Physiotherapy, or physical therapy (PT) is a type of allied health profession.[1][2][3][4] Physical therapists provide it by using physical examination, diagnosis, management, prognosis, patient education, physical intervention, rehabilitation, disease prevention, and health promotion to promote, maintain, or restore health. In many nations, physical therapists are referred to as physiotherapists.
Numerous specializations are available in this field, such as electromyography, geriatrics, sports medicine, neurology, endocrinology, orthopedics, cardiac, musculoskeletal, and women’s health. PTs work in a variety of public and private environments.[5]
Physical therapy profession encompasses not only clinical practice but also research, teaching, consultancy, and health administration. Physical therapy is offered in addition to other medical services or as a primary care intervention. Certain countries, including the United Kingdom, allow physical therapists to write prescriptions for drugs.[6]
Overview of Physical therapy
Physical therapy treats the conditions or traumas that restrict a person’s range of motion or capacity to carry out everyday tasks.[7] To make a diagnosis and create a treatment plan, physical therapists (PTs) consider a patient’s medical history, conduct a physical examination, and, if required, integrate the findings of laboratory and imaging tests, such as CT scans, MRIs, or X-rays. It is also possible to employ electrodiagnostic testing, such as nerve conduction velocity tests and electromyograms.[8]
Physical therapy (PT) management typically involves prescribing or helping with targeted exercises, manual therapy, manipulation, and other interventions; mechanical devices like traction; education; and electrophysical modalities like heat, cold, electricity, sound waves, radiation, prostheses, and other interventions.
Additionally, by creating fitness and wellness-focused programs for healthier and more active lifestyles, physical therapists (PTs) work with individuals to stop the loss of mobility before it starts. They offer services to individuals and populations to develop, maintain, and restore maximum movement and functional ability throughout the lifespan. This involves giving care when aging, injuries, illness, or environmental variables endanger a person’s ability to move and do their daily activities. Being able to move well is essential to being healthy.[Reference required]
Musculoskeletal, orthopedics, cardiac, neurology, endocrinology, sports medicine, geriatrics, pediatrics, women’s health, wound care, and electromyography are just a few of the numerous specializations available in the field of physical therapy.
Specifically, the field of neurological rehabilitation is one that is developing quickly. Physical therapists (PTs) can be found working in a variety of places, including privately owned physical therapy clinics, outpatient clinics or offices, health and wellness centers, hospitals for rehabilitation, skilled nursing facilities, extended care facilities, private homes, research and education centers, schools, hospices, industrial and other workplaces, fitness centers, and sports training facilities.[5]
In addition to providing patient care, physical therapists work in non-patient care positions such as those in health policy, insurance, administration, and executive positions. Physical therapists work as experts in the medical-legal sphere, conducting independent medical examinations and peer reviews.[Reference required]
Education differs widely between nations. The spectrum of education includes nations with minimal formal education to those with post-doctoral and PhD degrees.
History of Physical therapy
The earliest physical therapists are thought to have been doctors like Hippocrates and subsequently Galen, who promoted massage, manual therapy methods, and hydrotherapy as ways to heal patients in 460 BC.11] Similar to later advancements in physical therapy, devices like the Gymnasticon were created to cure gout and related conditions by methodically exercising the joints following the advent of orthopedics in the seventeenth century.[12]
The Royal Central Institute of Gymnastics (RCIG), established in 1813 for manipulation and exercise, was founded by Per Henrik Ling, the “Father of Swedish Gymnastics,” and is credited with the first recorded beginnings of physical therapy as a formal profession.
The term “physical therapist” in Sweden was sjukgymnast (meaning “someone who engages in gymnastics for those who are ill”) until 2014. After that, the word was changed to fysioterapeut (physiotherapist), which is the term used in the other Scandinavian nations.[13] In 1887, Sweden’s National Board of Health and Welfare officially registered PTs. Other nations soon after.
Four British nurses founded the Chartered Society of Physiotherapy in 1894.[14] The University of Otago in New Zealand’s School of Physiotherapy in 1913,[15] and Portland, Oregon’s Reed College in 1914, both produced “reconstruction aides.”[16] Spinal manipulative therapy has been a part of physical therapy practice since the profession’s founding.[17]
Events that had an impact on the world at large at the end of the 19th century necessitated quick advancements in physical therapy, leading to the establishment of modern physical therapy. Not long after, women with training in remedial exercise and physical education were employed by American orthopedic surgeons who were treating children with disabilities.
The 1916 polio outbreak saw the application and promotion of these remedies. Physical therapy was institutionalized during World War I, and women were hired to assist wounded troops in regaining their physical function. The term “Reconstruction Aide” was first used in 1918 to describe those who worked in physical therapy.
Following the start of World War I, the first physical therapy school was founded at Walter Reed Army Hospital in Washington, D.C.[18] The shift toward physical therapy was spurred by research. The United States published its first physical therapy research in March 1921 in “The PT Review.”
