Emerging Responsibility of a Physiotherapist in the Healthcare System for an Individual, Family, Community and Country

Muhammad Farhan Sarwar¹, Muhammad Taimoor Khalid¹, Muhammad Haroon Sarwar², Muhammad Sarwar^{3, *}

¹Department of Physical Therapy, University of Sargodha, Lyallpur Campus, Faisalabad, Punjab, Pakistan

²Faculty of Medicine and Allied Medical Sciences, Isra University, Hyderabad, Sindh, Pakistan

³Department of Plant Protection, Nuclear Institute for Agriculture & Biology (NIAB), Faisalabad, Punjab, Pakistan

Abstract

Health is not purely the nonappearance of disease or sickness, but it is a state of absolute bodily, mind and societal comfort of a person. There are different experts to guide the ways to maintain a good health including personal fitness trainers, exercise physiologists, nutritionists, medical experts and many more professionals. In the world of health experts, Physical therapists also known as Physiotherapists in most countries are an essential part of the team of health professionals who run the health related programs. This article is based on an extensive literature searches and critical appraisal that characterizes and provides to Physiotherapists and other Clinicians with carefully assembled summaries of evidence, effects and interventions in the management of health problems. Physical therapists are healthcare professionals who diagnose and treat individuals of all ages from newborn to the very oldest, facing medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. Physiotherapists examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function and prevent disability. In addition, these healthcare professionals work with individuals to prevent the loss of mobility before it occurs by developing fitness and wellness oriented programs for healthier and more active lifestyles. Physical therapists provide care for peoples in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. Physiotherapists help to the peoples affected by injury, illness or disability through movement and exercise, manual therapy, education and advice. They supervise patient's progress and make adjustments for treatment of plans as needed. These therapists can help to patients to maintain or restore flexibility, strength and range of motions. State’s licensure is required in each country in which Physical therapists practice and must obtain a license for practicing from the state in which they work. If a person has a medical emergency, he should always speak with a qualified Physician immediately before start, stop and change of any prescribed treatment or a part of care plan.

Keywords

Physiotherapist, Physical Therapist, Physiotherapy, Physician, Health Professional

Received:May 28, 2015
Accepted: June 17, 2015
Published online: July 24, 2015

@ 2015 The Authors. Published by American Institute of Science. This Open Access article is under the CC BY-NC license. http://creativecommons.org/licenses/by-nc/4.0/

1. Introduction

A good health is of fundamental importance for an individual, family, community and country, while a deprived health is a cause of poor quality of life. Health is an energetic practice for peoples since it is constantly changing. Every persons have the times of fine health, times of illness and may be even times of serious sickness. Because our lifestyles change, so does our level of health, and those of us who take part in normal physical actions do so somewhat to get better the current and future level of health (Sarwar et al., 2013; 2015; Sarwar et al., 2013; 2014). Health and illness can co-exist, as even peoples with multiple chronic diseases or terminal illnesses can consider themselves healthy. Some studies have shown that a lack of neighborhood recreational spaces including natural environment leads to lower levels of personal satisfaction and higher levels of obesity, linked to lower overall health and wellbeing. An increasing number of studies and reports from different organizations and contexts examine the linkages between health and different factors, including lifestyles, environments, health care organization, and health policy (Housman and Dorman, 2005; Bjork et al., 2008; Vogele, 2013).

Eating a balanced dietary supplements including vitamins, minerals, herbals and botanicals, amino acids, enzymes, and other products as diet, and trying to stay as active as possible can help to have an excellent general health. The latest health news and wellbeing advice including family health, alternative medicine, diet and fitness are necessary for overall health and for managing some health conditions. The majority of peoples in the various states take one or more dietary supplements either every day or occasionally. Good sources of information on health include the consulting to a health expert that is a good way to keep active and it needs more study to determine their values. Finding of a gym with staff is encouraging step towards healthcare and it gives a flexible exercise program (Leary, 1997; Bennell et al., 2000).

