
“physical medicine,” “physical
therapy,” physiotherapy,” and
the like came into use to
categorize the various healing
methods of exercise,
manipulation, and massage
(also collectively known as
mechanotherapy),
hydrotherapy, balneotherapy,
electrotherapy, light therapy,
air therapy, and heat and cold
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therapy (thermotherapy) under
one heading.
12
Historically
documented description of
practice and development of
physical therapy did date not
earlier than late 19
th
century.
The techniques though were
used through the ages- some
of them were hydrotherapy,
massage, mobilization,
assisted functional training-
they were not recognized a
being apart of the field till the
term “physiotherapie” was
coined in 1851.
In 1894, The Society
was founded by four young
nurses: Lucy Marianne
Robinson, Rosalind Paget,
Elizabeth Anne Manley and
Margaret Dora Palmer. They
set up the Society of Trained
Masseuses to protect their
profession from falling into
disrepute as a result of media
stories warning young nurses
and the public of unscrupulous
people offering massage as a
euphemism for other services.
By 1900, the Society acquired
the legal and public status of a
professional organization and
became the Incorporated
Society of Trained Masseuses.
In 1920, the Society was
granted a Royal Charter. It
amalgamated with the Institute
of Massage and Remedial
Gymnastics. As the Chartered
Society grew in strength,
branches and local boards
were established all over the
country and in 1944 the
Society adopted its present
name, the Chartered Society
of Physiotherapy (CSP), being
more representative of the
field of work it covered.
13
In 1916, there was an
epidemic of poliomyelitis or
most popularly known as polio
in New York and New
England. Many cases of
poliomyelitis can lead to
temporary paralysis, but
without proper treatment the
paralysis can be lifetime effect.
During this period, there were
documentation of young
women treating patients of the
“polio” epidemic using passive
movements and this was also
the period when manual
muscle testing was
established in its use by
physiotherapists.
It was during this time
that Mary McMillan, the first
physical therapy aide,
established the American
Women's Physical
Therapeutic Association. The
organization's name was later
on changed to the American
Physical Therapy Association
(APTA). Due to her significant
contribution in the
reconstruction aide services,
Mary McMillan came to be
known as the 'Mother of
Physical Therapy'.
World War II prompted
another historical period where
physical therapy became
widely used to care for
patients. Physical therapy was
used and showed impressive
results in veterans who have
been injured in the Korean and
Vietnam wars. This signaled
the start of using physical
therapy in hospital and
medical programs. Physical
therapists were getting
recognized as reconstruction
aides and rehabilitation
specialists for the victims of
war.
14
Treatments in this
decade were mostly exercise,
massage and traction. During
1950s, physical therapists
started learning and doing
procedures in the spine and
other joints. These
manipulative procedures
improved through continuous
research and studies. The so-
happened adoption of manual
therapy techniques into
Physical Therapy thus forming
a specialty of Orthopaedic
Manual Physical Therapy
revolutionized the
development of the field itself.
Until the early 1950s, physical
therapy was performed only in
hospitals. It was only in the
late 1950s that physical
therapists started treating the
patients beyond hospitals.
Public schools, universities,
skilled nursing facilities,
medical centers and
rehabilitation centers were
chosen by the
physiotherapists to treat their
patients.
Eventually in 1974, the
International Federation of
Orthopaedic Manipulative
Therapists (IFOMT) was
formed. This organization has
then played and is
continuously playing a major
role in the advancement and
development of physical
therapy. The history of IFOMT
is inevitably intertwined with
the development and rise of
physical therapy. The growth
of physical therapy over the
last fifty years has been
phenomenal. Paralleling that
growth has been the rise of
manual and manipulative
therapy. Indeed much of the
vigor and ideas for growth
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have come from this group. In
each country there have been
leaders who have seen the
future and striven for it.
Manual therapists have been
foremost in that leadership
and whether pushing for
physical therapy or for manual
therapy they have elevated the
standing and maturity of both.
Today, therefore, physical
therapy can look with pride on
the accomplishments of
manual and manipulative
therapists.
15
Several physical therapists
who made notable
contributions through manual
therapy in the field of
physiotherapy were members
of the IFOMT organization are
detailed in historical paper by
Peter Huijbregts in our first
issue of Journal of Physical
Therapy.
16
Three macro-
paradigms exist in Physical
Therapy clinical profession.
They are science (actions
aimed at describing and
explaining functions), art
(aesthetic factors) and religion
(ideology, values and ethical
factors).
5
The American
Physical Therapy Association
emphasized this in its National
Physical Therapy month for
October 2007 in its logo-
Physical Therapy: science of
healing and art of caring.
17
Physiotherapy has
been subject to considerable
criticism for its lack of research
and its sparse evidence-base.
It has often been perceived as
a profession that bases its
practice largely on anecdotal
evidence, and uses treatment
techniques that have little
scientific support.
