2. INTRODUCTION
Physiotherapy is a healthcare profession that works with people to identify and maximise
their ability to move and function. Functional movement is a key part of what it means to be
healthy. This means that physiotherapy plays a key role in enabling people to improve their
health, wellbeing and quality of life.
Physiotherapists use their professional knowledge and practical skills, together with thinking
skills and skills for interaction in their day-to-day practice. This combination of knowledge
and skills means that practitioners can work in partnership with the individual and other
people involved with that person. Physiotherapists recognise that physical, psychological,
social and environmental factors can limit movement and function. They use their knowledge
and skills to identify what is limiting an individual's movement and performance, and to help
individuals decide how to address their needs.
Physiotherapy's values means that practice is person-centred, ethical and effective. The
evidence-base underpinning physiotherapy is constantly evolving as practitioners develop
new knowledge and understanding through critical reflection, evaluation and research. This
evolving evidence base supports the use and development of physiotherapy's scope of
practice. The royal charter gives physiotherapy a broad scope of practice that includes manual
therapy, exercise and movement, electrotherapy and other physical approaches.
Physiotherapy is an autonomous profession. This means that physiotherapists can accept
referrals for assessment from a range of sources: from an individual themselves or from other
people involved with that individual. Physiotherapy can offer a range of interventions,
services and advice to improve individuals' health and wellbeing. Physiotherapy works to
maximise an individual's movement capability at three different levels. It can help maintain
and improve the body's movement and function by offering treatment when someone is
acutely ill in hospital. It can also improve someone's function and independence (at home, at
work) by offering rehabilitation and advice. It can also enhance their performance and
participation by offering advice and by challenging the environmental or social barriers that
limit participation.
ICAN COLLEGE
Page 2 of 10
3. Physiotherapy's strong clinical leadership and adaptable workforce means that it can deliver
high quality innovative services that are accessible, effective and efficient. Physiotherapy
maintains strong links between clinical and academic settings. This means that the profession
responds to developments in practice, education or research, and actively ensures its
workforce continues to be fit for purpose.
Physiotherapy plays an important role to rehabilitation the lost function of patient and
optimises patient function and well-being, to help integrate that patient back into their chosen
lifestyle activities whether at home, work or leisure. Rehabilitation should focus on changes
to functional disability and lifestyle restrictions based on the patient’s own goals for
functional improvement. Rehabilitation can be used for recovery from injury or disease and
also for the management of long-term conditions. Rehabilitation should start as soon as
possible to speed recovery. The programs that combine many different components are likely
to be most effective.19 minutes of additional exercise a day in an acute or rehabilitation
setting is all that is required to achieve to improved mobility and activity levels, shorter
length of stay in hospital and significantly improved quality of life back to normal.
Physiotherapy assessment, it is important to carry out a proper and thorough examination. A
correct diagnosis depends upon knowledge of functional anatomy, an accurate patient history,
diligent observation and a thorough examination. The purpose of the assessment is to fully
and clearly understand the patient's problems and the physical basis for the symptoms that
cause the patient to complain.
Initially, the physiotherapist will conduct a subjective examination where by information
regarding the mechanism of injury is obtained. Any history of previous injuries or conditions,
the patient's occupation or hobbies that may aggravate or be affected by the condition is also
obtained. Questions will be asked to determine the type and character of pain, and an effort
will be made to quantify this pain. You will be asked to rate this pain on a scale from 0 to 10,
0 being no pain, and 10 being so severe that you would seek out an emergency room. This is
a validated scale that provides outcome data unique to your condition and can be used as a
measure to determine quantitatively if your pain is getting better or worse. The subjective
examination is guided by the presenting system and complaint.
ICAN COLLEGE
Page 3 of 10
4. The objective assessment is guided by the history and the findings of the subjective exam. In
an orthopaedic assessment the physiotherapist will observe posture, patterns of movement,
any swelling, deformity, or asymmetry. Highly developed skills of palpation will identify
creditors, areas of heat, tenderness, or palpable deformity. The objective examination will use
quantifiable measures to establish base line measurements to monitor progress establish a
diagnosis and guide treatment intervention. Tests will be used to determine the type of tissues
involved, hypothesize a pathologic process, and guide the selection of exercise. Therapists
will use their clinical judgment with consideration of severity, irritability, acuity, and patient's
medical history when selecting tests. Often the outcome of one test will be a crucial factor in
the selection of additional assessment tools.
Through the use of all the assessment tools at our disposal, our physiotherapists can paint an
accurate picture of the patient's status and monitor progress and treatment planning.
ICAN COLLEGE
Page 4 of 10
5. Role of a Physical Therapist
Physical therapists (pts) are health care professionals who diagnose and treat individuals of
all ages, from newborns to the very oldest, which have medical problems or other healthrelated conditions that limit their abilities to move and perform functional activities in their
daily lives.
Pts 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, pts 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 people in a variety of settings, including hospitals, private
practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work
settings, and nursing homes. State licensure is required in each state in which a physical
therapist practices.
The Physical Therapy Profession
Physical therapy is a dynamic profession with an established theoretical and scientific base
and widespread clinical applications in the restoration, maintenance, and promotion of
optimal physical function. For more than 750,000 people every day in the United States,
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.
Prevent the onset, symptoms, and progression of impairments, functional limitations, and
disabilities that may result from diseases, disorders, conditions, or injuries.
The terms "physical therapy" and "physiotherapy," and the terms "physical therapist" and
"physiotherapist," are synonymous.
As essential participants in the health care delivery system, physical therapists assume
leadership roles in rehabilitation; in prevention, health maintenance, and programs that
promote health, wellness, and fitness; and in professional and community organizations.
