About Physiotherapy

What is physiotherapy?

Physiotherapy / Physical therapy is services provided by physiotherapists to individuals and populations to develop, maintain and restore maximum movement and functional ability throughout the lifespan. The service is provided in circumstances where movement and function are threatened by ageing, injury, pain, diseases, disorders, conditions or environmental factors and with the understanding that functional movement is central to what it means to be healthy.

Physiotherapy involves the interaction between the physical therapist, patients/clients, other health professionals, families, care givers and communities in a process where movement potential is examined/assessed and goals are agreed upon, using knowledge and skills unique to physical therapists. Physiotherapists are concerned with identifying and maximising quality of life and movement potential within the spheres of promotion, prevention, treatment/intervention, habilitation and rehabilitation. These spheres encompass physical, psychological, emotional, and social wellbeing.

What is the Scope of physiotherapy?

Physiotherapists are qualified and professionally required to:

  • Undertake a comprehensive examination/assessment of the patient/client or needs of a client group
  • Evaluate the findings from the examination/assessment to make clinical judgments regarding patients/clients
  • Formulate a diagnosis, prognosis and plan
  • Provide consultation within their expertise and determine when patients/clients need to be referred to another professional
  • Implement a physical therapist intervention/treatment programme
  • Determine the outcomes of any interventions/treatments
  • Make recommendations for self-management

The physiotherapist’s extensive knowledge of the body and its movement needs and potential is central to determining strategies for diagnosis and intervention. The practice settings will vary according to whether the physical therapy is concerned with health promotion, prevention, treatment/intervention, habilitation or rehabilitation.

The scope of physiotherapist practice is not limited to direct patient/client care, but also includes:

  • Public health strategies
  • Advocating for patients/clients and for health
  • Supervising and delegating to others
  • Leading
  • Managing
  • Teaching
  • Research
  • Developing and implementing health policy at the local, national and international levels.

Physiotherapists operate as independent practitioners, as well as members of health service provider teams, and are subject to the ethical principles. They are able to act as first contact practitioners, and patients/clients may seek direct services without referral from another health professional.

The education and clinical practice of physical therapists will vary according to the social, economic, cultural and political contexts in which they practice. However, it is a single profession, and the first professional qualification, obtained in any country, represents the completion of a curriculum that qualifies the physical therapist to use the professional title and to practise as an independent professional.

Where is physiotherapy practised?

Physiotherapy is an essential part of the health and community/welfare services delivery systems. Physiotherapy is delivered in a variety of settings, which allow it to achieve its purpose. Prevention, health promotion, treatment/intervention, habilitation and rehabilitation take place in multiple settings that may include, but are not confined to, the following:

  • Community based rehabilitation programmes
  • Community settings including primary health care centres, individual homes, and field settings
  • Education and research centres
  • Fitness clubs, health clubs, gymnasia and spas
  • Hospices
  • Hospitals
  • Nursing homes
  • Occupational health centres
  • Out-patient clinics
  • Physical therapist private offices, practices, clinics
  • Public settings (eg shopping malls) for health promotion
  • Rehabilitation centres and residential homes
  • Schools, including pre-schools and special schools
  • Senior citizen centres
  • Sports centres/clubs
  • Workplaces/companies

What is the nature of physical therapy process?

Physiotherapy is the service provided only by, or under the direction and supervision of, a physiotherapist. It includes examination/assessment, evaluation, diagnosis, prognosis/plan, intervention/treatment and re-examination.

Examination/assessment includes:

The examination of individuals or groups with actual or potential impairments, activity limitations, participation restrictions or abilities/disabilities by history-taking, screening and the use of specific tests and measures

The evaluation of the results of the examination and/or the environment through analysis and synthesis within a process of clinical reasoning to determine the facilitators and barriers to optimal human functioning.

Diagnosis and prognosis arise from the examination and evaluation and represent the outcome of the process of clinical reasoning and the incorporation of additional information from other professionals as needed. This may be expressed in terms of movement dysfunction or may encompass categories of impairments, activity limitations, participatory restrictions, environmental influences or abilities/disabilities.

Prognosis begins with determining the need for intervention/treatment and normally leads to the development of a plan, including measurable outcome goals negotiated in collaboration with the patient/client, family or caregiver. Alternatively, it may lead to referral to another agency or health professional in cases that are inappropriate for physical therapy.

Intervention/treatment is implemented and modified in order to reach agreed goals and may include:

  • Therapeutic exercise
  • Functional training in self-care and home management
  • Functional training work, community and leisure
  • Manual therapy techniques (including mobilisation/manipulation)
  • Prescription, application, and, as appropriate, fabrication of devices and equipment (assistive, adaptive, orthotic, protective, supportive and prosthetic)
  • Airway clearance techniques
  • Integumentary repair and protection techniques
  • Electrotherapeutic modalities
  • Physical agents and mechanical modalities
  • Patient-related instruction
  • Coordination, communication and documentation
    • Intervention/treatment may also be aimed at prevention of impairments, activity limitations, participatory restrictions, disability and injury including the promotion and maintenance of health, quality of life, workability and fitness in all ages and populations.

(Reference : the world confederation for physical therapy)