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Physical therapy (or '''physiotherapy'''The terms ''physical therapy'' and ''physiotherapy'' are synonymous and can be used interchangeably. The term ''physical therapy'' appears to be favored in the United States, while ''physiotherapy'' - or ''physio'' - appears to be favored in Canada, England, Australia, and many other countries.) is the provision of services to people and populations to develop, maintain and restore maximum movement and functional ability throughout the lifespan. It includes the provision of services in circumstances where movement and function are threatened by the process of aging or that of injury or disease. The method of physical therapy sees full and functional movement as at the heart of what it means to be healthy. Physical therapy is concerned with identifying and maximizing movement potential, within the spheres of promotion, prevention, treatment and rehabilitation. It involves the interaction between physical clients, families and care givers, in a process of assessing movement potential and in establishing agreed upon goals and objectives using knowledge and skills unique to physical therapists. The physical therapists’ distinctive view of the body and its movement needs and potential is central to determining a diagnosis and an intervention strategy and is consistent whatever the setting in which practice is undertaken. These settings will vary in relation to whether physical therapy is concerned with health promotion, prevention, treatment or rehabilitation. Description of Physical Therapy - What is Physical Therapy? WCPT website Physical therapy interventions may include: "Spinal and extremity manipulation; therapeutic exercise; electrotherapeutic and mechanical agents; functional training; provision of aids and appliances; patient education and counseling; documentation and coordination, and communication. Intervention may also be aimed at prevention of impairments, functional limitations, disability and injury including the promotion and maintenance of health, quality of life, and fitness in all ages and populations." Some of the conditions that physical therapists manage include:
HISTORY OF PHYSICAL THERAPY Physical therapy has its origins in ancient history with the advent of Physical Treatments and Massage in China circa 2500 BC. Hippocrates described massage and hydrotherapy in 460 BC. The modern practice of physical therapy was developed in London in 1896, believing hospital patients needed to be massaged 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 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 it's principle advocates was Sister Elizabeth Kenny , an Australian nurse who made a great impact on the progression of polio during the 1930s and 1940s. PHYSICAL THERAPISTS Physical therapists (PTs) are health care professionals who evaluate and manage health conditions for people of all ages. Typically individuals consult a PT for the management of medical problems or other health-related conditions that; cause pain, limit their ability to move, and limit the performance of functional activities. PTs also help prevent health conditions through prevention, restoration of function and through fitness and wellness programs that achieve healthy and active lifestyles. PTs evaluate individuals, diagnose conditions, and develop management plans using treatment techniques that promote the ability to move, reduce pain, restore function, and prevent disability. They provide care in hospitals, clinics, schools, sports facilities, and more. PHYSICAL THERAPY ASSESSMENT A physical therapist will initially conduct a subjective examination (interview) of a patient's medical history, and then go on to the objective assessment (physical examination). The subjective examination is guided by the presenting system and complaint, and the objective assessment is in turn guided by the history. This semistructured process is used to rule out serious pathology (so called Red Flags ), establish functional limitations, establish the diagnosis, guide therapy, and establish a baseline for monitoring progress. As such, the objective exam will then use certain quantifiable measurements to both guide diagnosis and for progress monitoring. These depend upon the system (and area) being managed, e.g. a musculoskeletal exam may involve, ''inter alia'', assessment of joint range of motion, muscle power, neurological assessment, motor control, and posture, whilst a cardiopulmonary assessment may involve lung Auscultation and exercise physiology testing. In some countries a physical therapist may order diagnostic imaging tests such as x-rays and MRIs to obtain more information about a patient's presenting condition and determine the treatment plan including referral to other practitioners. Physical therapists may also perform electromyography and nerve conduction testing to aid in the diagnosis of muscle and nerve disorders. PHYSICAL THERAPY TREATMENT Guided by the assessment findings, the physical therapist will then develop and facilitate a treatment plan. Aside from the various physiotherapeutic techniques involved in therapy, the treatment regime may include prescribing and advice regarding Assistive Technology including mobility aids, Standing Frames , and walking devices. The physical therapist should consider functional progress; and include ongoing review and refinement. Patient education is a key aspect of all treatment plans. It is difficult to explore the many aspects of physiotherapeutic treatment options, especially considering their ongoing development in the face of an increasing research base. Nonetheless, some examples of treatment options are listed below. Musculoskeletal physical therapy Musculoskeletal physiotherapists are able to diagnosis, treat and using the range of techniques outlined below help with prevention of pain/pathology. Various therapeutic physical therapy modalities are available, including exercise prescription (strength, motor control, stretching and endurance), Manual Therapy techniques like Joint Mobilization/manipulation , soft tissue Massage , and various forms of so-called " Electrophysical Agents " (such as Cryotherapy , Heat Therapy , Iontophoresis and Electrotherapy ). Nowadays in various countries physiotherapists are specializing in orthopaedic medicine. Those people can use diagnostic and therapeutic infiltration/injections to various soft tissue and joints. They are trained to diagnose and treat various orthopaedic conditions. Despite ongoing research giving a clearer picture regarding the use of various modalities in specific conditions, the benefits of electrotherapy are widely debated. The practice of physical therapy should not be defined by the use of modalities but rather the integration of examination, history, and analysis of movement dysfunction. 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. Cardiopulmonary physical therapists use physical modalities to treat people. This may involve using manual techniques to clear infected mucus from a person's chest, or using non-invasive ventilation to help a person breathe, or prescribing exercises to improve a patient's functional exercise capacity. 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. PHYSICAL THERAPY EDUCATION 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.
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. 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 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. 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. Physical therapist education is rigorous, so interested students should attain superior grades in high school and college, especially in science courses. Courses useful when applying to physical therapist educational programs include anatomy, biology, chemistry, social science, mathematics, and physics. Before granting admission, many professional education programs require experience as a volunteer in a physical therapy department of a hospital or clinic. Physical therapists should have strong interpersonal skills to successfully educate patients about their physical therapy treatments. They should also be compassionate and possess a desire to help patients, and sometimes to interact positively with the patient's family. Physical therapists are expected to continue professional development by participating in continuing education courses and workshops. A number of states require continuing education to maintain licensure. Many physical therapists pursue board certification in one of seven specialty areas (orthopaedic, pediatric, neurologic, sports, electrophysiologic, geriatric, and cardio-pulmonary). Board certified specialists must have demonstrated special expertise in their clinical area. JOURNALS AND PUBLICATIONS Physical therapists have access to a wide range of publications and and Surgical journals) are not as specific, yet physical therapists contribute to them and read them. Here are a few:
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REFERENCES EXTERNAL LINKS
''National associations''
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