Physical therapists also play important roles both in developing standards for physical
therapist practice and in developing health care policy to ensure availability, accessibility,
and optimal delivery of health care services. Physical therapy is covered by federal, state, and
private insurance plans. Physical therapists' services have a positive impact on health-related
quality of life.
As clinicians, physical therapists engage in an examination process that includes:
Taking the patient/client history,
Conducting a systems review, and
Performing tests and measures to identify potential and existing problems.
ICAN COLLEGE
Page 5 of 10
6. 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 practice. Based on their judgments about diagnoses and
prognoses and based on patient/client goals, physical therapists:
Provide interventions (the interactions and procedures used in managing and instructing
patients/clients),
Conduct re-examinations,
Modify interventions as necessary to achieve anticipated goals and expected outcomes, and
Develop and implement discharge plans.
Physical therapy can be provided only by qualified physical therapists (pts) or by physical
therapist assistants (pts) working under the supervision of a physical therapist.
Physiotherapy is practised by professionals that are concerned with improving a person’s
mobility and subsequently their quality of life. These professionals are tertiary-qualified and
highly trained. Physiotherapy is widely accessible with physiotherapists available in private
practices, sports facilities, hospitals, schools, workplaces, aged care facilities and more.
Techniques Employed
Physiotherapy is a drug-free therapy and some techniques that are employed include:
Joint mobilisation and manipulation
Exercise and stretches
Soft tissue massage
The use of electro physical agents such as ice, heat packs and ultrasound
Breathing exercises and techniques
Conditions Treated by a Physiotherapist
Physiotherapy is available to people of all ages – from infants to the elderly – and is an
important tool in the management of some conditions. Conditions that can be treated include:
Back and neck pain
Muscular pain and sports injuries
Neurological disorders such as stroke or Parkinson’s Disease
Rehabilitation after major accidents or injuries occur
Headaches
Incontinence
Recovery after surgery or childbirth
The management and prevention of chronic conditions such as asthma, diabetes,
arthritis, cardiovascular disease and chronic obstructive pulmonary disease (COPD)
ICAN COLLEGE
Page 6 of 10
7. The Benefits of Structural Therapies
All structural therapies aim to improve the way that the body moves, so that movement
becomes easier, posture is improved, and pain is minimised or eradicated all together. The
actual structure or framework of the body is being worked upon. As well as working on the
body, structural therapies also work on the mind, as they understand that the body and the
mind work together.
Undergoing treatment with a structural therapy is beneficial as movement, balance and
coordination are all improved. In fact, the key benefit of a structural therapy is the regaining
of the freedom of movement. Movement may have been previously restricted due to stress,
tension in the body, injuries, illnesses, or incorrect body posture or movement. Structural
therapies aim to track down the source of restriction or pain and eliminate it.
Level of health care
Primary health care
District hospitals, Health Clinics
Health Centers, Private Clinics
Rehab. Centre, Day Care Centre
Residential Home, Home Visit
School Visit
Health clinic
Secondary health care
E.g. Hospitals
Tertiary health care
E.g. Referral hospitals such as HUKM, Selayang Hospital
ICAN COLLEGE
Page 7 of 10
8. Settings in which physiotherapists work
Secondary & tertiary health care
-
State & referral hospitals
Primary health care
-
District hospitals
- Private practices
-
Health clinics & centre’s
- Education & research centre’s
-
Hopices
- Community settings – home, school
-
Nursing / residential homes
-
-
Sport institutions
-
Rehab.centres
-
Day care centre
Industries
International classification of impairments,
disabilities and handicaps (ICIDH)
Impairment
– Loss / abnormality of psychological, physiological or Anatomical function (decrease range
of motion of knee)
Disability
- Restriction or lack ( resulting from impairment )of ability to Perform an activity in the
manner or within the range Considered normal for a human being ( unable to squat )
Handicap
- Disadvantage for a given individual, resulting from Impairment / disability that limits or
prevents the fulfillment of a role that is normal for that individual (knee Stiffness contracture)
ICAN COLLEGE
Page 8 of 10
9. Therapy and rehabilitation services
1. Cognitive-Perceptual Training
Cognitive assessment activities to improve memory, attention span and perceptual
problems.
2. Home Visits Evaluation and Modification
Visitation to the home to ensure safety and comfort. Offer advice on modification when
indicated. Work place visit to ensure accessibility and safety.
3. School Visit
Discussion with school authority for any modification necessary. Reintegration to
community by visit to public places
4. Self Care Training and Retraining
Activities to improve grooming, hygiene, bathing, dressing and eating skills. Activities to
improve on work and home skills for example cooking, gardening and others.
5. Joint Protection Technique and Energy Conservation
Education Program Discuss and teach technique/principles to help persons with Arthritis
to cope with the demands of daily activities.
6. Hands/Upper Limbs Retraining Program
Active or assisted therapeutic activities to improve hand and upper limbs task
performance
ICAN COLLEGE
Page 9 of 10
10. Definition of team work
Team:
A group of people (health care team) who perform a particular job
(rehabilitation) together.
Team mate:
The other members of your health care team(i.e. other rehab. team members)
Team spirit:
Attitude / feeling of liveliness, energy, determination, pride and loyalty that
exists among the rehab. Team members and make them want their team to do
well or to be the best.
Team work:
Ability of rehab team to work well together.
Definition of networking
Defined as:
Opportunity to form possibly advantageous associations with other people
Importance of networking:
Usually people meet through industry events & practice
Being a Malaysian Physiotherapy Association (MPA) member have one
shared interest ‘physiotherapy‘
Easier to talk with an industry contact when we have the same start point and
are talking about common interests
Fundamentally most people are happy to help out others
ICAN COLLEGE
Page 10 of 10