Current scope of Physiotherapy in India in response to the ever growing & changing needs of the society

back pain relief spray

Health is a condition of inclusive physically, mentality and socially wellbeing of a person, but not exclusively the lack of illness or disease. Physiotherapy often abbreviated as PT is an active healthcare occupation that aims to help the individuals with the achievement, maintenance and restoration of maximal physical functioning and health throughout their lifetimes. Physiotherapy is a healthcare profession that remediates impairments and promotes mobility, function, and quality of life through examination, diagnosis, and physical intervention (therapy using mechanical force and movement). In addition to clinical practice, other activities encompassed in the Physiotherapy profession include research, education, consultation and administration. Physiotherapy is grounded in the belief that to be effective, its services must respond to the changing needs of populations and our health system. In many settings, Physiotherapy services may be provided alongside or in conjunction with other medical or rehabilitation services, including occupational therapy.

The profession is built by scientific evidence and the education and competencies of the physiotherapists delivering the services. Each area of Physiotherapy intervention has its own specialized techniques and is based on scientific evidence. Physical therapy is a professional career which has many specialties including sports, neurology, wound care, cardiopulmonary, geriatrics, orthopaedic and paediatrics. Thus, the main interest and objective of this article are to identify and maximize the quality of life and potential for movement of each person in the areas of promotion, prevention, treatment or intervention, in addition to adaptation and rehabilitation of health in the field of Physiotherapy.

Physiotherapy Education

Worldwide, Physiotherapy education greatly varies from country to country. Globally Physiotherapy training ranges from basic work education in hospitals and outpatient clinics to professional Bachelor, Master and Doctorate degrees and programs. Most of Physiotherapists practicing under a specialty have to undergone further training in Physiotherapy. The Universities admit Physiotherapists in their programs of study related to health sciences and rehabilitation in order to credit courses that have been completed in colleges. They get admitted after finishing Higher Secondary College in the field of Science (10 +2) depending on their scores of NEET or equivalent entrance examinations necessary for getting admitted to professional Physiotherapy courses either in State run or Private Colleges.  After completing degree programs they have the opportunity to pursue their studies at the university level to obtain a Master’s degree in Physiotherapy. The licensing requirements for Physiotherapists vary among jurisdictions of a state, as each state has passed its own Physiotherapy regulations. In India, due to lack of a Central Council they get affiliated to the state councils and must follow the rules of laid down by them. They can further undertake Doctoral Programs that enable the students to go on in the field of Research and Development in Physiotherapy.

Specialty in Physiotherapy

In Physiotherapy, a broad statement Prognosis predicts a patient’s likely status, or degree of change, at some time in the future; at the level of the individual, a prognosis provides the practitioner and patient with critical information, including the patient’s expected future health status, likely response to intervention, and likely duration of treatment (Beattie and Nelson, 2007). There are many areas of Physiotherapy, below are stated some of the specialist certifications.

Cardiovascular and Pulmonary Physiotherapy

Physiotherapy offers therapy for a wide variety of cardiopulmonary disorders or pre and post cardiac or pulmonary surgery. Primary goals of this specialty include increasing endurance and functional independence. Pulmonary disorders, heart attacks, post coronary bypass surgery, chronic obstructive pulmonary disease and pulmonary fibrosis, treatments can benefit from cardiovascular and pulmonary specialization.

Clinical Electrophysiology & Electro-Diagnosis

This specialty area includes electrotherapy, electrophysiological evaluation, physical agents and wound management.

Geriatric Physiotherapy

It covers a wide area of issues concerning peoples as they go through normal adult aging but is usually focused on the older adults. There are many conditions that affect many peoples as they grow older and include arthritis, cancer, hip and joint replacement, balance disorders, incontinence, and providing therapy for such conditions in older adults.

Integumentary Physiotherapy 

Integumentary deals with the treatment of conditions involving the skin and all its related organs. Common conditions managed include wounds and burns by utilizing surgical instruments, mechanical lavage, dressings and topical agents to debride necrotic tissue and promote tissue healing. Other commonly used interventions include exercise, oedema control, splinting and compression garments.

Neurological Physiotherapy

Neurological Physiotherapy or neurophysiotherapy focuses on working with individuals who have a neurological disorder or disease including stroke, chronic back pain, brain injury, cerebral palsy, multiple sclerosis, facial palsy and spinal cord injury. Common impairments associated with neurologic conditions include impairments of vision, balance, ambulation, movement, muscle strength and loss of functional independence (McEwen, 2006).

