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[Maestro]

Dr. SURAJ KUMAR Dr V. P. Gupta
Lecturer, C.S.J.M. University, Superintendent Physiotherapy
Kanpur. A.I.I.M.S., New Delhi.

Physiotherapy means physiotherapeutic system of medicine which includes examination, treatment advice and instructions to any person preparatory to or for the purpose of or in connection with movement dysfunction, bodily malfunction, physical disorder, disability, healing and pain from trauma and disease, and mental conditions using physical agents including exercises, mobilization, manipulation, mechanical and electrotherapy, activity and devices or diagnosis, treatment and prevention.

These days the Physiotherapy profession has grown to acquire the form of a complete system of medicine on account on the bank of knowledge which has been acquired after through scientific and clinical research work. The therapeutic clinical Science each broadly composed of manual, mechanical and electrotherapy and achieves thermal, mechanical, chemical and electrical energy effects at cellular levels in tissue at different depths. These effects are regulated by the physiotherapists.

The physiotherapists skills are many times required in the health care team in most disciplines in medicine including surgery, neurology, orthopedics, gynecology, obstetrics, dermatology, ENT, cardiothoracic, vascular surgery, burns, plastic surgery, pediatrics, rehabilitation and sports medicine, etc.

Nature of Physiotherapy: -

Physical therapy is about working with people and population to maintain restore maximum movement and functional ability through out the life span .physical therapy is particularly important in circumstances where movement and function are threatened by the process of aging or that of injury or disease .It is concerned with identifying and maximizing movement potential with in the spheres of promotion ,prevention, treatment and rehabilitation .
The process of physical therapy, which is the service, provided by, or under the direction and supervision of a physical therapist includes assessment, diagnosis, planning, intervention and evaluation.
Assessment includes both the examination of individuals or groups with actual or potential impairments, functional limitations, disabilities, or other conditions of health by history taking, screening and the use of specific tests of and examination through analysis and synthesis within a process of clinical reasoning
Diagnosis arises from the examination and evaluation and represents the outcome of the process of the clinical reasoning. This may be expressed in terms of movement dysfunction or may encompass categories of impairment, functional limitations, abilities or disabilities or syndromes.
A planning begins with determination of the need for intervention and normally leads to the development of a plan of intervention, including measurable outcome goals negotiated in collaboration with the patient or client family or caregiver. Alternatively it may leads to referral to another agency in cases, which are inappropriate for physical therapy.
Intervention 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 aids and appliances, patients related instruction, documentation and coordination and communication. Intervention may also be aimed at prevention of impairments, functional limitations, disabilities and injury including the promotion and maintenance of health, quality of life and fitness in all ages and populations.

Purpose of Physiotherapy: -

The purpose of physiotherapy is to decrease body dysfunctions, reduce pain caused either by trauma, inflammation, degeneration and surgery. The various conditions in which physiotherapy is useful are as follows-
1) After correct and firmly management of a fracture, return to normal function is possible with simple methods of physiotherapy. It allows for regain of full joint movements and muscles power after healing of a fracture.
2) In joints and soft tissue injury rapid repair of damaged tissue occurs with quick reduction of pain and swelling.
3) Restoration of full joint movements with reduction of pain and deformity is possible in various kinds of joint diseases like osteoarthritis, rheumatoid arthritis juvenile arthritis etc.
4) In degenerative disease of spine, physiotherapy arrests the progress of disease as in cervical spondylosis, ankylosing spondylosis. Suitable arthroses are also provided for giving support to spine. It also has a major role to play congenital disease of spine like spina-bifida.
5) Chest physiotherapy has a vital role to play in medical and surgical conditions like bronchial asthma, chronic obstructive lungs disease, pneumothorax but also surgical procedures involving spine, pelvis, extremities and abdomen.
6) In hemiplegia or paraplegia physiotherapy greatly helps the patient to gradually increase his mobility.
7) In children physiotherapy is assuming real importance in children with cerebral palsy, spina-bifida, clubfoot, muscular dystrophy etc.
8) It easies labor and return to normal after delivery. It is also useful in gynecological problems like incontinence, prolepses of uterus, pelvis inflammatory disease.
9) Sports medicine- A physiotherapist is mandatory for any sport event. He maintains the fitness of sports person and provide first aid in case of various sports injuries.



The aims of Physiotherapy education are:-
1. To produce the Physiotherapists with basic knowledge and skill.
2. To enable them to recognize the disease, traumatic, physical and mental conditions affecting health.
3. Take steps to prevent such diseases.
4. To treat such diseases scientifically.
5. To be able to recognize and referred patients for the timely intervention of other healthcare professional specialized in the area of investigation and skilled treatment.
6. Must be capable of undertaking further study and advancing the knowledge and be able with further training to undertake teaching, research and practice.

Scope of physiotherapy: -

Physical therapy is an essential part of health. Service delivery system and is often undertaken within interdisciplinary rehabilitation or habilitation programmes for the restoration of optimal function and quality of life in individuals with loss and disorder of movements. However, physical therapists also work independently as other health care workers and are guided by their own code ethical principals.

Physical therapists practiced in: -