Overview of Physiotherapy Profession

Received: 06-Nov-2023, Manuscript No. IJMRHS-23-119333; Editor assigned: 08-Nov-2023, Pre QC No. IJMRHS-23-119333 (PQ); Reviewed: 22-Nov-2023, QC No. IJMRHS-23-119333; Revised: 13-Jan-2025, Manuscript No. IJMRHS-23-119333 (R); Published: 20-Jan-2025

Highlights

• There are an increased number of patients with chronic, occupational and lifestyle-related conditions seeking physiotherapy.
• Healthcare providers continue to inquire about physiotherapy roles in the health service sector.
• Physiotherapy patient assessment is both a facilitator and catalyst to positive healthy outcomes.
• Physiotherapy research and evidence-based physiotherapy are key to ensuring quality and consistency of physiotherapy care.

Introduction

Globally, physiotherapy is a recognized profession and is an essential member of modern healthcare service sector. Physiotherapy is identified in management of conditions in their acute, subacute and chronic states, and prevention of illnesses and injuries.

Historically, physiotherapy grew from the practice of massage, gymnastic exercises to a more organized profession with a wider area of practice in most of the nations. Physiotherapy profession is therapy (treatment) for the preservation, enhancement or restoration of movement and physical function impaired or threatened by disease, injury or disability using therapeutic exercise, physical modalities (for example electrotherapy), assistive devices and patient education and training [1]. Physiotherapy is important in the management and prevention of health problems, improving general quality of life of an individual patient and public health [2].

The world physiotherapy is a global voice of the physiotherapy profession and the practice of physiotherapy requires one to obtain a license for practice from the state recognized board of the country in which he/she works in. Physiotherapy can be done in both outpatient and inpatient settings for example in hospitals, rehabilitative care centers, homes, but also from office or workplaces and in sports areas. The rising wages paid on healthcare, the physiotherapy professionals’ shortage, the expanding number of elderly populations and the increasing factors contributing to ill-health have made physiotherapy care institutions transform to respond to the concerns.

Description

Physiotherapy professionals

Physiotherapy professionals work across the health care systems such as in hospitals, schools, private clinics, sports, home care, long-term care facilities and public settings.

Trained physiotherapy professionals actively participate in patients’ assessments, establish diagnoses, develop and implement intervention plans, advise patients and family members on adherence to care for better outcomes. They work on individuals of all ages facing health and functional problems or are threatened by ill-health which would impact on their functional abilities. Physiotherapy professionals educate patients and caregivers about preventing and dealing with chronic disease, utilize group-based programmes by focusing on preventing and managing chronic conditions and on promoting health and wellness [3]. Physiotherapy professional communities have intensely increased the marketing of physiotherapy services; this replicates a rapidly expanding workforce allowing the public to directly access physiotherapy without the need for medical referral [4].

Physiotherapy professionals should collaborate with other healthcare professionals to dismantle professional hierarchies, as a way of expanding its wider roles of patient care [5]. Physiotherapy professionals are well positioned to address the sustainable development goals which are among others; reducing child mortality rates, improving maternal health and other chronic diseases of lifestyle [6].

Core roles of physiotherapy

Physiotherapy patient assessment: In healthcare, patient assessment is vital for the selection of setting goals, selecting intervention strategies, prognosis and evaluation of the progression achieved towards the treatment goals; for instance, the assessor wants to assess the patient’s perceptions on how the disease process, activity and disability interfere with their life situation [7].

Physiotherapy care process necessitates systematic patient assessment, diagnosis and prognosis, developing as well as implementing intervention plans and patient re-assessment. Physiotherapy patient assessment begins by obtaining and documenting individual demographic data. Patients' demographic data has been determined to affect their health status and forms the basis from which certain chronic disease prevalence vary [8]. Individual patient demographic data mainly includes; name, gender, date of birth, marital status, height/weight, occupation contact, address and income status. Initial encounters with patients and clients must include asking the patient's medical history whereas subsequent visits may only require a review of the medical history and update with any changes. Obtaining medical history of the patient is an essential part that guides care givers towards appropriate, effective and safe patient care. Information gathered by doing a thorough medical history can have life or death consequences. A complete medical history includes in-depth inquiry into the patient's medical issues such as all diseases and illnesses currently being treated and their residual effects. Obtaining medical history from the patient helps understand the state of health of the patient more.

Surgical history should include all invasive procedures the patient underwent while family history links to any relationships of disease to genetic predispositions and social history establishes personal behaviors, occupation, spiritual and sexual or relationships.

The history acts as a form of tool that relates to any acute complaints and directs toward a diagnosis [9]. Information obtained from patient’s history serves to prevent potential harm to the patient during treatment such as recognition of contraindications of certain interventions. History obtained during patient assessment creates a window for patient physical examination. Physical examination includes various clinical tests to investigate joint movement, muscle strength and length, movement control moreover patients complain of pain, impaired activity and other patient functional aspects.

Poor physical exam skills are a noteworthy threat to patient safety as they can lead to incorrect as well as missed diagnoses. If physical examination is not performed or poorly done, patient safety is threatened and diagnostic errors are likely, therefore a careful examination can help a physiotherapy professional develop an intervention plan that accurately responds to patient problems [10].

Physiotherapy professionals use information obtained during patient assessment for developing an intervention plan to promote the ability to function, reduce pain, maintain or restore function and prevent disability.