Orthopaedic / Musculoskeletal Physiotherapy

Orthopaedic Physiotherapy deals with diagnose, manage and treat disorders, and injuries of the musculoskeletal system including rehabilitation after orthopaedic surgery. This specialty of Physical therapy is most often found in the outpatient clinical settings. Orthopaedic therapy also deals in the treatment of post-operative orthopaedic procedures, fractures, acute sports injuries, arthritis, sprains, strains, back and neck pain, spinal conditions, and amputations. Those who have suffered injury or disease affecting the muscles, bones, ligaments or tendons can benefit from a Physical orthopaedics.

Paediatric Physiotherapy

Paediatric therapy assists in the diagnosis, treatment and management of infant, child and adolescent populations with a variety of congenital, developmental, neuromuscular, skeletal or acquired disorders and diseases. The treatments focus mainly on improving gross and fine motor skills, balance and coordination, and strength and endurance.

Sports Physiotherapy

This is closely involved in the care and wellbeing of athletes including recreational, semi-professional (paid) and professional (full-time employment) participants. This area of practice covers athletic injury management under 5 main categories, acute care (assessment and diagnosis of an initial injury), treatment (application of specialist advice and techniques to encourage healing), rehabilitation (progressive management for full return to sport), prevention (identification and address of deficiencies known such as movement assessment), and education (sharing of specialist knowledge to individual athletes, teams or clubs to assist in prevention or management of injury).

Women’s Health & Mother and Child care Physiotherapy

Women’s health Physical therapy mostly addresses women’s issues related to the female reproductive system, child birth and post-partum. These conditions include pelvic pain, prenatal and post-partum periods, urinary incontinence and other disorders associated with pelvic floor dysfunction. Manual Physical therapy has been demonstrated in multiple studies to increase rates of conception in women with infertility (Kramp, 2012; Rice et al., 2015).

Pelvic Floor Conditions extending to the male population is also covered by a Physiotherapist specialised in the field of Musculoskeletal Conditions

Palliative Care / Onco Physiotherapy

Physiotherapy in the field of Oncology and Palliative care is a continuously evolving and developing specialty, both in malignant and non-malignant diseases. Rehabilitation for both groups of patients is now recognized as an essential part of the clinical pathway, as early diagnoses and new treatments are enabling patients to live longer, so that they can function at a minimum level of dependency and optimize their quality of life.

Importance of Physiotherapy

Physiotherapy profession has seen some significant advances and gained the recognition as a specialized field of medicine few decades ago. This practice has come a long way from the early employed heat, electrical stimulation and water-based applications to aid movement and function. Physiotherapy is the most commonly prescribed treatment to assist in the recovery of many injuries and conditions, chronic pain, sports injuries, and challenges with mobility can all be greatly improved with the use of Physiotherapy.

Benefits of Physiotherapy

Many benefits are available to the public through the widening scope of Physiotherapy. The profession mainly addresses Orthopaedic, Neurological, Cardiopulmonary Problems Early intervention in infants, Children & Adults and Geriatric Populations.

Protection of Title and Practice

Physiotherapy is a primary care, autonomous, client-focused health profession dedicated to improving quality of life by promoting optimal mobility, physical activity and overall health and wellness. The Physiotherapy profession is a self-regulated and recognized health profession in the world. Physiotherapists are primary care practitioners whereby patients may directly access their services. This practice has evolved to a high level of professional autonomy that is supported by legislation in all jurisdictions. Protection of title and clarity of professional activity is considered important for the protection of the public (Canadian Physiotherapy Association, 2012).

Employment in Physiotherapy

Jobs related to Physio therapy have shown rapid growth in recent years, but employment rates and average wages may vary significantly between different countries, states, provinces or regions. Job duties requirements for Physiotherapist may vary country by country depending on the employer of states.

Physiotherapists can embark on professional duties comprising clinicians, consultants, academic professionals, researchers, and administrative professionals.

In Conclusion, Each area of Physiotherapy intervention has its own specialized techniques and is based on scientific evidence. The techniques used in Physiotherapy have been evolved since the ancient times of history, and in today’s complex world, there are even Physiotherapists specialized in just one area, and within that area they treat some specific diseases (stroke, traumatic knee injuries and incontinence). Physiotherapy is an essential participant in the healthcare delivery system, using its expertise in rehabilitation and movement science to enhance the physical function and mobility of individuals of all ages. It is a profession of highly educated, autonomous practitioners who function as clinicians, educators, scientists, consultants and administrators who practice in all healthcare environments, in the home, in the community, and in many businesses and organizations. Physiotherapy is not only involved in providing the highest quality of care to individuals, but also is very active in promoting public health initiatives.