- The document provides an introduction to physiotherapy practice, covering its history from World Wars I and II and polio epidemics leading to increased demand, as well as its nature and scope worldwide and in Malaysia. - It describes the key areas physiotherapists work in including promotion, prevention, assessment, treatment, rehabilitation, and habilitation. It also outlines where physiotherapists typically practice and their responsibilities in diagnosis, referral, and determining treatment outcomes.

2. INTRODUCTION TO
PHYSIOTHERAPY
PRACTICE
AVANIANBAN CHAKKARAPANI
Lecture 5
6.2.2015
8.30 to 9.30 am, LT2

3. PHYSIOTHERAPY/
PHYSICAL THERAPY

4. Contents
1. The nature and scope of Physiotherapy practice, world
wide and in Malaysia.
2. Boundaries of professional competence and making
referral.
3. Inter-professional approaches to health care delivery.
4. Team-working and cross-professional collaboration and
communication.

5. THE NATURE AND SCOPE OF
PHYSIOTHERAPY PRACTICE, WORLD
WIDE AND IN MALAYSIA.

6. HISTORY
World War I
28 July 1914 and lasted until 11
November 1918
World War II
from 1939 to 1945
Poliomyelitis

7. WORLD WAR
WORLD WAR I

8. HISTORY
 American physical therapists formed their first professional
association in 1921.
 American Women's Physical Therapeutic Association.
 Led by President Mary McMillan.
 By the end of the 1930s
 The Association changed its name to the American
Physiotherapy Association.
 Men were admitted, and membership grew to just under
1,000.

9. WORLD WAR II

11. POLIO

12. 3 CONSEQUENCES
 With the advent of World War II and a
nationwide polio epidemic during the 1940s and 1950s.
 Physical therapists were in greater demand.
 The Association's membership swelled to 8,000, and the
number of physical therapy education programs across the
US increased from 16 to 39.

13. What is Physical Therapy
 Physical therapists have
different titles in different
countries.
 Many countries they are
called physiotherapists.
 Physical therapist.
 Kinesiologist.

14. What is Physical Therapy
 Physical therapists provide services
that develop, maintain and restore
people’s maximum movement and
functional ability.
 They can help people at any stage of
life, when movement and function are
threatened by ageing, injury,
diseases, disorders, conditions or
environmental factors.
 Physical therapists help people
maximise their quality of life, looking
at physical, psychological, emotional
and social wellbeing.

15. What is Physical Therapy
They work in the health spheres of ;
 PROMOTION;
 PREVENTION;
 ANALYSIS/ DIAGNOSIS ;
 TREATMENT/INTERVENTION;
 HABILITATION AND REHABILITATION.

16. PROMOTION
Promoting the health and
well being of individuals and
the general public/society,
emphasizing the importance
of physical activity and
exercise.

17. PREVENTION
Preventing impairments, activity
limitations, participatory restrictions
and disabilities in individuals at risk
of altered movement behaviors due
to health or medically related
factors, socio-economic stressors,
environmental factors and lifestyle
factors.

18. ANALYSIS/ DIAGNOSIS
 Diagnosis and prognosis arise from the examination and
evaluation and represent the outcome of the process of
clinical reasoning and the incorporation of additional
information from other professionals as needed.
 This may be expressed in terms of movement dysfunction
or may encompass categories of impairments, activity
limitations, participatory restrictions, environmental
influences or abilities/disabilities.

19. TREATMENT & INTERVENTION
Intervention/treatment is implemented
and modified in order to reach agreed
goals and may include manual handling;
movement enhancement; physical,
electro-therapeutic and mechanical
agents; functional training; provision of
assistive technologies; patient related
instruction and counseling;
documentation and co-ordination, and
communication. Intervention/treatment
may also be aimed at prevention of
impairments, activity limitations,
participatory restrictions, disability and
injury including the promotion and
maintenance of health, quality of life,
workability and fitness in all ages and
populations.

20. HABILITATION
The process of supplying a
person with the means to
develop maximum
independence, in the
Activities of Daily Living
through training or
treatment.
Mosby's Medical
Dictionary/8th edition/
2009/ Elsevier.

21. REHABILITATION
The physical restoration of a
sick or disabled person by
therapeutic measures and re-
education to participation in
the activities of a normal life
within the limitations of the
person's physical disability.

22. What a Physical Therapist can do?
 undertake a comprehensive examination/assessment of the
patient/client or needs of a client group.
 evaluate the findings from the examination/assessment to make
clinical judgments regarding patients/clients.
 formulate a diagnosis, prognosis and plan.
 provide consultation within their expertise and determine when
patients/clients need to be referred to another healthcare
professional.
 implement a physical therapist intervention/treatment programme.
 determine the outcomes of any interventions/treatments.
 make recommendations for self-management.

