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Physiotherapists (also known as Physical therapists in the United States and Canada) provide
therapy intended to help restore function, improve mobility, relieve pain, and prevent or
limit permanent physical disabilities of patients suffering from injuries or disease. Treatment aims to restore, maintain, and
promote overall fitness and health. They treat conditions in patients that include accident victims and individuals with disabling conditions
such as low back pain, arthritis, heart disease, fractures, head injuries, and cerebral palsy.
A physiotherapist can function either privately (as in a private practice) or publicly (in a hospital setting). There are
fundamental differences between the two but as these are concerned mainly with the types of conditions seen, time to discharge
and the obvious financial issue, they can be ignored. Some physical therapists treat a wide range of conditions, while others
specialize in certain fields such as pediatrics, geriatrics, orthopedics, sports medicine, neurology, and cardiopulmonary physical therapy.
Assessment
A therapist will initially conduct a subjective examination (interview) of a patients' medical history, and then go on to the
objective assessment. A good interview will allow the therapist to eliminate many possible causes of the problem, as well as to
narrow down the symptomatic structures. The objective exam will then use certain quantifiable measurements to determine the exact
nature of the problem . These include assessment of posture, muscle strength and flexibility, joint range of motion, balance and
coordination, respiration, and motor function.
Treatment
The therapist will then develop a plan of treatment, describing a treatment strategy, purpose and anticipated outcome. There
are various therapeutic modalities available to the physiotherapist, including education, exercise, manual techniques, soft tissue massage,
cryotherapy, heat therapy and electrotherapy. The benefits of
electrotherapy are widely debated, with research supporting both sides of the argument. Many therapists will choose to use or
avoid a specific modality based on their own clinical experience of it. Therapists will also teach patients to use assistive and
adaptive devices such as crutches, prostheses, and wheelchairs. As treatment continues, physical therapists document progress,
conduct periodic examinations, and modify treatments when necessary. Such documentation is used to track the patient's progress,
and identify areas requiring more or less attention. A patient will sometimes be discharged from the care of the physiotherapist
with a home exercise programme, if the therapist feels they have little to benefit from visits to the practice.
Training
A physiotherapy degree is usually undertaken over a 4 year period, with the first 2 and a half years being mainly theoretical.
During the third year, students will find themselves in increasingly applied situations, with the entirety of the fourth year
based in a clinical setting (e.g. hospital). Some tertiary institutions recognize the (BSc.) Physiotherapy degree to be an
Honours degree, since the fourth year includes a research project.In the United States an undergraduate student they will not
major in physical therapy but in a science related course such as biology or physics. Once they finish their undergraduate degree they must be accepted into a graduate
program specializing in physical therapy. There a physical therapist will learn how to treat conditions in people ranging from
children (paediatrics) to elderly people (geriatrics).
Teamwork
A common but incorrect belief is that physiotherapists prepare patients for reintegration into their work or home
environments. This is more commonly the goal of Occupational therapists, although there is considerable overlap with regard the
therapies. This is one of the reasons that physiotherapists are generally seen as being part of a larger, multi-disciplinary team
involving physicians, nurses, educators, social workers, occupational therapists, speech and language therapists, dieticians and
audiologists.
In the United States, experienced physical therapists can 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,
Pediatric, and Sports physical therapy. Therapists who have board certification will have a designation such as "OCS" (Orthopedic
certified specialist) after their names. You can search a directory of accredited specialists on the APTA website: http://www.apta.org/Education/specialist/dir_cert_cln_pt-85-97
A number of physical therapists have found the Alexander
Technique, acupuncture, aromatherapy and reflexology to be a useful tool to
incorporate into their practice. There are probably as many who find such alternative methods to be lacking in empirical evidence and therefore avoid them.
Physical therapist assistants, under the direction and supervision of a physical therapist, may be involved in the
implementation of the treatment plan. Physical therapist aides perform routine support tasks, as directed by the therapist.
Qualifications in the United States
All States (in the United States) require physical therapists to pass
a licensure exam after graduating from an accredited physical therapist educational program before they can practice.
According to the American Physical Therapy Association, there were 189 accredited physical therapist
programs in 1999. Of the accredited programs, 24 offered bachelor's degrees, 157 offered master's degrees, and 8 offered doctoral
degrees. By 2002, all physical therapist programs seeking accreditation will be required to offer degrees at the master's degree
level and above, in accordance with the .
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, manifestations of disease, examination techniques, and therapeutic procedures. Besides classroom and
laboratory instruction, students receive supervised clinical experience. Individuals who have a 4-year degree in another field
and want to be a physical therapist, should enroll in a master's or a doctoral level physical therapist educational program.
Competition for entrance into physical therapist educational programs is very intense, 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. Similar traits are also needed to interact
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.
Note: There are many overlapping areas in physiotherapy, occupational therapy and respiratory therapy. The US and Canada are
two of only a few countries whose physiotherapists are not also trained in respiratory therapy.
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