Physical Therapy!
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Indeed, the ball hit one of the men, and he immediately clasped his hands together at his crotch, fell to the ground and proceeded to roll around in evident agony.
The woman rushed down to the man and immediately began to apologize. She explained that she was a physical therapist: "Please allow me to help. I'm a physical therapist and I know I could relieve your pain if you'd allow me", she told him earnestly.
Ummph, oooh, nnooo, I'll be alright...I'll be fine in a few minutes, he replied breathlessly as he remained in the fetal position still clasping his hands together at his crotch.
But she persisted, and he finally allowed her to help him. She gently took his hands away and laid them to the side, she loosened his pants, and she put her hands inside and began to massage him. She then asked him: How does that feel? To which he replied: It feels great, but my thumb still hurts like hell.
Physical therapy
Physical therapy (or physiotherapy) is a healthcare profession concerned with prevention and management of movement disorders arising from conditions and diseases occurring throughout the lifespan. Physical therapy is performed by either a physical therapist (physiotherapist) or physical therapist assistant (PTA) under the direction of a physical therapist. Despite this, various alternative health professions continue to employ the use of some physical therapeutic modalities in practice. A program of physical therapy will typically also involve a patient's caregivers.Modern physical therapy
The modern practice of physical therapy was developed in London in 1896, believing hospital patients needed to be mobilized on a regular basis in order to maintain adequate muscle function and mobility. This special interest group grew rapidly and in 1920 the Chartered Society of Physiotherapy was formed in the Country of United Kingdom. Similar organizations were developed in other countries, including the USA.The care and rehabilitation of the large numbers of amputees resulting from the World Wars of the early 20th century, as well as care of patients suffering from diseases such as polio galvanized the development of physical therapy worldwide. One of its principal advocates was Sister Elizabeth Kenny, an Australian nurse who made a significant impact on the treatment of polio during the 1930s and 1940s.
There are many specialty areas within physical therapy The more common areas are listed below. -
Physical Therapy Musculoskeletal
Musculoskeletal (Orthopaedic) physiotherapists are able to diagnose, treat and help with prevention of pain/pathology, using the range of techniques outlined below.A number of therapeutic modalities are available in physical therapy. These include exercise prescription (strength, motor control, stretching and endurance), manual therapy techniques like joint mobilization/manipulation, and soft tissue massage.
Nowadays, in various countries physiotherapists are specializing in orthopaedic medicine. Those specialists can use diagnostic and therapeutic infiltration/injections to various soft tissue and joints. They are trained to diagnose and treat various orthopaedic conditions.
Also, various forms of "electrophysical agents" are available (such as cryotherapy, heat therapy, iontophoresis and electrotherapy).
Cardiopulmonary physical therapy
Cardiopulmonary physical therapists work with patients in a variety of settings. They treat acute problems like asthma, acute chest infections and trauma; they are involved in the preparation and recovery of patients from major surgery; they also treat a wide range of chronic cardiac and respiratory conditions like Chronic Obstructive Pulmonary Disease (COPD), cystic fibrosis (CF) and post-myocardial infarction (MI). They work with all ages from premature babies to older adults at the end of their life. Physical therapists are pioneering new management techniques for non-organic respiratory problems like hyperventilation and other stress-related disorders as well as leading the development of cardio-pulmonary rehabilitation and non-invasive ventilation.Neurological physical therapy
Treatment in neurological conditions is typically based upon exercises to restore motor function through attempting to overcome motor deficits and improve motor patterns. To achieve this aim various theoretical frameworks have been promoted, each based upon inferences drawn from basic and clinical science research. Whilst some of these have remained static, others are designed to take into account new developments, perhaps the most notable example being the "movement science" framework. The various philosophies often generate considerable debate.Integumentary physical therapy
Treatment of conditions involving the skin and related organs. Common conditions include wounds and burns. Treatment interventions include debridement of wounds and burns, dressings, scar prevention and reduction.Pediatric physical therapy
Treatment and management of pediatric neurological, cardiothoracic, and musculoskeletal conditions. Common conditions include asthma, cerebral palsy, developmental delay and torticollis.Physical therapist management
Physical therapists initially take a history from the patient, perform a physical examination and arrive at a diagnosis. The physical therapist will then develop a plan of treatment.Physical therapy and science
For decades, Physical therapy practice has been the subject of criticism for its lack of a research base. In a late 1990s survey of English and Australian physical therapists, fewer than five percent (5%) of survey respondents indicated that they regularly reviewed scientific literature to guide practice decisions. Despite an overall positive attitude towards evidence based practice, most physical therapists utilized treatment techniques with little scientific support. Although numerous calls have been made for a shift toward the use of research and scientific evidence to guide practice decisions, most physical therapists continued to base practice decisions largely on anecdotal evidence.To overcome these limitations, the World Confederation for Physical Therapy (WCPT), the American Physical Therapy Association (APTA), and a number of authors have called on the profession to adopt and adhere to evidence based practices formally based on the best available scientific sources. The move towards the Doctor of Physical Therapy (DPT) professional postbaccalaureate degree indicates increased awareness of and training in the sciences, research, and interventions.
