What is physical therapy?

Physical therapy or physiotherapy is among the many allied health professions that focus on the diseases and/or injuries that limit a person’s movement and ability to perform functional activities in their daily lives. It assesses and improves the physical functions of the patient through history, physical examination, intervention, rehabilitation, and education. Treatment measures during physiotherapy include certain exercises, mechanical traction devices, manual therapy, and manipulation. Many electrophysical modalities such as heat, cold, electric current, sound waves, and radiation, as well as assistive devices, prostheses, and orthoses are also commonly used to treat such patients.

In addition to treatment and rehabilitation of patients, physiotherapists also work to prevent or lessen the loss of mobility which may occur due to age, injury, or disease. This allows patients to develop, preserve, and restore maximum physical strength and functional ability through fitness plans and healthy lifestyle choices.  Physiotherapists can work in a variety of fields along with normal clinical practice. These professions include research work, education, consultation, and administration departments as well as in conjunction with other medical fields. There are also many fields that are not directly associated with patient care such as health-care policymaking, health-care insurance, health-care executives, and medico-legal experts.

Types of physical therapy

The field of physical therapy is a vast field with various specializations and clinical areas. 

Licensed physiotherapists can also choose from a wide range of work environments such as outpatient clinics, private clinical practices, tertiary health-centers, rehabilitation centers, nursing homes, home-based health, sports and fitness centers, schools, offices, government agencies, and research facilities. The different fields of physical therapy are described below:

  • Cardiovascular and Pulmonary

Cardiovascular and pulmonary rehab specialists work with a variety of patients with cardiopulmonary disorders or before and after such surgeries. The main aim of this specialty is to enhance the endurance capacity and functional independence of patients and to restore the maximum strength after surgery. Different cardiopulmonary disorders such as coronary bypass surgery, myocardial infarction, cystic fibrosis, and chronic obstructive pulmonary disease can benefit from physical therapy.

  • Geriatric

Geriatric physical therapy is based on providing therapy for age-related health conditions and focuses on the elderly. The elderly suffer from many conditions such as osteoarthritis, osteoporosis, Alzheimer’s disease, hip, and joint replacement, vestibular disorders, urinary incontinence, etc that can be managed with physical therapy. This includes various activities like stretching, strength training, and other exercises to improve the patient’s symptoms and ensure a better recovery.

  • Integumentary

This branch involves all conditions related to the skin and its associated organs such as wounds and burns. Integumentary physical therapy helps remove damaged tissue and promotes healing with the help of proper wound irrigations, dressing, and topical medication. Other therapies include specific exercises, splinting, and pressure garments to promote circulation.

  • Neurological

Neuro physiotherapy focuses on rehabilitation of patients with neurological disorders and often works in close association with psychology treatments. Neurological disorders such as stroke, paralysis, herniated disc, multiple sclerosis, nerve palsies, spinal cord injuries, etc can be dealt with neuro physiotherapy. This field helps improve and manage the problems with vision, balance, movement, functioning, and other symptoms associated with neurological disease.

  • Orthopedic

Orthopedic physiotherapy deals with the diagnosis, management, and treatment of musculoskeletal disorders and also includes rehabilitation therapy after orthopedic surgery. It is beneficial for sprains, strains, bone deformities, bursitis, and post-operatively for fractures, amputations, arthritis, and back, neck pain, etc. 

  • Pediatric

Pediatric physiotherapy works to help children achieve their peak physical development and also helps in early detection and management of various congenital, developmental, or acquired pediatric conditions such as developmental delays, cerebral palsy, and muscular dystrophies, etc. The therapy includes different exercises to improve fine and gross motor functions, vestibular function, and strength, along with cognitive and sensory processing ability.

  • Sports

Sports physiotherapists work closely with athletes in the acute management of injuries, treatment of chronic conditions, rehabilitation, education as well as prevention of conditions commonly associated with particular sports.

  • Women’s health

This branch of physiotherapy revolves around issues faced specifically by women and is usually associated with reproductive health, childbirth, and postpartum care. These issues include conditions such as pelvic pain, prolapse, incontinence, lymphedema, osteoporosis, sexual dysfunctions, and other pregnancy-related conditions.

  • Back pain

Physical therapy is one of the most effective ways to treat back pain since it not only reduces pain but also reduces the chances for a future injury. Physiotherapy exercises and other treatment modalities help reduce inflammation, pain, and swelling as well as improve overall function and strength.

Benefits of physical therapy

  • Management of pain with reduced dependence on opioids. 
  • Decreased need for surgery.
  • Enhances joint mobility and movement.
  • It can speed up the recovery time.
  • Improves prognosis for patients with stroke or paralysis.
  • Improves balance in patients with Parkinson’s disease.
  • An important role in fall prevention in the elderly.
  • Improves geriartic care.
  • Sports physiotherapy helps enhance the performance of athletes through focused exercises and training.

Physical therapy also utilizes various electrophysical modalities for treatment such as:

  • Ultrasound therapy- This modality uses high-frequency sound waves to improve blood flow, decrease pain, and increases soft tissue mobility at the site of the tendon, muscle, or soft tissue injury.
  • Phonophoresis- It is a form of physiotherapy that uses ultrasound waves for the administration of topical medication such as steroids to reduce inflammation at the injury site.
  • Electrical nerve stimulation or E-stim- This involves the use of electrodes on the skin to enhance wound healing by improving blood flow, decreasing swelling and inflammation, and may decrease pain sensation at the spinal cord level. Research also shows that electrical nerve stimulation may reverse spinal cord injury by improving peripheral nerve function.
  • Thermotherapy- Application of heat, moist heat, or cold temperatures (cryotherapy) are used in the treatment of musculoskeletal and soft tissue injuries for pain management due to their effects on circulation, inflammation, and edema.
  • Phototherapy- This branch of physiotherapy uses special lights and lasers that affects hormones and chemicals in the brain regulating mood, behavior, and sleep and is useful in the treatment of mood disorders, and sleep disorders. Laser therapy uses light energy to target the site of injury and helps reduce pain and inflammation.

Dr. Anique Ali

 

References

  1. Jensen G, Gwyer J, Hack L, Shepard K. Expertise in physical therapy practice. Elsevier Inc.; 2007.
  2. Warden SJ, Fuchs RK, Castillo AB, Nelson IR, Turner CH. Exercise when young provides lifelong benefits to bone structure and strength. Journal of Bone and Mineral Research. 2007 Feb;22(2):251-9.
  3. Roerdink M, Lamoth CJ, Kwakkel G, Van Wieringen PC, Beek PJ. Gait coordination after stroke: benefits of acoustically paced treadmill walking. Physical therapy. 2007 Aug 1;87(8):1009-22.
  4. Chipchase LS, Williams MT, Robertson VJ. A national study of the availability and use of electrophysical agents by Australian physiotherapists. Physiotherapy theory and practice. 2009 Aug 8;25(4):279-96.