2. Education Qualifications of Physiotherapist

Education qualifications and educational criteria for Physical therapy provider experts vary from state to state and from country to country, and among various levels of professional responsibility. It is carried out by Physical therapists (known as Physiotherapists in most countries) and Physical therapist assistants (known as Physical rehabilitation therapists or Physiotherapy assistants in some countries). The span of education ranges from some countries having little formal education to others requiring bachelor, master or doctoral degrees. Physiotherapists or Physical therapists must complete a F. Sc. (O level) class before enrolling in a bachelor's degree or Doctor of Physical Therapy (DPT) degree program from an accredited college or university which may be conferred upon successful completion of a professional syllabus. Following admission, Physical therapy students learn on a Bachelor of Science level with a major in Physical therapy and rehabilitation. The 5-years degree programs include courses in gross anatomy and applied physiology along with a hands-on practical experience requirement. Graduates who obtain their bachelor's degree must successfully pass the membership examination to become member of the professionals. The typical time frame for completion of a house job of Physical therapy is 1 year after earning a bachelor's degree. Students must then enter Post graduate school to complete a Master or Master of Philosophy (M. Phil.) degree in Physical therapy, which normally requires two years of study. The research in Master of Science (M. Sc.) and Doctor of Philosophy (Ph. D.), programs is available at some university. Aside from academic research, practitioners can upgrade their skills and qualifications through continuing education courses and curriculums. Continuing education is a requirement of the provincial regulatory bodies. Physiotherapists can pursue their education in such fields as rehabilitation sciences, sports medicine, kinesiology and physiology. There are few Physiotherapy Associations which are offering a curriculum of continuing education courses in orthopedics and manual therapy. Physiotherapists are considered leaders in the field, having extensive post-graduate education in orthopedics and manual therapy. In Pakistan there are more than 20 colleges offering DPT, 3 universities are offering DPT., 2 universities are offering M. Phil., in Physiotherapy and 1 university offering Ph. D., in Physiotherapy.

3. Physical Therapy Assistants or Technicians-Aides

Some jurisdictions allow Physical therapists to employ technicians or therapy assistants or aides to perform designated routine tasks related to Physical therapy under the direct supervision of a Physical therapist. Some jurisdictions require Physical therapy technicians or aides to be certified, and education and certification requirements vary among jurisdictions greatly country by country. Physical therapist aides may deliver treatment and physical interventions for patients and clients under a care plan established and under the supervision of a Physical therapist. Physical therapist assistants are trained under associate of applied sciences curricula specific to the profession, and are accredited to two years Associate degree programs for Physical therapy. Curricula for the Physical therapist assistant associate degree include, Anatomy, Physiology, Exercise physiology, Human biology, Physics, Biomechanics, Kinesiology, Neuroscience, Clinical pathology, Behavioral sciences, Communication, Ethics, Research and other coursework as required by individual programs (Fact Sheet, 2010-2011; Summary Report for 31-2021.00, 2012; 31-2022.00, 2012).

4. Physiotherapy and Physiotherapist

Physiotherapy or Physical therapy (often abbreviated to PT) also known as Movement Science is a rehabilitation profession that remediates impairments and promotes mobility, function, and quality of life through examination, diagnosis, prognosis, and physical interventions (therapy using physical agents, mechanical force, adaptive devices, and movements). It is carried out by Physical therapists (known as Physiotherapists or Physical rehabilitation therapists in most countries). In addition to clinical practice, other activities encompassed by Physiotherapists include research, education, consultation and administration. In many settings, the services of Physiotherapists may be provided alongside or in conjunction with other medical services. Physiotherapists (Physios) are an essential part of the team of healthcare professionals that run the health related programs. Physiotherapists help to peoples affected by injury, illness and disability through movement and exercise, manual therapy, education and advice. When a person sees to a Physio, he will assess the problem of the patient and gives advice. Some Physios are highly-skilled in neurological conditions, so it is a checking by a specialist and they may give a physical treatment to patient.

When a person’s function or mobility is affected by pain, ageing, injury, disease, disability or long periods of inactivity, the Physiotherapist is the health professional qualified to complete a full medical check-up of the patient. This check-up focuses on the person as a whole that the Physiotherapist will consider not only the physical but also the psychological, emotional and social wellbeing of each patient with the view to reaching a diagnosis and developing the most appropriate treatment plan. Physiotherapists have their in-depth anatomical and physiological knowledge of the body and movement, and they promote wellbeing, mobility and independence in peoples of all ages (Jette, 1994; Critchley et al., 2007; Dean, 2009).

