INTRODUCTION OF
PHYSIOTHERAPY
Fundamentals of Physiotherapy Practice
(Lecture 1)
Physiotherapy is a dynamic profession which consists
of theoretical and scientific base and widespread clinical
applications to restore, maintain, and optimize physical
function.
“Physical therapy is services provided by physical
therapists to individuals and populations to develop,
Physiotherapy maintain and restore maximum movement and
functional ability throughout the lifespan” –
WCPT(World physiotherapy)
Physiotherapy helps to prevent, minimize, or eliminate
impairments of body functions and structures, activity
limitations, and participation restrictions.
Physiotherapist is a health care professional who
aim to optimize physical performance, enhance
health, well-being and quality of life of
Physiotherapist individuals by helping them maintain, restore,
and enhance movement, activity and physical
functioning.
• Provides rehabilitation and habilitation
• Performance enhancement
• Prevention and risk reduction
• Develops standards for physiotherapy practice
• Develops health care policy
Role of
Physiotherapy “Rehabilitation is a set of interventions needed when a
person is experiencing or is likely to experience limitations
in everyday functioning due to ageing or a health
condition, including chronic diseases or disorders, injuries
or traumas.” WHO
“Habilitation refers to a process aimed at helping disabled
people attain, keep or improve skills and functioning for
daily living.” –RI Global
Treatments OPD
given Speciality
by Ward
Physiotherapist ICU/Critical care
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HISTORY OF
PHYSIOTHERAPY
(Fundamentals of Physiotherapy Practice
(Lecture 2) )
Tharig Majeed/Aishath Najiha
How the word
“Physiotherapy”
evolved 1813: Per Henrik Ling (father of Swedish gymnastics.), founded the royal
Central Institute of Gymnastics. for massage, manipulation and exercise
1851: German word "Physiotherapie" was used in an article written by Dr.
Lorenz Gleich (military physician).
1894: Dr. Edward Playter used the word "Physiotherapy.“in an article
published in Montreal Medical Journal.
Over the years, the word "Physiotherapie" changed to "Physiotherapy“.
A Physiotherapist with a polio case
• The first recorded physician to prescribe exercise for his patients
Before World • He stated that, “it should be taken every day” but taken “only to
war I Indus half extent of his capacity” as otherwise “it may prove fatal”
River Civilization • Before prescribing exercise, consider the age, strength,
physique, exercise terrain, and diet of the patient.
• Advocated exercise as it had several benefit (body stout, strong,
firm, compact, and light, enhanced the growth of limbs and
muscles, improved digestion and complexion, prevented
laziness, and reduced senility)
• Physical exercise should be included in the prescription for
obesity
• Prescribed exercises for diabetes (curable form)
Susruta - India [600 Before • Exercise to be done in moderation, or else, lead to many
Common Era (BCE)] diseases and ultimately death. (discouraged active participation)
Before World war
I Yellow River
Civilization • 2600 BCE – China practiced breathing exercises, regarded as
medical gymnastics
• 1050-256 BCE ( Era of yellow emperor) – Breathing exercise,
massage with exercise of the extremities - for subjects experiencing
chills, fevers, or complete paralysis
• 25 BCE – 250BCE ( East Han Dynasty) - Chinese physician and
surgeon, Hua T'O prescribed exercise for his patients and followers
because of its yang( life and health) effect.
• Hua T’O said, “The body needs exercise only it must not be to the point
of exhaustion for exercise expels the bad air in the system promotes
free circulation of the blood and prevent sickness.”
Hua T'O of China [100
Common Era (CE)]
• 500 BCE - Herodicus (a former teacher of Hippocrates)- was a physician
who practiced dietetic medicine who later became recognized for his
Before World war I emphasis on the therapeutic effects of exercise
[Classical Period, the • criticized by both Hippocrates and Plato for prescribing exercises they
city-state of Athens, believed were too strenuous for his patients
and the Post-
• father of sports medicine
Hippocratic Era]
• Recommending exercise to aid recovery from athletic and gymnastic
injuries.
• Hippocrates- the first recorded physician to provide a written exercise
prescription for a patient with disorder of consumption
• Hippocrates wrote that “eating alone will not keep a man well, he must
also take exercise”.
• Hippocrates also stated that “. . . food and exercise, while possessing
opposite qualities, yet work together to produce health”
Hippocrates [460–370 BCE]
Before
• He used exercise to treat patients suffering from a variety of diseases.
World war I
[Roman • Galen believed exercise will make “thinning” of the body, harden and
strengthen muscles, increase flesh, and elevate blood volume while
Empire] achieving “good condition” of the wrestler or heroes like Hercules and
Achilles in Homer's epics.
• Galen prescribed exercises for arthritis, depression, dropsy, epilepsy,
gout, tuberculosis, and vertigo
Claudius Galenus (129–210 CE)
or Galen of Pergamon
Women started treating Polio cases with residual paralysis- used
passive movements
Developed Manual muscle testing- Assess strength of the muscles
Developed muscle re-education techniques- strengthening
technique for weaker muscles
In the year Beginning of hydrotherapy- Franklin D. Roosevelt, in 1926, used a
1916 (PT in an resort at Warm Springs Georgia, as a Hydrotherapy Center for
polio patients
Epidemic) This center presently operates as Roosevelt Warm Springs
Institute for Rehabilitation.
