Physiotherapy
Physiotherapy helps to restore
movement and function when someone is affected by injury, illness, or
disability. It can also help to reduce your risk of injury or illness in the
future. It takes a holistic approach that involves the patient directly in
their care.
Physical therapy (PT), also known as
physiotherapy, is one of the allied health professions. It is provided by
physical therapists who promote, maintain or restore health through physical
examination, diagnosis, management, prognosis, patient education, physical
intervention, rehabilitation, disease prevention, and health promotion. Physical
therapists are known as physiotherapists in many countries.
In addition to clinical practice,
other aspects of physical therapist practice include research, education,
consultation, and health administration. Physical therapy is provided as a
primary care treatment or alongside, or in conjunction with, other medical
services. In some jurisdictions, such as the United Kingdom, physical
therapists have the authority to prescribe medication.
Specialty areas
The body of knowledge on physical therapy is
large, and therefore physical therapists may specialize in a specific clinical
area. While there are many different types of physical therapy, the American
Board of Physical Therapy Specialties lists ten current specialist
certifications. Most Physical Therapists practicing in a specialty will have
undergone further training, such as an accredited residency program, although
individuals are currently able to sit for their specialist examination after
2,000 hours of focused practice in their respective specialty population, in
addition to requirements set by each respective specialty board.
1. Cardiovascular and
pulmonary
Cardiovascular and pulmonary
rehabilitation respiratory practitioners and physical therapists offer therapy
for a wide variety of cardiopulmonary disorders or pre and post-cardiac or pulmonary surgery. An
example of cardiac surgery is coronary bypass surgery. The primary goals of
this specialty include increasing endurance and functional independence. Manual
therapy is used in this field to assist in clearing lung secretions experienced
with cystic fibrosis. Pulmonary disorders, heart attacks, post coronary bypass
surgery, chronic obstructive pulmonary disease, and pulmonary fibrosis,
treatments can benefit[citation needed] from cardiovascular and pulmonary
specialized physical therapists.
2. Clinical electrophysiology
This specialty area includes
electrotherapy/physical agents, electrophysiological evaluation (EMG/NCV),
physical agents, and wound management. Clinical electrophysiology is the application of electrophysiology principles to medicine. The two main branches of this discipline are electrotherapy and electrophysiologic testing (EEG, electromyography, etc.) Clinical electrophysiology can be utilized in the study and treatment of various physiological conditions, most notably in clinical cardiac electrophysiology.
3. Geriatric Physiotherapy
Geriatric physical therapy covers a
wide area of issues concerning people as they go through normal adult aging but
is usually focused on the older adult. Many
conditions affect many people as they grow older and include but are not limited to the
following: arthritis, osteoporosis, cancer, Alzheimer's disease, hip, and joint replacement,
balance disorders, incontinence, etc. Geriatric physical therapists specialize
in providing therapy for such conditions in older adults.
Physical rehabilitation can prevent
deterioration in health and activities of daily living among care home
residents. The current evidence suggests benefits to physical health from
participating in different types of physical rehabilitation to improve daily
living, strength, flexibility, balance, mood, memory, exercise tolerance, fear
of falling, injuries, and death. It may be both safe and effective in improving
physical and possibly mental state while reducing disability with few adverse
events.
The current body of evidence suggests
that physical rehabilitation may be effective for long-term care residents in
reducing disability with few adverse events. However, there is insufficient to
conclude whether the beneficial effects are sustainable and cost-effective. The findings are based on
moderate quality evidence.
4. Wound Management Physical Therapy
Wound management physical therapy
includes the treatment of conditions involving the skin and all its related
organs. Common conditions managed include wounds and burns. Physical therapists
may utilize surgical instruments, wound irrigations, dressings, and topical
agents to remove damaged or contaminated tissue and promote tissue healing.
Other commonly used interventions include exercise, edema control, splinting,
and compression garments. The work done by physical therapists in the
integumentary specialty does work similarly to what would be done by
medical doctors or nurses in the emergency room or triage.
5. Neurology Physiotherapy
Neurological physical therapy is a
field focused on working with individuals who have a neurological disorder or
disease. These can include stroke, chronic back pain, Alzheimer's disease,
Charcot-Marie-Tooth disease (CMT), ALS, brain injury, cerebral palsy, multiple
sclerosis, Parkinson's disease, facial palsy, and spinal cord injury.