Physiotherapy interventions (Patient care): Physiotherapy interventions are a pillar in physiotherapy-patient care process. Determining interventions depends entirely on findings from physiotherapy patient assessment. Physiotherapy professionals are embedded in supervising patient's progress and making adjustments for intervention (treatment) plans as needed, helping patients to maintain or restore flexibility, strength and range of motions [11]. The interventions (treatments) in physiotherapy include; therapeutic exercises, functional training in self-care and home management, functional training in work, community and leisure, manual therapy, prescription and application of appropriate assistive devices, electrotherapy and mechanical modalities, patient instruction, coordination and documentation [12].

Physiotherapy professionals provide care for peoples of all ages and in a variety of settings, including hospitals, private practices, outpatient clinics, rehabilitation centres, home health agencies, schools, sports and fitness facilities, places of work and nursing homes.

Health promotion: The global health resources continue to shrink in relation to population growth and this creates a vital need for and value of the health promotion and disease prevention approach in health services. Presently, health promotion is very relevant and ought to also embrace approaches to promote health in specific settings such as schools, hospitals, workplaces, residential areas and among groups of people [13]. Whereas health promotion received an impetus following Alma Ata declaration, it needs to be built into all the policies and once applied proficiently will lead to positive health outcomes. Addressing health promotion issues can be effective through adopting a holistic approach of empowering people and their communities to act for the good of their health.

Physiotherapy professionals come across patients with chronic conditions and unhealthy lifestyle behaviors [14]. They are therefore well suited to promote health and wellness for their patients and families who are maintain contact with them. Health promotion should be developed, reviewed and included in undergraduate physiotherapy curriculum and contain effective approaches to reduce and control modern day preventable diseases and situations leading to ill-health.

Research: The purpose of research is to enhance society by advancing knowledge through scientific theories, concepts and ideas.

The rising disease burden, increase research in physiotherapy and evidence-based practice have led to more physiotherapy professionals being involved in research. Views offer engagement in research right from leaders and physiotherapists, participating in a research project is beneficial for institutions, individual physiotherapy professionals and the patients [15]. Substantial prerequisites to participating in research among physiotherapy professionals that exist are; clinical applicability, support, sufficient time and initial contribution of leaders.

Research has high value to society, it may provide vital evidence about disease trends and risk factors, outcomes of care interventions, functional abilities, patterns of care and health care costs and use. Conditions to support physiotherapy professionals use research exist at individual, workplace as well as extra-organizational levels [16]. Physiotherapy professionals should therefore close the gap of scarcity of research in some areas of physiotherapy.

Evidence based physiotherapy

The emergence of Evidence-Based Practice (EBP) movements in 1990s created high prominence for a more research-informed physiotherapy practice hence need for a more research-informed physiotherapy practice was recognized decades. Quality of care can be driven and achieved by evidence-based physiotherapy. The expanding workforce of physiotherapy profession should tailor mainly on quality evidence-based physiotherapy services if it has to maintain the expansion and growing patients (or clients) seeking quality care.

The European region of world confederation for physical therapy defined EBP as a commitment to use the best available evidence to inform decision-making about the care of individuals that involves integrating physiotherapist practitioners and individual professional judgement with evidence gained through systematic research [17]. The physiotherapy profession embraces quality patient care through Evidence Based Physiotherapy (EBP); it is an emerging and increasing theme in rehabilitation and physiotherapy [18]. Evidence based physiotherapy includes research, clinical practice and the values of patients and clients; it is an important factor determining the quality of physiotherapy care. The approaches to achieve a more EBP have largely targeted individual healthcare professionals to affect their attitudes, beliefs, knowledge and skills as a means of changing clinical practice [19].

Physiotherapy professionals fulfil several healthcare roles in a collaborative inter-professional team and the community through an evidenced-informed approach to care, they should therefore appreciate evidence-based physiotherapy.

Physiotherapy practice and patient safety

Safety is a primary concern in any activity involving risks. Although it was not part of the original Hippocratic Oath, patient safety is a fundamental principle of health care derived from Latin non nocere (do no harm) it is deeply embedded in medical profession. The axiom 'do no harm' lies in the centre of patient safety which is defined by the World Health Organisation (WHO) as a framework of organized activities which create culture, processes, procedures, behaviors, technology and environments in health [20]. Unsafe care remains one of the top ten causes of death and disability globally. The recent findings reveal that in each year; unsafe hospital-based care causes 134 million adverse events, claim 2.6 million deaths in low and middle-income countries [21].

The idea of ensuring patient safety is less developed in physiotherapy than in other areas of health care. Physiotherapy is among other professions where patient safety is emerging, error perception and recognition are lacking, analyzing errors tend to focus on individual blame rather than on the components of the process leading up to errors.

Physiotherapy as services provided to develop, maintain and restore maximum movement and functional ability throughout the lifespan, including services where movement and function are threatened by aging, injury, pain, diseases, disorders, conditions and/or environmental factors. The retained perception that standard physiotherapy interventions cause little harm serious hinders detection, reporting and documenting involved risks and analyzed for prevention [22].

As a common practice, healthcare settings patient safety programs must include physiotherapy professionals along other healthcare providers during in-service induction trainings, and patient safety training should be appreciated in university physiotherapy courses.

Conclusion

In the healthcare sector, physiotherapy is important in enhancing patients’ recovery from illnesses, restore and maintain function and prevent diseases in all age groups. Physiotherapy professionals are observing an increased access to their services by members of the public presenting with health problems brought about by rising technology use, injuries, increase in lifestyle related diseases and the effects of poverty and malnutrition. Physiotherapy workforce upscale to heighten accessibility require quality training, education and research. The Ugandan education sector has made a significant contribution to raise a workforce to strengthen the health service sector. The physiotherapy workforce and the physiotherapy education department should strive to observe the core roles of physiotherapy profession, health promotion, embrace research, evidence-based physiotherapy and patient safety.

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