Lecture 5 Introduction to Physical Therapy

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Transcript of Lecture 5 Introduction to Physical Therapy

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INTRODUCTION TO PHYSIOTHERAPY PRACTICEAVANIANBAN CHAKKARAPANILecture 56.2.20158.30 to 9.30 am, LT2

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PHYSIOTHERAPY/PHYSICAL THERAPY

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Contents

1. The nature and scope of Physiotherapy practice, world wide and in Malaysia.

2. Boundaries of professional competence and making referral.

3. Inter-professional approaches to health care delivery.

4. Team-working and cross-professional collaboration and communication.

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THE NATURE AND SCOPE OF PHYSIOTHERAPY PRACTICE, WORLD

WIDE AND IN MALAYSIA.

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HISTORY

World War I

28 July 1914 and lasted until 11 November 1918

World War IIfrom 1939 to 1945

Poliomyelitis

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WORLD WAR I

WORLD WAR I

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HISTORY

American physical therapists formed their first professional association in 1921.

American Women's Physical Therapeutic Association.

Led by President Mary McMillan.

By the end of the 1930s

The Association changed its name to the American Physiotherapy Association.

Men were admitted, and membership grew to just under 1,000.

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WORLD WAR II

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POLIO

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3 CONSEQUENCES

With the advent of World War II and a nationwide polio epidemic during the 1940s and 1950s.

Physical therapists were in greater demand.

The Association's membership swelled to 8,000, and the number of physical therapy education programs across the US increased from 16 to 39.

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What is Physical Therapy

Physical therapists have different titles in different countries.

Many countries they are called physiotherapists.

Physical therapist.

Kinesiologist.

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What is Physical Therapy

Physical therapists provide servicesthat develop, maintain and restorepeople’s maximum movement andfunctional ability.

They can help people at any stage oflife, when movement and function arethreatened by ageing, injury,diseases, disorders, conditions orenvironmental factors.

Physical therapists help peoplemaximise their quality of life, lookingat physical, psychological, emotionaland social wellbeing.

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What is Physical Therapy

They work in the health spheres of ;

PROMOTION;

PREVENTION;

ANALYSIS/ DIAGNOSIS ;

TREATMENT/INTERVENTION;

HABILITATION AND REHABILITATION.

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PROMOTION

Promoting the health andwell being of individuals andthe general public/society,emphasizing the importanceof physical activity andexercise.

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PREVENTION

Preventing impairments, activitylimitations, participatory restrictionsand disabilities in individuals at riskof altered movement behaviors dueto health or medically relatedfactors, socio-economic stressors,environmental factors and lifestylefactors.

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ANALYSIS/ DIAGNOSIS

Diagnosis and prognosis arise from the examination andevaluation and represent the outcome of the process ofclinical reasoning and the incorporation of additionalinformation from other professionals as needed.

This may be expressed in terms of movement dysfunctionor may encompass categories of impairments, activitylimitations, participatory restrictions, environmentalinfluences or abilities/disabilities.

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TREATMENT & INTERVENTION

Intervention/treatment is implemented and modified in order to reach agreed goals and may include manual handling; movement enhancement; physical, electro-therapeutic and mechanical agents; functional training; provision of assistive technologies; patient related instruction and counseling; documentation and co-ordination, and communication. 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.

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HABILITATION

The process of supplying a person with the means to develop maximum independence, in the Activities of Daily Living through training or treatment.

Mosby's Medical Dictionary/8th edition/ 2009/ Elsevier.

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REHABILITATION

The physical restoration of asick or disabled person bytherapeutic measures and re-education to participation inthe activities of a normal lifewithin the limitations of theperson's physical disability.

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What a Physical Therapist can do?

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 healthcare professional.

implement a physical therapist intervention/treatment programme.

determine the outcomes of any interventions/treatments.

make recommendations for self-management.

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SCOPE OF PHYSICAL THERAPY PRACTICE

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SCOPE OF PHYSICAL THERAPY PRACTICE

The scope of physical therapy 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, locally, nationally and internationally

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SCOPE OF PHYSICAL THERAPY PRACTICE

Physical therapists operate as independent practitioners, as well asmembers of health service provider teams, and are subject to the ethicalprinciples of WCPT.