5. Responsibilities and Duties of Physical Therapist

Physiotherapists have a role to play in unhealthy conditions through exercise prescription, therapeutic modalities, specific techniques and education. Appropriate treatment goals can be established following a thorough assessment of signs and symptoms, risk factors and functional status as stated below:-

1.    Initiate appropriate Physiotherapy intervention programs for patients or clients suffering from immobility.

2.    Assess and evaluate physical disabilities caused by neurological disorders, stroke, diseases or injuries.

3.    Bring wellness and mobility in physical disabilities caused by injuries, stroke or other neurological disorders through Physiotherapy treatment programs.

4.    Handle pain and physical problems caused by illnesses, disabilities and injuries.

5.    Manage and treat patients with disabilities in home and community care.

6.    Collaborate with multidisciplinary teams to provide patient care and comfort.

7.    Maintain and update patient records and documents.

8.    Provide quality Physiotherapist treatment to the highest possible levels.

9.    Consult and collaborate with consulting Physicians and other medical professionals in providing Physiotherapy treatments.

10.    Being active expert can really help to stay mobile, independent and may offer exercise for some conditions.

11.    Teach patients and their families about self-care treatment interventions.

12.    Offer advice before and after an operation, as a help to walk properly and make sure the patients are recovering well.

Physiotherapy is a science-based profession and takes a ‘whole person’ approach to health and wellbeing, which includes the patient’s general lifestyle. At the core is the involvement of patients in their own care, through education, awareness, empowerment and participation in their treatment. Physiotherapists are the important health professionals like those of doctors and nurses. They work in the national health units, in private practice, for charities and in the work place, through occupational health schemes. Physical activity and exercise advised by Physios can be helpful on how to become more active and suitable for personal activities during specific circumstances. They maintain health for peoples of all ages, helping patients to manage pain and prevent disease. These professionals help to encourage development and facilitate recovery, enabling peoples to stay in work while helping them to remain independent for as long as possible (Wilson et al., 2009).

Physiotherapists help to peoples with the problems of back pain or sudden injury, managing long-term medical condition such as asthma, and in preparing for childbirth or a sporting event. Physiotherapist is a degree-based healthcare professional and can use his knowledge and skill to improve a range of conditions associated with different systems of the body, such as, neurological (stroke, multiple sclerosis) neuromusculoskeletal (back pain, whiplash associated disorder, sports injuries, arthritis) cardiovascular (chronic heart disease, rehabilitation after heart attack) and respiratory (asthma, chronic obstructive pulmonary disease, cystic fibrosis). Physiotherapists work in a variety of specialists in health and social care. Additionally, some Physiotherapists are involved in education, research and service management. When persons see Physios, they can assess their problems and give advice; they may give a physical treatment and can have a good look at how someone moves. Physios have to perform the largest responsibilities like Doctors and other health care experts. They involve in official and private practices, for charities and in the work-place through occupational health schemes. Physiotherapists have been shown to work through clinical studies and research and it is a treatment and profession upon which peoples can trust. A person can takes benefits from Physiotherapists at any time in his life time (Cameron et al., 2005; Taylor et al., 2007).

6. Role of a Physical Therapist

Physiotherapists are dynamic experts with an established theoretical and scientific base and widespread clinical applications in the restoration, maintenance, and promotion of optimal physical function. Physiotherapists help and treat peoples with physical problems caused by illness, accident or ageing. A Physiotherapist's core skills include manual therapy, therapeutic exercise and the application of electro-physical modalities. They also have an appreciation of psychological, cultural and social factors influencing their clients. For millions of peoples every day, Physical therapists diagnose and manage movement dysfunction and enhance physical and functional abilities; restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health; and prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, abnormal conditions or injuries (Wang et al., 2011).

The services of Physical therapists have a positive impact on health-related quality of life. As Clinicians, Physical therapists engage in an examination process that includes taking the patient or client history, conducting a systems review, and performing tests and measures to identify potential and existing problems. To establish diagnoses, prognoses and plans of care, Physical therapists perform evaluations, synthesizing the examination data and determining whether the problems to be addressed are within the scope of Physical therapist’s practice. Based on their judgments about diagnoses and prognoses and based on patient or client goals, Physical therapists provide interventions (the interactions and procedures used in managing and instructing patients or clients), conduct re-examinations, modify interventions as necessary to achieve anticipated goals and expected outcomes, and develop and implement to discharge plans (Miller et al., 2010; Michael et al., 2010).