Physical therapy education
Physical Therapy Programs around the world
As with many aspects of the profession, physical therapy training varies considerably across the world. As a rule, physical therapy studies involve a minimum of four years of tertiary education. Some examples are described here.In the United Kingdom, university degrees tend to be three rather than four years in length, as British students historically specialise earlier in their education than in most other developed countries. In order to qualify, students are required to complete 1000 hours of clinically based learning: this typically takes place in the final two years; however, some courses also have clinical placement in the first year. Thirty-five universities and tertiary level institutions train physiotherapists in the UK. The vast majority of physiotherapists work within the National Health Service, the state healthcare system.
In Turkey, the Physiotherapy (BPT) education is provided by physiotherapy schools in universities (Hacettepe University, Dokuz Eylül University, IstanbulUniversity, Baskent University, Pamukkale University, Dumlupinar University, Süleyman Demirel University) after high school education. Education takes 4 years or 5 years with preb classes. MSc and PHD education is given by institutes of medical sciences.
In Bangladesh, the Bachelor of Physiotherapy (BPT) course is provided by the Medicine Faculty of University of Dhaka. There are two affiliated institute who provides 4 years of Professional education including one year mandatory internship. Those are Bangladesh Health Professions Institute (BHPI) situated at Savar and the another one is National Institute of Traumatology Orthopaedic and Rehabilition, situated at Dhaka. Bangladesh Physiotherapy Association and Bangladesh Physiotherapy Society are two professional body of Physiotherapy here. Recently Bangladesh Physiotherapy Association has got the Professional Recognistion from WCPT at 2007, Vancouver. Presently BPA Members are working for the
Registered Interest Group of IFOMT to develop Orthopaedic Manipulative Therapy skills in here. But its a great Regrat that in Bangladesh Government still dont take any step for Posts of Physiotherapits.
In Pakistan there are 8 colleges offering Bsc. Physiotherapy and 2 colleges offering Msc in PT.physical therapist have a good scope in government and private hospitals and they are awarded 17 grade pay scale.
In Australia, where physical therapy is called physiotherapy, A few different programs are available. The physiotherapy degree can be undertaken over a four-year period with the early components being predominantly theoretical including basic anatomy, biology, physics, psychology, kinesiology, goniometry and physiology. In the latter half of the degree students partake in practical components focusing on musculoskeletal physiotherapy, neuromuscular physiotherapy (notably Souvlis pain mechanisms), paediatric physiotherapy, geriatric physiotherapy, cardiothoracic physiotherapy, and women's health. The program generally progresses with an increasingly clinical focus and usually the final year involves practical placements at clinics, and research. These programs are usually offered to those with no prior degree and graduate with the (B.Physio) degree.
Postgraduate entry into physiotherapy is possible in some institutions, typically involving 3 years of study following the completion of a related (e.g. exercise physiology or science) Bachelor degree. The University of Melbourne is introducing a new postgraduate physiotherapy degree as part of the Melbourne Model. The Melbourne Model will enable students to enrol in a 3 year undergraduate degree in Biomedicine or Science (commencing in 2008) followed by a 3 year postgraduate Physiotherapy degree the (D.Phys) degree. Also, Bond University in Queensland is now offering a (DPT) program to those who have already completed a bachelors degree in a related field.
In Canada, entry-level physiotherapy education is offered at 13 universities. Many of these university programs are at the Master's level, meaning that applicants must have already completed an undergraduate degree prior to applying. (All entry-level programs in Canada are slated to be at the Masters level by 2010.) Many universities also offer graduate programs in physiotherapy, rehabilitation, or related disciplines at the masters or doctoral level. Many physiotherapists may advance their education at these levels in such Clinical Practice Areas as cardiorespirology, geriatrics, neurosciences, orthopaedics, pediatrics, rheumatology, sports physiotherapy, and women's health.
In New Zealand, there are currently two schools of physiotherapy offering four-year undergraduate programs. Many New Zealand physiotherapists work in the private health care system as musculoskeletal physiotherapists and the curriculum reflects the need to prepare graduates for autonomous practice. Students follow an educational program similar to Australia with an emphasis on biomechanics, kinesiology and exercise. Postgraduate study typically involves three years of subject specific learning.