They are able to act as first contact practitioners, and patients/clients mayseek direct services without referral from another health care professional.

The education and clinical practice of physical therapists will varyaccording to the social, economic, cultural and political contexts in whichthey practice.

However, it is a single profession, and the first professional qualification,obtained in any country, represents the completion of a curriculum thatqualifies the physical therapist to use the professional title and to practiseas an independent professional.

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Where is physical therapy practised?

Physical therapy is an essential part of the health and community/welfare services delivery systems.

Physical therapists practise independently of other health care/service providers and also within interdisciplinary rehabilitation/habilitation programmes that aim to prevent movement disorders or maintain/restore optimal function and quality of life in individuals with movement disorders.

Physical therapists practise in a wide variety of settings.

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Where is physical therapy practised?

Hospitals

Hospices

Nursing homes

Geriatric care centres

Physiotherapy clinic

Community settings

Health/fitness/sports clubs

Education institutions and research

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Boundaries of professional competence and making referral

An integral part of physical therapy is interaction between the physical therapist and the patient/client/family or caregiver to develop a mutual understanding.

This kind of interaction is necessary to change positively the body awareness and movement behaviours that may promote health and wellbeing.

Members of inter-disciplinary teams also need to interact with each other and with patients/clients/family and caregivers to determine needs and formulate goals for physical therapy intervention/treatment.

Physical therapists also interact with administration and governance structures to inform, develop and/or implement appropriate health policies and strategies.

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Boundaries of professional competence and making referral

Diagnosis in physical therapy is the result of a process of clinical reasoning that results in the identification of existing or potential impairments, activity limitations, participation restrictions, environmental influences or abilities/disabilities.

The purpose of the diagnosis is to guide physical therapists in determining the prognosis and most appropriate intervention/treatment strategies for patients/clients and in sharing information with them.

In carrying out the diagnostic process, physical therapists may need to obtain additional information from other professionals.

If the diagnostic process reveals findings that are not within the scope of the physical therapist’s knowledge, experience or expertise, the physical therapist will refer the patient/client to another appropriate practitioner.

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Bibliography

World Confederation for Physical Therapy. WCPT guideline for the development of a system of legislation/regulation/recognition of physical therapists. London, UK: WCPT; 2011.

World Confederation for Physical Therapy. Policy Statement: Regulation of the physical therapy profession. London, UK: WCPT; 2011.

World Confederation for Physical Therapy. Ethical principles. London, UK: WCPT; 2011.

World Confederation for Physical Therapy. Policy statement: Ethical responsibilities of physical therapists and WCPT members. London, UK: WCPT; 2011.

World Confederation for Physical Therapy. Policy Statement: Direct access and patient/client self-referral to physical therapy. London, UK: WCPT; 2011.

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Bibliography

World Confederation for Physical Therapy. WCPT guideline for physical therapist professional entry level education. London, UK: WCPT; 2011.

World Confederation for Physical Therapy. Policy statement: Education. London, UK: WCPT; 2011.

World Confederation for Physical Therapy. Policy statement: Autonomy. London, UK: WCPT; 2011.

World Health Organization. Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948. Geneva, Switzerland: WHO; 1948.

World Health Organization. International Classification of Functioning, Disability and Health. Geneva, Switzerland: WHO; 2001.

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Bibliography

World Confederation for Physical Therapy. Policy statement: Support personnel for physical therapy practice. London, UK: WCPT; 2011.

Department of Health. Self-referral pilots to musculoskeletal physiotherapy and the implications for improving access to other AHP services. London, UK: Department of Health; 2008.

American Physical Therapy Association. Guide to Physical Therapist Practice. Physical Therapy. 1997;77(11):1168-650.

American Physical Therapy Association. Guide to Physical Therapist Practice. Second Edition. American Physical Therapy Association. Physical Therapy2001. p. 9-746.

World Health Organization. The International Classification of Functioning, Disability and Health – ICF. Geneva: World Health Organization; 2001.

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Thank You


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