23. SCOPE OF PHYSICAL THERAPY
PRACTICE

24. SCOPE OF PHYSICAL THERAPY PRACTICE
The scope of physical therapy practice is not limited to direct patient/client care, but
also includes:
 public health strategies
 advocating for patients/clients and for health
 supervising and delegating to others
 leading
 managing
 teaching
 research
 developing and implementing health policy, locally, nationally and internationally

25. SCOPE OF PHYSICAL THERAPY PRACTICE
 Physical therapists operate as independent practitioners, as well as
members of health service provider teams, and are subject to the ethical
principles of WCPT.
 They are able to act as first contact practitioners, and patients/clients may
seek direct services without referral from another health care professional.
 The education and clinical practice of physical therapists will vary
according to the social, economic, cultural and political contexts in which
they practice.
 However, it is a single profession, and the first professional qualification,
obtained in any country, represents the completion of a curriculum that
qualifies the physical therapist to use the professional title and to practise
as an independent professional.

26. Where is physical therapy practised?
 Physical therapy is an essential part of the health and
community/welfare services delivery systems.
 Physical therapists practise independently of other health
care/service providers and also within interdisciplinary
rehabilitation/habilitation programmes that aim to prevent
movement disorders or maintain/restore optimal function
and quality of life in individuals with movement disorders.
 Physical therapists practise in a wide variety of settings.

27. Where is physical therapy practised?
 Hospitals
 Hospices
 Nursing homes
 Geriatric care centres
 Physiotherapy clinic
 Community settings
 Health/fitness/sports clubs
 Education institutions and research

28. Boundaries of professional competence and making referral
 An integral part of physical therapy is interaction between the physical
therapist and the patient/client/family or caregiver to develop a
mutual understanding.
 This kind of interaction is necessary to change positively the body
awareness and movement behaviours that may promote health and
wellbeing.
 Members of inter-disciplinary teams also need to interact with each
other and with patients/clients/family and caregivers to determine
needs and formulate goals for physical therapy
intervention/treatment.
 Physical therapists also interact with administration and governance
structures to inform, develop and/or implement appropriate health
policies and strategies.

29. Boundaries of professional competence and making referral
 Diagnosis in physical therapy is the result of a process of clinical
reasoning that results in the identification of existing or potential
impairments, activity limitations, participation restrictions,
environmental influences or abilities/disabilities.
 The purpose of the diagnosis is to guide physical therapists in
determining the prognosis and most appropriate
intervention/treatment strategies for patients/clients and in sharing
information with them.
 In carrying out the diagnostic process, physical therapists may need
to obtain additional information from other professionals.
 If the diagnostic process reveals findings that are not within the scope
of the physical therapist’s knowledge, experience or expertise, the
physical therapist will refer the patient/client to another appropriate
practitioner.

30. Bibliography
 World Confederation for Physical Therapy. WCPT guideline for the development of a
system of legislation/regulation/recognition of physical therapists. London, UK:
WCPT; 2011.
 World Confederation for Physical Therapy. Policy Statement: Regulation of the
physical therapy profession. London, UK: WCPT; 2011.
 World Confederation for Physical Therapy. Ethical principles. London, UK: WCPT;
2011.
 World Confederation for Physical Therapy. Policy statement: Ethical responsibilities
of physical therapists and WCPT members. London, UK: WCPT; 2011.
 World Confederation for Physical Therapy. Policy Statement: Direct access and
patient/client self-referral to physical therapy. London, UK: WCPT; 2011.

31. Bibliography
 World Confederation for Physical Therapy. WCPT guideline for physical therapist
professional entry level education. London, UK: WCPT; 2011.
 World Confederation for Physical Therapy. Policy statement: Education. London, UK:
WCPT; 2011.
 World Confederation for Physical Therapy. Policy statement: Autonomy. London,
UK: WCPT; 2011.
 World Health Organization. Preamble to the Constitution of the World Health
Organization as adopted by the International Health Conference, New York, 19-22
June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official
Records of the World Health Organization, no. 2, p. 100) and entered into force on
7 April 1948. Geneva, Switzerland: WHO; 1948.
 World Health Organization. International Classification of Functioning, Disability and
Health. Geneva, Switzerland: WHO; 2001.

32. Bibliography
 World Confederation for Physical Therapy. Policy statement: Support personnel for
physical therapy practice. London, UK: WCPT; 2011.
 Department of Health. Self-referral pilots to musculoskeletal physiotherapy and the
implications for improving access to other AHP services. London, UK: Department of
Health; 2008.
 American Physical Therapy Association. Guide to Physical Therapist Practice.
Physical Therapy. 1997;77(11):1168-650.
 American Physical Therapy Association. Guide to Physical Therapist Practice.
Second Edition. American Physical Therapy Association. Physical Therapy2001. p.
9-746.
 World Health Organization. The International Classification of Functioning, Disability
and Health – ICF. Geneva: World Health Organization; 2001.

33. Thank You