18
Clinical decision-
making in Physical Therapy
was considered synonymous
to patient’s problem solving.
Earliest report of problem-
solving model in clinical
patient management dated
back to 1980s.
19
The
therapeutic decisions though
initially relied on anecdotal
evidence of personal
experience and expert opinion,
later realized the importance
of hypothesis-generation by
application of hypothesis-
oriented algorithm for
clinicians.
20,21
This model was
modified and organized with a
much better and globally
recognized clinical reasoning
model.
22,23
Recent amassment
of research findings and
publications witnessed
application of evidence-based
practice model and the ICF
(International Classification of
Functioning, Disability and
Health) model.
24
The future
would definitely support an
integrated problem-solving
model for successful clinical
management and patient-
centered clinical outcomes.
In clinical Physical
Therapy practice, though
documentation is widely
practised, an audit revealed
86% cases lacked other
aspects of documentation
except of initial day of
assessment, lacked
objectivity, limited range of
measurement parameters
used, and absence of
functional assessments.
18
The
above issue also raises
serious questions about both
critical aspects of the
professionalism of
physiotherapists in the hospital
environment, and the
effectiveness of their
treatments. Art is testing the
limits and leaving a thorough,
logical, and reproducible trail
for others to view and follow
and that is the basis of
science. Therefore, the art and
science of medicine are
inextricably intertwined and
you do not have art without
science nor science without
art.
25
Reproducibility is difficult
in both art and science.
Documentation is the only
direct path to appreciate “art”
and to understand “science.”
26
Changes in health
policies, prioritization and
funding continue to influence a
great deal, on the practice
issues and patterns, if not
therapists’ attitudes and
decisions.
27
There are two
proposed solutions to this
issue- the need for improved
methodology in workforce
development research to
explore patient outcomes as
much as outputs; and the
potential for physical
interventions (including
physiotherapy) to be
enhanced by a better
understanding and response
to how people think, respond
and behave. Scope of
Physical Therapy practice-
The scope of physiotherapy
practice
4
is influenced by the
ratio of qualified
physiotherapists to the
population. The number of
physiotherapists per head of
population varies enormously,
particularly within the AWP
region, ranging from 1:1,750 in
Australia to 1:212,000 in India,
with the average ratio for the
region being 1:60,000
people.
4,28
In Ethiopia there
are approximately 14
physiotherapists for 60 million
people.
4
With the emergence of
patient-centered care,
consumers are becoming
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effective managers of their
care- in other words, "effective
consumers." To support
patients to become effective
consumers, a number of
strategies to translate
knowledge to action (KTA)
have been used with varying
success. The use of a KTA
framework can be helpful to
researchers and implementers
when framing, planning, and
evaluating knowledge
translation activities and can
potentially lead to more
successful activities. Using the
framework, tailored consumer
summaries, decision aids, and
a scale to measure consumer
effectiveness were created in
collaboration with
consumers.
29
Research- past, present and
future:
Journals are
acknowledged as crucial
sources of evidence-based
information relevant to
physiotherapy practice.
30
The
first research about physical
therapy in the United States
was published in March 1921
in The PT Review.
14
The first
RCT in Physical Therapy
evaluated Ultra-Violet radiation
therapy and was published in
1929 by Dora Colebrook in
Medical Research Council
Special Report Series.
31,32
Initially the RCTs were
published in medical journals
and not until 1967, for the first
time an RCT evaluating
physical therapy intervention
was published in a physical
therapy journal. This unique
credit goes to author- Landen
B whose study evaluated
superficial heat vs. cold in LBP
and was published in Physical
Therapy journal.
The first systematic
review was published in 1975
by Kolind-Sorensen which was
on lateral ankle ligament
injuries in a Danish journal
Ugeskr Laeger. The first
evidence-based clinical
practice guideline was
published in the year 1987, a
report of the Quebec task
force on spinal disorders
which was on activity-related
spinal disorders by Spitzer W
in Spine.
31
In the recent past,
systematic review of
systematic reviews also came
to be published, on Spinal
Manipulation
33
in Chronic
LBP.
34
The rapid growth of
evidence as witnessed by the
presence 1 record in 1929 to
100 records in 1972, to 1000
records in 1986, 5000 in 1999
and to 10,000 in 2005 is an
indicator of a rapid shift
towards research and
evidence-based practice.
29
Presently as on March 2010,
there are 15,920 records in
Physiotherapy Evidence
Database
35
which includes
2257 systematic reviews and
13,096 randomized controlled
trials and 567 clinical practice
guidelines in physiotherapy
alone. As we observe the
growth of evidence when
analyzed specialty-wise,
Musculoskeletal holds the
highest position with more
than 2,000 records followed by
Cardiothoracic with less than
1,250 records.
