Physical therapy
(or Physiotherapy) is a health care profession primarily concerned with
the remediation of impairments and disabilities and the promotion of mobility,
functional ability, quality of life and movement potential through examination,
evaluation, diagnosis and physical intervention carried out by Physical Therapists
(known as Physiotherapists in most countries). In addition to clinical
practice, other activities encompassed in the physical therapy profession
include research, education, consultation and administration.
Physical
Therapists play an important role in today’s healthcare system. As
trusted healthcare experts in restoring and improving motion, they contribute
to their patients’ quality of life by keeping them healthy, fit, and active
and, in many instances, avoiding surgery and long-term use of prescription
medications. In work-related injuries, physical therapy is often the last
course of treatment utilized before the patient is released to return to work
and placed at Maximum Medical Improvement. Although most people are
familiar with the term physical therapy, few know of how this very important
profession came to be.
From the elite athlete, person with
back or neck pain to someone having a spinal cord injury or stroke, the
profession of physical therapy now treats a multitude of musculoskeletal
injuries and disorders. Physical Therapy, like modern medicine, has constantly
evolved over the last century, now able to treat problems successfully better
than ever before. Here is a small look at the history of physical therapy.
Physicians like Hippocrates
and later Galenus
are believed to have been the first practitioners of physical therapy,
advocating massage,
manual
therapy techniques and hydrotherapy to treat people in 460 BC. After the
development of orthopedics in the eighteenth century, machines like the Gymnasticon
were developed to treat gout
and similar diseases by systematic exercise of the joints, similar to later
developments in physical therapy.
The earliest documented origins of actual physical therapy as
a professional group date back to Per
Henrik Ling, “Father of Swedish Gymnastics,” who founded the Royal Central
Institute of Gymnastics (RCIG) in 1813 for massage, manipulation, and exercise. The
Swedish word for physical therapist is sjukgymnast = someone involved in
gymnastics for those who are ill. In 1887, PTs were given official registration
by Sweden’s National Board of Health and Welfare.
Other countries soon followed. In 1894 four nurses in Great
Britain formed the Chartered Society of Physiotherapy. The School of
Physiotherapy at the University of Otago in New Zealand in 1913 and the United
States' 1914 Reed College in Portland, Oregon, which graduated
"reconstruction aides."
Modern physical therapy was established in Britain towards
the end of the 19th century. Soon following American orthopedic surgeons began
treating children with disabilities and began employing women trained in
physical education, massage, and remedial exercise. These treatments were
applied and promoted further during the Polio outbreak of 1916. During the
First World War women were recruited to work with and restore physical function
to injured soldiers, and the field of physical therapy was institutionalized.
In 1918 the term "Reconstruction Aide" was used to refer to individuals
practicing physical therapy. The first school of physical therapy was
established at Walter Reed Army Hospital in Washtington D.C. following the
outbreak of World War I.
Research catalyzed the physical therapy movement. The first
physical therapy research was published in the United States in March 1921 in
"The PT Review." In the same year, Mary McMillan organized the
Physical Therapy Association (now called the American Physical Therapy
Association (APTA) and which currently represents approximately 76,000
members throughout the United States. The APTA defines physical therapy as:
"clinical applications in the restoration, maintenance, and promotion of
optimal physical function."
In 1924, the Georgia
Warm Springs Foundation promoted the field by touting physical therapy as a
treatment for polio.
Treatment through the 1940s primarily consisted of exercise,
massage, and traction. Manipulative procedures to the spine and extremity
joints began to be practiced, especially in the British Commonwealth countries,
in the early 1950s. Later that decade, physical therapists started
to move beyond hospital-based practice to outpatient orthopedic clinics, public
schools, colleges/universities health centers, geriatric settings (skilled
nursing facilities), rehabilitation centers and medical centers.
Specialization for Physical Therapy
in the United States occurred in 1974, with the Orthopaedic Section of the APTA
being formed for those Physical Therapists specializing in Orthopedics.
In the same year, the International Federation of Orthopaedic Manipulative
Therapy (IFOMT) was formed, which has heralded change and progress in manual
therapy worldwide ever since. During this period, the eastern United
States were greatly influenced by the training of Norway's Freddy Kaltenborn
(Osteopathic Physician, Chiropractor, Physical Therapist, and Athletic Trainer.
Mariano Rocabado, PT of Chile, who specialized in treatment of
Temporomandibular disorders, also brought much new information and continues to
contribute to our profession. Australia's Geoffrey Maitland, PT
initially influenced the training of manual therapy on the west coast.
In the 1980's, the explosion of
technology and computers led to more technical advances in rehabilitation. Some
of these advances have continued to grow, with computerized modalities such as
ultrasound, electric stimulators, and iontophoresis with the latest advances in
therapeutic cold laser, which finally gained FDA approval in the United States
in 2002. Other advances, such as electronic resistive exercise known as
Isokinetics, have fallen out of popularity for various reasons, despite having
their place within the profession.
The 1990's brought much attention to
manual therapy, with formal residency programs becoming more numerous. During
the summer of 1991, Norwegian manual therapist Freddy Kaltenborne helped create
the American Academy of Orthopedic Manual Physical Therapy (AAOMPT). Dr.
Stanley Paris, PT and Ola Grimsby, PT were among the founding members. This
organization was a means for physical therapists to band together with a common
specialization in manual and manipulative therapy.
In the
21st century, the profession has continued to grow substantially, by further
developing the scientific basis for its services, and by creating entry-level
education standards to meet the demands of today’s health care system. This
vital work will continue as the health care system is reformed.
Today’s
physical therapy profession boasts confident, accomplished, professional
practitioners on the cutting edge of health care, and it consistently ranks as
one of the international most desirable careers. These practitioners help
individuals of all ages to have optimal functioning and quality of life, while
ensuring patient safety and applying evidence to provide efficient and
effective care. Extensive education, clinical expertise, and "hands
on" approach give Physical Therapist a unique, individualized approach.
When you are in the hands of a physical therapist, you have a plan of care that
is safe and appropriate and customized to meet your individual needs.
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