In the Philippines, physical therapy programs are generally 5 years in length and award the B.S. Physical Therapy degree upon graduation. The program consists of 2 years of general education, 2 years of physical therapy subjects, and a final year of internship & research/thesis. Some schools require students to complete a full 12 months of internship while other schools only require 10. During the internship year, students are required to fulfill clinical affiliations with hospitals, outpatient clinics, and other healthcare facilities. Due to the healthcare structure in the Philippines, clinics and therapy departments are often headed by a Physiatrist who writes out specific treatment orders for the PT to follow, and majority of the treatments are cash-based since not a lot of people have health insurance. Recently, the M.S. Physical Therapy postgraduate program has been made available by the University of Santo Tomas (Manila, Philippines). Once a student graduates from the BSPT program, he/she is then required to pass a national licensure exam administered by the Professional Regulation Commission. The said paper-based exam is a grueling 2 day ordeal which consists of approximately 730 questions. It is only administered twice a year and the names of those who pass the exam are published in several national newspapers. Those who pass the exam become licensed PTs and are then entitled to add the initials PTRP (Physical Therapist Registered in the Philippines) after their name.
In South Africa the degree (B.PhysT, B.Sc Physio or B.Physio) consists of four years of general practice training, involving all aspects of Physiotherapy. Typically, the first year is made up of theoretical introduction. Gradually, time spent in supervised practice increases until the fourth year, in which the student generally spends about 80% in practice. In the fourth year, students are also expected to complete Physiotherapy research projects, which fulfills the requirements of an Honours degree. Professional practice and specialization can only be entered into after a state governed, compulsory year of community service is completed by the student after graduation.
In the United Arab Emirates the Bachelor Of Physiotherapy (BPT) consists of a 4 year undergraduate degree program. In the first year of the program they are introduced to pre-clinical subjects such as Anatomy, Physiology, Biochemistry, Human Behaviour & Socialisation & Basic Medical Electronics & Computers. The students also get hands on experiences in cadaveric dissections while learning Human Anatomy during the first year of the program. The students progressively are introduced to supervised clinical practice and the integrated curriculum offers the best learning experiences in addition to extensive inhouse elearning programs. The course offers Case Based Learning experiences and focusses on Evidence
Based Practices. The program culminates with a six month internship ending with a research project work. In Spain university degrees constist of a 3 years program and several post-graduated courses are available for practitioners. There are 38 universities training physiotherapists in Spain.
In the United States a student completes an undergraduate degree with a strong science component prior to gaining entry into a Doctor of Physical Therapy program. Students complete clinical internships as part of their education.
In the Republic of Ireland, Physiotherapy is available as an undergraduate course in four universities, Trinity College, University College Dublin, Royal College of Surgeons and University of Limerick. Courses are four years in length with clinical practice in the final two years. Students are required to complete 1000 hours of clinical practice before graduation.
In India, universities offer undergraduate program of physiotherapy with four years of academic and clinical program and 6 months of compulsory internship. There are over 250 collages offering undergraduate program in physiotherapy (BPT) and more than 50 collages offering masters in Physiotherapy (MPT) with 2 years duration. PhD in Physiotherapy is offered in some universities of the states Maharashtra, Karnataka and Tamil Nadu.
In Sri Lanka, Physiotherpay is available as a Diploma course for 2years in School of Physiotherapy & Occupational Therapy which is affilited to the National Hospital of Colombo from 1957. After the 6 months of class room training students were sending to the Hospitals for clinical practise. During the 80's foreign students from Australia, Belgium have studied at the Physiotherapy School. From the year 2005 Medical Faculties of University of Peradeniya & University of Colombo have started the undergarduate course for 4years.
Following basic physical therapy training, experienced practitioners may undertake further study towards certification as a specialist practitioner. For example, in the United States, experienced physical therapists may apply to take a specialty exam to earn board certification in any of seven sub-specialty areas: Cardiovascular and Pulmonary, Clinical Electrophysiologic, Geriatric, Neurologic, Orthopaedic, Paediatric, and Sports physical therapy.
Physical Therapy Qualifications in the United States
Physical Therapists must have a graduate degree from an accredited physical therapy program before taking the national licensing examination. Most educational programs now offer the Doctor of Physical Therapy (DPT) degree. All states (in the United States) require physical therapists to pass the National Physical Therapy Examination after graduating from an accredited physical therapist educational program before they can practice.According to the American Physical Therapy Association, there were 209 accredited physical therapist programs in 2007. Of the accredited programs, 31 offered the Master of Physical Therapy, and 179 offered the Doctor of Physical Therapy degree. Virtually all programs are in transistion to the DPT degree.
It should be noted that those who have graduated with either the BSPT (Bachelor of Physical Therapy) or the MSPT (Master of Physical Therapy) degrees are considered "equivalent" and equally qualified to practice physical therapy as those who have graduated with the DPT degree.
Physical therapist programs start with basic science courses such as biology, chemistry, and physics, and then introduce specialized courses such as kinesiology, biomechanics, neuroanatomy, human growth and development, pathology, diagnostics, physical examination techniques, and therapeutic procedures. Besides classroom and laboratory instruction, students receive supervised clinical education.