Physiotherapists usually work as part of a team of health and social care professionals who will help to patients for plan how to look after themselves and best manage the life they would like to lead. They will discuss with patients the priorities and plan how to manage their conditions, offer advice based on individual needs, which may include how to prevent falls, exercises to maintain body balance, strength and flexibility, and techniques to help with walking and general fitness. As patients get older, and as the condition progresses, Physiotherapist will support them in making decisions about how they can cope with these changes. Physical activity is important for strengthening of muscles, improving mobility and keeping fit. It can also help to feel on top of things, and a regular exercise routine can reduce stress, anxiety and low mood. This can help to persons to stay active and manage the condition. Physiotherapists as member of healthcare team can provide with a rehabilitation program to help to become as mobile and as independent as possible. As part of rehabilitation, Physio will provide treatment tailored to specific needs of patients (American Physical Therapy Association, 2003).

A Physiotherapist may also work in outpatients department, intensive care, women health, elderly care, stroke services, orthopedics, mental health and learning disability services, occupational health, and pediatrics. It involves the interaction between a Physical therapist or Physiotherapist, patients or clients, other health professionals, families, care givers, and communities in a process where movement potential is assessed and goals are agreed upon, using knowledge and skill unique to Physical therapists. Physiotherapists use an individual's history and physical examination to arrive at a diagnosis and establish a management plan, and when necessary, incorporate the results of laboratory and imaging studies. Electrodiagnostic testing (e.g., electromyograms and nerve conduction velocity testing) may also be of assistance. Physiotherapist’s management commonly includes prescription or assistance with specific exercises, manual therapy, education and other interventions. Physical therapists also practice in non-patient care roles such as health policy, health insurance, healthcare administration and as healthcare executives. Physical therapists are involved in the medical-legal field serving as experts, performing peer review and independent medical examinations (Adam et al., 2010; Chen and Rimmer, 2011).

7. Career Prospects

Once Physiotherapists have completed a pre-registration program in physiotherapy and have registered with the Health Council, they can normally be in a position to apply for jobs. Once Physiotherapists have some clinical experience, they can specialize in any one of a range of areas, such as orthopedics, obstetrics or working with older peoples. Or else Physiotherapists can go into research or teaching, or gain promotion to a more senior Physiotherapy post as well as can also move into health service management.

Job vacancies for Physiotherapists and Physiotherapy assistants or clinical support workers are advertised in a range of places such as newspapers, Jobs website, Journals and on trust websites. In Pakistan, Physiotherapists have a good scope in government and private hospitals and they are awarded 17 grade pay scales (Gazetted Officer). In this way, Pakistan has become in the rank of top countries offering DPT degree and job in the world.

8. Conclusion

The terms "Physical therapy" and "Physiotherapy," and the terms "Physical therapist" and "Physiotherapist," are synonymous. Physical therapy is a primary care health profession, it is performed by a Physical therapist (PT) or Physiotherapist (Physio), and sometimes services are provided by a Physical therapy assistant (PTA) acting under the direction of Experts. The observations that can be made from cohort and other observational or qualitative studies show that Physiotherapists have the potential to provide guidance to design interventions, studies, making the reviews that assess and improve health, and increasing relevance to the daily practice of Physiotherapy. Physiotherapists help to patients with physical difficulties resulting from illness, injury and disability through movement and exercise, manual therapy, education and advice. Working with patients, Physiotherapists identify and improve their movement and function. When Physiotherapists see to patients, they can assess their problems and give health advice. Some Physios are highly skilled in neurological conditions, so, they may give a physical treatment to a person. Physiotherapists or Physical therapists help to accident victims, medical patients and chronically disabled peoples to maintain and improve their physical wellbeing by designing, implementing and supervising custom treatment plans. This check-up of Physiotherapist focuses on the person as a whole, by considering not only the physical but also the psychological, emotional and social wellbeing of each patient with the view to reach a diagnosis and developing the most appropriate treatment plan. Physiotherapists provide services to individuals and populations to develop, maintain and restore maximum movement and functional ability throughout the lifespan. This includes providing services in circumstances where movement and function are threatened by aging, injury, disease or environmental factors. Functional movement is central to what it means to be healthy. On the way to varying health problems, this review serves as the basis for informing the practices and provision of Physiotherapy services to patients with chronic diseases. It also highlights the crucial areas of research that require further exploration. The communities should never delay or disregard seeking professional medical advice from Doctor or other qualified healthcare providers because of something a person has read or understood that reading individually can be a helpful resource, but it is never a substitute for professional medical advice, diagnosis or treatment from a qualified healthcare provider.

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