31
Region-wise, 1,037
studies were on treatment of
lumbo-pelvic disorders and
condition-wise, there were 173
records “surprisingly” for
incontinence alone. Regarding
dissemination of “this”
evidence, it is a rare
occurrence that only 3% of this
number (340 out of 11,494
records as on September 3,
2007) was published in
general medical journals.
31
It is
not a matter of pride that 97%
of physiotherapy evidence is
published in physiotherapy
journals like Physical Therapy,
Physiotherapy, Journal of
Physiotherapy (formerly
Australian Journal of
Physiotherapy) and
Physiotherapy Canada. It is
indeed a matter of question
and uncertainty why
physiotherapy evidence is not
published in general medical
journals. The need of the
present hour to improve inter-
disciplinary awareness and
multi-disciplinary collaboration
in clinical practice is
achievable only if Physical
Therapy scientific community
works in liaison with other
medical community towards
solving this issue, if we really
mean to aim global
professional autonomy in
practice.
The existing
researcher-clinician gap
should be minimized in order
that- improved application of
best research findings and
evidence into practice; and
also for generation of best
research evidence from expert
clinical practice- can go hand-
in-hand towards betterment of
our society and our
profession.
36
Research or
science in Physical Therapy
has changed from positivism
(verifiable by observation) to
hermeneutics (based on
understanding) and then finally
to pragmatism (based on
actions).
5
Physical Therapy
research was based upon two
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supposedly different
philosophies- positivism and
phenomenology. Positivism
relied on quantitative research
methods and phenomenology
relied on qualitative ones.
37
Combining science (which is
objective and is based on the
body) and art (which is
subjective and is based on the
mind) using an inextricably
blended mixed model of
quantitative-qualitative
research is essential.
16
Professional
autonomy is achievable
through the following five
steps outlined by Professor
Stanley Paris in his keynote
address at Biennial
conference of New Zealand
Society of Physiotherapy
(NZSP) in 2008, as- definition
of scope of practice; research;
clinical doctorate programs;
marketing; and, maintenance
and advancement of our
autonomy.
38
Summary-
professionalization to
professionalism:
It is extremely
essential to transform the
physical therapy profession
from professionalization into
professionalism.
Professionalization
and professionalism, as
distinct entities according to
Julia Evetts;
39
Professionalization is a series
of diverse and variable, social
and historical processes of
development, of how work
sometimes becomes an
occupation, and how
occupations achieve various
forms of occupational control
of work sometimes called
professional.
Professionalization
occurred in physical therapy in
its practice areas in diverse
fields of medicine (from
obstetrics to geriatrics and
palliative care) directed
towards patient care from
before birth till after death
(bereavement care).
40
Professionalization in
physical therapy research was
witnessed by the growth in
number of journal publications
added every year. Whilst
journals such as Physical
Therapy, Journal of Physical
Therapy, Physiotherapy,
Journal of Physiotherapy,
Physical Therapy Reviews,
Physiotherapy Research
International, Physiotherapy
Canada, Physiotherapy
Theory and Practice existed,
journals of specialty-oriented
names- Pediatric Physical
Therapy, Cardiopulmonary
Physical Therapy Journal,
Journal of Neurologic Physical
Therapy, Manual Therapy,
Journal of Manual and
Manipulative Therapy, Journal
of Orthopedic and Sports
Physical Therapy, Physical
Therapy in Sport, Journal of
Geriatric Physical Therapy,
Journal of Women’s Health
Physical Therapy added value
to identification of various
areas of research as domains
of development together with
technique-based journal
names- Journal of Aquatic
Physical Therapy and
International Journal of
Mechanical Diagnosis and
Therapy.
Professionalism as defined by
Julia Evetts;
39
Professionalism includes
those aspects of the
occupational control of work
which are in the best interests
of customers, clients and
patients, as well as in the
advice-giving, lobbying and
sometimes oppositional
aspects of professions’
relations with states,
legislative bodies, and regional
and local administrative
agencies.
Herbert Swick
41
outlined nine
main attributes of
professionalism as;
Subordination of one’s
own interests to the
interests of others
Adherence to high
ethical and moral
standards
Responding to
societal needs
Evincing core
humanistic values
Exercising
accountability for
themselves and for
their colleagues
Demonstration of a
continuing
commitment to
excellence
Demonstration of a
commitment to
scholarship and to
advancement of their
field
Dealing with high
levels of complexity
and uncertainty
Reflection upon one’s
own actions and
decisions
Professionalism is the
key to move physical therapy
forward, in all the three core
areas of education, practice
and research. Studies on
professional development and
impact of professional
development programmes
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Core values of
professionalism
Description
Accountability
Accountability is active acceptance of the responsibility for the
diverse roles, obligations, and actions of the physical therapist
including self-regulation and other behaviors that positively
influence patient/client outcomes, the profession and the health
needs of society.