Common impairments associated with neurologic conditions include impairments of
vision, balance, ambulation, activities of daily living, movement, muscle
strength, and loss of functional independence. The techniques involve in
neurological physical therapy are wide-ranging and often require specialized
training.
Neurological physiotherapy is also
called neuro physiotherapy or neurological rehabilitation. It
is recommended for neuro physiotherapists to collaborate with psychologists
when providing physical treatment of movement disorders. This is especially
important because combining physical therapy and psychotherapy can improve the
neurological
status of the patients.
6. Orthopedics Physiotherapy
Orthopedic physical therapists
diagnose, manage, and treat disorders and injuries of the musculoskeletal system
including rehabilitation after orthopedic surgery. Acute trauma such as
sprains, strains, injuries of insidious onset such as tendinopathy, bursitis,
and deformities like scoliosis. This specialty of physical therapy is most
often found in the outpatient clinical setting. Orthopedic therapists are
trained in the treatment of post-operative orthopedic procedures, fractures,
acute sports injuries, arthritis, sprains, strains, back and neck pain, spinal
conditions, and amputations.
Joint and spine mobilization/manipulation,
dry needling (similar to acupuncture), therapeutic exercise, neuromuscular
techniques, muscle reeducation, hot/cold packs, and electrical muscle
stimulation (e.g., cryotherapy, iontophoresis, electrotherapy) are modalities
employed to expedite recovery in the orthopedic setting. An emerging adjunct to
diagnosis and treatment is the use of sonography for diagnosis and to guide
treatments such as muscle retraining. Those with injury or disease affecting
the muscles, bones, ligaments, or tendons will benefit from assessment by a
physical therapist specialized in orthopedics.
7. Paediatrics
Paediatric physical therapy assists in
the early detection of health problems and uses a variety of modalities to
provide physical therapy for disorders in the pediatric population. These
therapists are specialized in the diagnosis, treatment, and management of
infants, children, and adolescents with a variety of congenital, developmental,
neuromuscular, skeletal, or acquired disorders/diseases. Treatments focus
mainly on improving gross and fine motor skills, balance and coordination,
strength and endurance as well as cognitive and sensory processing/integration.
8. Sports
Physical therapists are closely
involved in the care and well-being of athletes including recreational,
semi-professional (paid), and professional (full-time employment) participants.
This area of practice encompasses athletic injury management under 5 main
categories:
- Acute care – assessment and diagnosis of an initial injury.
- Treatment – application of specialist advice and techniques to encourage healing.
- Rehabilitation – progressive management for a full return to sport.
- Prevention – identification, and address of deficiencies known to directly result in, or act as precursors to injury, such as movement assessment.
- Education – sharing of specialist knowledge to individual athletes, teams, or clubs to assist in the prevention or management of injury.
Physical therapists who work for
professional sports teams often have a specialized sports certification issued
through their national registering organization. Most Physical therapists who
practice in a sporting environment are also active in collaborative sports medicine
programs too.
9.
Women's Health
Women's health or pelvic floor
physical therapy mostly addresses women's issues related to the female
reproductive system, childbirth, and post-partum. These conditions
include lymphedema, osteoporosis, pelvic pain, prenatal and post-partum
periods, and urinary incontinence. It also addresses incontinence, pelvic pain,
and other disorders associated with pelvic floor dysfunction. Manual physical
therapy has been demonstrated in multiple studies to increase rates of
conception in women with infertility.
10. Oncology
Physical therapy in the field of
oncology and palliative care is a continuously evolving and developing
specialty, both in malignant and non-malignant diseases. Physical therapy for
both groups of patients is now recognized as an essential part of the clinical
pathway, as early diagnoses and new treatments are enabling patients to live
longer. it is generally accepted that patients should have access to an
appropriate level of rehabilitation, so that they can function at a minimum
level of dependency and optimize their quality of life, regardless of their
life expectancy.
11. Intensive care unit
Therefore, they require a multidisciplinary team in critical care who are uniquely qualified with skills and expertise to work with the assessment and management of respiratory complications, physical deconditioning, and neuromuscular and musculoskeletal conditions.
Physiotherapy
treatment as part of a multi-disciplinary approach to care is integral in
promoting lung function, reducing the incidence of ventilator-associated
pneumonia, facilitating weaning, and promoting safe and early discharge from
the intensive care unit.