The American Women’s Physical Therapeutic Association (now known as the American Physical Therapy Association (APTA)) was founded by Mary McMillan in the same year. The Georgia Warm Springs Foundation championed physical therapy as a polio remedy in 1924, thus advancing the field.[19] Up until the 1940s, the main forms of treatment were traction, massage, and exercise. In the early 1950s, manipulation of the spine and extremities joints became common, particularly in the British Commonwealth nations.[20][21]
Physical therapists started showing up regularly in hospitals across Europe and North America at the same time that polio vaccines were introduced.[22] Physical therapists began to expand their practice outside of hospitals in the late 1950s.
These new settings included outpatient orthopedic clinics, public schools, health centers at colleges and universities, geriatric settings (skilled nursing institutions), rehabilitation centers, and medical centers. In 1974, physical therapists in the United States began to specialize on orthopedics, and the APTA established the Orthopaedic Section to accommodate these practitioners. The International Federation of Orthopaedic Manipulative Physical Therapists was established that same year[23], and it has since contributed significantly to the global advancement of manual therapy.
Education
States, nations, and different degrees of professional responsibility have different educational requirements for physical therapists. Physical therapists (PTs) and PTAs are recognized under physical therapy practice acts in the majority of US states, and some jurisdictions additionally recognize physical therapy technicians (PT Techs) or assistants. Physical therapists must be members of the licensing bodies in the majority of nations in order to begin working as independent practitioners.
Canada
There are fifteen universities in Canada that provide physiotherapy programs, most of them through their respective colleges of medicine. The three-year Bachelor of Science in Physical Therapy (BScPT) programs that required two years of prerequisite university coursework (5-year bachelor’s degree) have been replaced by two-year Master of Physical Therapy (MPT) programs that also require prerequisite bachelor’s degrees in all of Canada’s physical therapy schools.
The University of Manitoba became the final Canadian university to adopt the MPT program in 2012, so making the MPT certification the official entry-level norm for practicing medicine in Canada. It is not necessary for practicing professionals who currently hold a BScPT certificate to update their credentials.
To apply to a physiotherapy school or university program in the province of Quebec, prospective physiotherapists must have completed a college diploma in either physical rehabilitation technology, which takes at least three years, or health sciences, which takes an average of two years.
Students majoring in physical therapy and rehabilitation pursue a bachelor of science degree after being admitted. Typically, the B.Sc. program takes three years to finish. Following that, students must enroll in graduate school to finish their master’s degree in physical therapy, which typically takes between one and a half and two years to complete. Upon earning their M.Sc., graduates are eligible to join the Ordre Professionnel de la physiothérapie du Québec (PPQ) by passing the membership exam.
Sports medicine, physiology, kinesiology, and rehabilitation sciences are among the academic specializations available to physiotherapists.
According to expert De Van Gerard, physical rehabilitation therapists in the province of Quebec are medical professionals who must finish a three-year college diploma program in physical rehabilitation therapy and become members of the Ordre Professionnel de la physiothérapie du Québec (OPPQ) in order to legally practice in the nation.
The majority of physical rehabilitation therapists obtain their undergraduate degrees from Cégep Marie-Victorin, Dawson undergraduate, or Collège Montmorency, all of which are located in or around Montreal.
Graduates from technical colleges can continue their education at a university to potentially earn a bachelor’s degree in physiotherapy, kinesiology, exercise science, or occupational therapy after earning their diploma. Among the Quebec institutions that accept physical rehabilitation therapists into their health sciences and rehabilitation programs are Université de Montréal, Université Laval, and Université de Sherbrooke. These programs also grant credit for courses taken during college.
As of right now, there are no bridge programs available to make the transition from the BScPT to the MPT certification easier.
All universities do offer research-focused Master of Science (MSc) and Doctor of Philosophy (Ph.D.) degrees, though. In addition to scholarly research, continuing education programs and curricula allow practitioners to advance their credentials and skill sets. The provincial regulatory agencies mandate continuing education.
The national Physiotherapy Competency Examination (PCE) is available for qualifying program graduates to apply for through the Canadian Alliance of Physiotherapy Regulators (CAPR). To practice as a licensed physiotherapist in Canada, one of the criteria in the majority of provinces and territories is passing the PCE.[24] The following physiotherapy regulating bodies are members of CAPR and are approved in their home provinces and territories:
Yukon Government, Consumer Services
British Columbia College of Physical Therapists
Alberta College + Association of Physiotherapy
The Saskatchewan College of Physiotherapists of Manitoba College of Physical Therapists
Ontario College of Physiotherapists
Quebec’s Professional Organization for Physiotherapy
College des physiothérapeutes du Nouveau-Brunswick, often known as the College of Physiotherapists of New Brunswick
The New England Physiotherapy College of Prince Edward Island Physiotherapists’ College of Newfoundland and Labrador Physiotherapy College[25]
A curriculum of orthopedics and manual therapy continuing education courses is provided by the Canadian Physiotherapy Association. The curriculum consists of seven training stages, each with continuous mentoring and assessment.