Are physiotherapists the exercise specialists of choice for people with long term conditions?

A genealogical perspective

INTRODUCING MEDICAL GYMNASTICS

1900 – 1920s

1908: Society introduces exam in Swedish Remedial Exercises 1920: Royal Charter ‘to improve the training, education & professional status of persons engaged in the practice of massage, medical gymnastics, electrotherapeutics or kindred methods of treatment & to foster & develop the use of these & kindred forms of treatment’.

RISE OF MEDICAL REHABILITATION

1930 – 1960s

1945: a new national curriculum

‘Physiotherapeutic methods of rehabilitation… classified as follows: (a) Individual Remedial Treatment - Massage, manipulations and movements Remedial exercises, including apparatus Electrotherapy Hydrotherapy (b) Group Remedial Exercises – Free, assisted or resisted by means of remedial apparatus Remedial games and equipment'.

(CSP, 1945. p3)

AUTONOMY & MOVEMENT

1970s

Hislop’s (1975) model of physiotherapy as a moving profession whose professional practice is underpinned by pathokinesiology

HSC(33)77: recognition of physiotherapy’s technical autonomy

Recognition of autonomy followed by rapid multiplication of exercise to work with ‘new’ client groups

EXPANSION & CONSOLIDATION

1980s

CSP’s 1984 curriculum defines physiotherapy practice as:

A systematic method of assessing musculo-skeletal, cardio-vascular, respiratory and neurological disorders of function including pain and those of psychosomatic origin and dealing with or preventing those problems by natural methods based essentially on movement, manual therapy and physical agencies.

(CSP, 1984. p2)

An autonomous problem-solving practitioner who can exercise people with complex/multiple needs

So what does our past produce in the present?

A physiotherapist has knowledge of: • Structure/function of the human body in

health, disease, disorder or dysfunction • Biological sciences • Physical sciences • Clinical sciences • Behavioural sciences Capacity for: • autonomous problem-solving practice Ability to: • meet ethical/legal/policy demands of

practice • maintain safety of practice environment

HCPC (2013) Standards of Proficiency – Physiotherapists

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