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Physiotherapy (also Physical Therapy) as referred to by the World Confederation for Physical Therapy (WCPT) is a healthcare profession concerned with human function and movement and maximising potential. It is concerned with identifying and maximising quality of life and movement potential within the spheres of promotion, prevention, treatment/intervention, habilitation and rehabilitation [1].

It uses physical approaches to promote, maintain and restore physical, psychological and social well-being, taking account of variations in health status. It is science-based, committed to extending, applying, evaluating and reviewing the evidence that underpins and informs its practice and delivery. The exercise of clinical judgment and informed interpretation is at its core [2].

Examples of definitions of physiotherapy from around the world indicate that there is a consensus that ‘movement’ is the core expertise/business of physiotherapy [3]

Physiotherapists and Physical Therapists (PTs) work in a wide variety of health settings to improve a broad range of physical problems associated with different ‘systems’ of the body. In particular, they treat neuromuscular (brain and nervous system), musculoskeletal (soft tissues, joints, and bones), cardiovascular and respiratory systems (heart and lungs and associated physiology).

Physiotherapists work autonomously, often as a member of a team with other health or social care professionals. Physiotherapy practice is characterised by reflective behaviour and systematic clinical reasoning, both contributing to and underpinning a problem-solving approach to patient-centred care.

People are often referred for physiotherapy by doctors or other health and social care professionals. Increasingly, as a result of changes in health care, people are referring themselves directly to physiotherapists without previously seeing any other healthcare professional.

Brief History

Physicians like Hippocrates and later Galenus are believed to have been the first practitioners of physiotherapy, advocating massage, manual therapy techniques, and hydrotherapy to treat people in 460 B.C.[4] After the development of orthopedics in the eighteenth century, machines like the Gymnasticon were developed to treat gout and similar diseases by systematic exercise of the joints, similar to later developments in physiotherapy.[5]

The earliest documented origins of actual physiotherapy as a professional group date back to Per Henrik Ling “Father of Swedish Gymnastics” who founded the Royal Central Institute of Gymnastics (RCIG) in 1813 for massage, manipulation, and exercise. In 1887, PTs were given official registration by Sweden’s National Board of Health and Welfare.

Other countries soon followed. In 1894 four nurses in Great Britain formed the Chartered Society of Physiotherapy.[6] The School of Physiotherapy at the University of Otago in New Zealand in 1913,[7] and the United States’ 1914 Reed College in Portland, Oregon, which graduated “reconstruction aides.”[8]

Research catalyzed the physiotherapy movement. The first physiotherapy research was published in the United States in March 1921 in The PT Review. In the same year, Mary McMillan organized the Physical Therapy Association (now called the American Physical Therapy Association (APTA).

Treatment through the 1940s primarily consisted of exercise, massage, and traction. Manipulative procedures to the spine and extremity joints began to be practiced, especially in the British Commonwealth countries, in the early 1950s.[9][10] Later that decade, PTs started to move beyond hospital-based practice, to outpatient orthopaedic clinics, public schools, college/universities, geriatric settings, rehabilitation centres, hospitals, and medical centres.

Specialization for physical therapy in the U.S. occurred in 1974, with the Orthopaedic Section of the APTA being formed for those physical therapists specializing in orthopaedics. In the same year, the International Federation of Orthopaedic Manipulative Therapy was formed, [11] and has played an important role in advancing manual therapy worldwide since.

History of Physiotherapy in Nigeria

Physiotherapy was introduced into Nigeria in 1945 by two British Chartered Physiotherapists; Miss Manfield and Mr. Williams. They were employed by the government of Nigeria and attached to the Royal (now National) Orthopaedic Hospital, Igbobi, Lagos[12]. Their primary assignments were; first, to treat wounded and disabled Nigerians soldiers who returned home from Burma and other countries during the Second World War. Secondly, they were to start a training programme in physiotherapy. The three-year diploma course was attended by a number of Nigerians. On completion of the training and passing out of the school, they were designated as Assistant Physiotherapists. They were specifically asked to work strictly under the supervision of Chartered Physiotherapists who had trained in England[12].

With time, the training programme at Igbobi was discontinued. Just before then, plans were in progress to start a diploma course at University College Hospital, Ibadan. This was later changed to the Bachelor of Science Degree in Physiotherapy at the University of Ibadan. The course took off in October 1966. The graduation of the foundation students in Ibadan in 1969 was a landmark in the annals of physiotherapy in Nigeria. Thus, University of Ibadan was the first in Nigeria and West Africa, to award a degree in physiotherapy [12].