Altruism
Altruism is the primary regard for or devotion to the interest of
patients/clients, thus assuming the fiduciary responsibility of
placing the needs of the patient/client ahead of the physical
therapist’s self interest.
Compassion/ caring
Compassion is the desire to identify with or sense something of
another’s experience; a precursor of caring. Caring is the concern,
empathy, and consideration for the needs and values of others.
Excellence
Excellence is physical therapy practice that consistently uses
current knowledge and theory while understanding personal limits,
integrates judgment and the patient/client perspective, challenges
mediocrity, and works toward development of new knowledge.
Integrity
Integrity is steadfast adherence to high ethical principles or
professional standards; truthfulness, fairness, doing what you say
you will do, and “speaking forth” about why you do what you do.
Professional duty
Professional duty is the commitment to meeting one’s obligations
to provide effective physical therapy services to individual
patients/clients, to serve the profession, and to positively influence
the health of society.
Social responsibility
Social responsibility is the promotion of a mutual trust between the
profession and the larger public that necessitates responding to
societal needs for health and wellness.
Table-1: Seven core values of professionalism according to American Physical Therapy
Association (APTA)
42
Article pre-publication
history:
Date of submission: 4
th
April 2010
Reviewer: Peter A Huijbregts
Sent for 1
st
revision: 8
th
April 2010
Date of 1
st
resubmission: 11
th
April
2010
Reviewer: Prof Maureen Simmonds
Sent for 2
nd
revision: 18
th
April 2010
Date of 2
nd
resubmission: 20
th
April
2010.
Date of acceptance: 24
th
April 2010.
Date of publication: 27
th
June 2010.
WFIN: JPT-2010-ERN-101-1(2)-
though plenty, do not
adequately reflect the
knowledge, attitudes, beliefs
and experiences of therapists
in seven core values of
professionalism namely
accountability, altruism,
compassion/caring,
excellence, integrity,
professional duty, and social
responsibility (table-1).
42,43
Development of
professionalism is solely
dependent upon curricular
44
framework not only at entry-
level but also in the post-
graduate physical therapy,
45
doctoral
46
and post-doctoral
47
degree levels.
Such a professionalism-
based paradigm shift is
evidently the need of the hour
to weather the storm
48
of
challenges and opportunities
facing us. Come on,
therapists, let’s embark on the
noblest role of mentorship.
49
ACKNOWLEDGMENTS
None.
CONFLICTS OF INTEREST
None identified.
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Key points:
Past-
The techniques used in Physical Therapy were used well
before the name “Physical Therapy” came into existence.
History is filled with moments of milestones and of pride.
Present-
The recent developments are owed mainly to
international collaborations especially in research and its
dissemination.
Future-
We need to perform a thorough reflection and strategic
planning in our doctoral programmes, practice autonomy and
imparting professionalism among therapists. Impact analysis of
such paradigm shift is thus warranted.
... Many of these new approaches are underpinned by a developing understanding of historical discourses informing physiotherapy's present tensions (Brauchle, 1971;Korobov, 2005;Kumar, 2010;Nicholls & Cheek, 2006;Nicholls & Holmes, 2012;Ottoson, 2011;Repschläger, 2011;Schöler, 2005;Terlouw, 2006). Studies have explored physiotherapy's positivistic, biomedical foundations and the rise of evidence-based medicine (Gibson & Martin, 2003;B. ...
... In line with a growing body of research, in Chapter One I argued that any attempt at reviewing and further developing physiotherapy theory and practice at a fundamental level requires the thorough scrutiny of the profession's history, as well as its contemporary theories and practices (Kumar, 2010;Nicholls & Cheek, 2006;Ottoson, 2011;Terlouw, 2006). Particularly research from the emerging field of critical physiotherapy history suggests that contemporary physiotherapy is predominantly shaped by biomedical discourses. ...
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... Por ello, es importante la incorporación de estos profesionales en hospitales, balnearios, centros deportivos, gimnasios, centros de salud, centros de enseñanza e investigación, asilos, empresas privadas y en equipos deportivos, entre otros (9,10). Sin embargo, el futuro de estos profesionales se ve restringido debido a que en México no se toma en cuenta su trabajo, sino que M. Yoselin Muñoz-Rosales, G. Mercado-Mercado Evaluación del servicio al paciente por los practicantes de Fisioterapia en el sector de salud en Tepic Nayarit fisioGlía 2022, 9(2): 21-31 en los sectores de salud pública, por lo que las tendencias en el sector salud son tentadoras debido a que se están abriendo espacios en el sector público para que los fisioterapeutas ejerzan su profesión (3,10,13). Por ello, el objetivo del presente estudio fue evaluar la atención recibida por los practicantes de Fisioterapia y el grado de satisfacción del ambiente de trabajo en los centros de salud de Nayarit. ...
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