In 1937, National foundation for infantile paralysis was formed and
further enhanced Physiotherapy
US entered war in 1917, army needed to rehabilitate soldiers
Special Unit formed
Established 15 reconstruction aide training programs- to train
medical workers in rehabilitation
In 1920, interdisciplinary team(PT, medical and surgical) work
started-gained public recognition and validation
PT during In 1930s, the polio epidemic was still continuing, and in the year
World War I 1937 the National Foundation for Infantile Paralysis was
established, which gave major support to the growth of Physical
(1917) Therapy as a profession
March 1921- The first physiotherapy research in US was
published in The PT Review and the Physical Therapy Association
(now called the American Physical Therapy Association (APTA)
was formed.
In 1940- PT began for soldiers who returned home with
amputations, burns, cold injuries, wounds, fractures, and nerve
and spinal cord injuries.
Application of electrical stimulation began
PT during The “galvanic exercise” was given by the PTs on the atrophied
world war II hands of patients who had an ulnar nerve lesion from surgery upon
a wound
1942- Pt started getting relative military rankings.
1946- Hospital-based practice for PTs was increased.
1947- Need for PTs reduced and active PTs assigned to newly
established Women's Medical Specialist Corps (WMSC).
1955- Accepted male therapists into the Corps and changed the
name of Corps to the Army Medical Specialist Corps (AMSC).
Post war Need for rehabilitation began to surface. “proprioceptive
neuromuscular facilitation” (PNF) was developed as a part of the
armamentarium of skills of the PTs.
Dr. Bobath (neurologist) and Mrs. Bobath (physiotherapist)
developed the Bobath concept for CP and adults with neurological
conditions.
1950- Professionalism and professional autonomy needed as PTs
progressed from technicians to professional practitioners.
1954- Professional competency examination was developed by
American Physical Therapy Association (APTA) in conjunction with
Post war the Professional Examination Service, which was made available
to the state licensing boards.
1955- Growth of Private practice and the Self-Employed Section
was formed as a component of APTA
Treatment through the 1940s mainly consisted of exercise, massage
and traction.
1950s- Manipulative procedures to the spine and extremity joints
began to be practiced, especially in the British Commonwealth
Post war countries
PTs started to move beyond hospital based practice, to outpatient
orthopedic clinics, public schools, college/universities, geriatric
settings, rehabilitation centers, hospitals, and medical centers.
1973: Physiotherapy during Korean war and Vietnam war, restored
the use of damaged arms and legs, rehabilitated surgical wounds,
increased range of motion, and restored flexibility and strength
Post war following serious burns, and it speeded patient recovery and
repaired the wounded soldier.
1967-1976- expansion of the profession into the management of
orthopedics and cardiopulmonary disorders.
• Duchenne de Boulogne, French neurologist, described
several nervous and muscular disorders, and developed
History of treatment for them and created electrodiagnosis and
Electrotherapy electrotherapy.
(1831-1875) • Explored the effects of electrical stimulation on diseased
nerves and muscles.
Duchenne, the founder of modern
electrotherapy, faradizing the frontalis
muscle
Physiotherapy today is an independent health care profession for
all the age groups from neonatal to geriatrics. (from birth to old
age.)
The task of early intervention in neonatal cases is taken over by a
physiotherapist, new born babies with birth defects are evaluated
Physiotherapy and treated, which helps in minimizing disabilities and helps in
Today early ambulation.
Women's wellness, maintaining healthy lifestyle after menopause
needs attention.
Common problems are: obesity, Arthritis, incontinence of urine,
fatigue, aches & pains in joints etc
Pain management in acute & chronic cases are managed by
physiotherapists.
Sports physiotherapy is becoming popular amongst the young
physios. In fact special post-graduate courses are conducted by
the association, to promote this new emerging avenue of
physiotherapy.
Industrial physiotherapy deals with ergonomics and safety
measures. Guidance on work positions etc. is given by
Physiotherapy physiotherapists.
Today Manipulative Therapy is gaining momentum due to its instant
relief in pain and increase in range of motion. Special training is
required before practicing this technique.
Nowadays, physiotherapy as a treatment for the motion of mass is
applied in a complex of rehabilitation measures in hospitals,
dispensaries, clinics and other health care facilities.
All these have gained immense popularity for today's
Physiotherapists.
There is scope for physiotherapy even in space, where there is a
high possibility of gravity related injury.
Physiotherapy Backpain, muscle strain and headache is common in space-craft.
Tomorrow Micro-gravity induces calcium loss from bones. Assessment of the
limbs or back are difficult in space.
The future of physiotherapy for the astronauts in space is
promising. Physiotherapists can help "body positioning", and
exercises for micro-gravity posture.
Tipton C. M. (2014). The history of "Exercise Is Medicine" in ancient
civilizations. Advances in physiology education, 38(2), 109–117.
[Link]
Shaik AR, Shemjaz AM. The rise of physical therapy: A history in
footsteps. Arch Med Health Sci 2014;2:257-60
Physiopedia
[Link]