In 1971, University of Lagos commenced a three-year diploma course, which was upgraded to Bachelor of Science Degree program in 1977. The University of Ife, Ile-Ife (now Obafemi Awolowo University) followed Ibadan and Lagos in 1977. The program at Ile-Ife was a four year Bachelor of Medical Rehabilitation. The University of Nigeria, Nsukka also commenced a degree programme in 1987. There is also a training programme at the Federal School of Physiotherapy, Kano affiliated with the Bayero University, Kano. Training programs have also been commenced at the University of Maiduguri and Nnamdi Azikiwe University, Nnewi[12].

Physiotherapy practice has spread all over the nation in the last five decades. Many of the products of our Universities are practicing as Physiotherapists in many establishments in the country and abroad. Some are lecturers in Universities in Nigeria and overseas. A sizeable number are in the United Kingdom, United States of America and Canada pursuing postgraduate courses and working to gain further experience and for a pecuniary purpose. Several Nigerian Physiotherapists are known to be in employment in Saudi-Arabia. The vogue at home has gradually shifted from working in teaching, state and specialized hospitals to venturing into private practices by a handful of practitioners[12].

Clinical Specialities

PTs tend to specialize in a specific clinical area. These include:

  • Cardiorespiratory: providing support, prevention, and rehabilitation for people suffering from diseases and injuries that affect the heart and lungs, such as asthma.
  • Oncology: treating, managing or preventing fatigue, pain, muscle and joint stiffness, and deconditioning.
  • Women’s health: addressing health issues surrounding pregnancy, birth, post-partum care, breastfeeding, menopause, bedwetting, prolapsed, loss of bladder or bowel control.
  • Musculoskeletal: preventing and treating clients with musculoskeletal conditions such as neck and back pain.
  • Neurological: promoting movement and quality of life in patients who have had severe brain or spinal cord damage from trauma, or who suffer from neurological diseases such as stroke, Parkinson’s disease, and multiple sclerosis.
  • Orthopaedics: helping patients prevent or manage acute or chronic orthopaedic conditions such as arthritis and amputations.
  • Pain: managing or preventing pain and its impact on function in patients.
  • Paediatrics: assists in early detection of health problems and uses a wide variety of modalities to treat disorders in the paediatric population.
  • Sports physiotherapy: deals with the management of sport injuries.
  • Geriatrics: focuses on optimizing function for the aging adult.

References

  1. WCPT. Policy statement: Description of physical therapy. http://www.wcpt.org/policy/ps-descriptionPT#appendix_1. Retrieved 18/06/2018.
  2. Chartered Society of Physiotherapy.”What is Physiotherapy?”. Chartered Society of Physiotherapy. http://www.csp.org.uk/director/public/whatphysiotherapy.cfm. Retrieved 20/06/2018.
  3. Jull, G; Moore, A. Physiotherapy’s Identity. Manual Therapy, Volume 18, Issue 6 , Pages 447-448, December 2013
  4. Wharton MA. Health Care Systems I; Slippery Rock University. 1991
  5. Sarah Bakewell, “Illustrations from the Wellcome Institute Library: Medical Gymnastics and the Cyriax Collection,” Medical History 41 (1997), 487-495.
  6. Chartered Society of Physiotherapy (n.d.). “History of the Chartered Society of Physiotherapy”. Chartered Society of Physiotherapy. http://www.csp.org.uk/director/about/thecsp/history.cfm. Retrieved 20/06/2018.
  7. Knox, Bruce (2007). “History of the School of Physiotherapy”. School of Physiotherapy Centre for Physiotherapy Research. University of Otago. http://physio.otago.ac.nz/about/history.asp. Retrieved 20/06/2018.
  8. Reed College (n.d.). “Mission and History”. About Reed. Reed College. http://www.reed.edu/about_reed/history.html. Retrieved 20/06/2018.
  1. McKenzie, R A (1998). The cervical and thoracic spine: mechanical diagnosis and therapy. New Zealand: Spinal Publications Ltd.. pp. 16–20. ISBN 978-0959774672.
  2. McKenzie, R (2002). “Patient Heal Thyself”. Worldwide Spine & Rehabilitation 2 (1): 16–20.
  3. Lando, Agneta (2003). “History of IFOMT”. International Federation Orthopaedic Manipulative Therapists (IFOMT). http://www.ifomt.org/ifomt/about/history. Retrieved 20/06/2018.
  4. Nigeria Society of Physiotherapy (2009). “History of Physiotherapy in Nigeria” https://nsphysio.org/history-physiotherapy-nigeria. Retrieved 26/06/2018.
  5. southvanphysio.com/what-is-physiotherapy. Retrieved 18/06/2018.