Physiotherapy: A History
Tony Beecroft, February 2017
Physiotherapy, which is commonly called physical therapy in other countries, is a branch of science that primarily deals with physical medicine and physical rehabilitation. The process involves the use of mechanical movements and force to remediate impairments and help promote function, mobility, and quality of life. This is completed through the use of careful assessment, evaluation, diagnosis, prognosis, and physical intervention. The work is done by physiotherapists or physical therapists.
The practice is generally undertaken in local physiotherapy clinics, medical centres and hospitals. The physiotherapy profession encompasses activities and programmes including consultations, research, education, and administration. Physiotherapy services may be performed and conducted alongside, or together with, other relevant medical services.
With their degree-based healthcare profession, physiotherapists use their skills and knowledge to improve a wide range of conditions associated with various parts of the body including:
- Neuromusculoskeletal system (sports injuries, back pain), neurological system (multiple sclerosis, stroke)
- Respiratory system (chronic obstructive pulmonary disease, asthma)
- Cardiovascular system (rehabilitation after heart attack, chronic heart disease), and many others.
The History of Physiotherapy
The science of physiotherapy is believed to have been practised as early as 400 BC by Hippocrates and Galen physicians as they advocated manual therapy techniques, massage, and hydrotherapy methods in treating their patients.
In the eighteenth century, following the development of orthopaedics, the Gymnasticon was developed to help treat gout and similar conditions through systematic exercise of the joints, which was similar to other physiotherapy developments.
As a professional system, physiotherapy has its earliest documented origins that date back to the physical manipulation and exercise in 1813 as advocated by the father of Swedish gymnastics, Per Henrik Ling, the Royal Central Institute of Gymnastics’ founder.
In Swedish, the term sjukgymnast is used to refer to the physiotherapist or someone involved with treating those who are ill in gymnastics. Sweden’s National Board of Health and Welfare gave physical therapists official recognition in 1887, which triggered other countries to follow suit.
The Chartered Society of Physiotherapy was then organised by four nurses in Great Britain in 1894. In 1913, the School of Physiotherapy was opened at the University of Otago in New Zealand and the Reed College in Portland, Oregon, had reconstruction aide graduates in 1914. With the inception of the science of physical therapy, the concept of spinal manipulative therapy then became a major element of the practice.
It was toward the end of the nineteenth century when modern physical therapy was established. The growing popularity of physical therapy and relevant events that made a global impact called for immediate developments in the industry. Women were slowly being hired for physical education and the application of remedial exercises, following American orthopaedic surgeons getting an overwhelming number of cases with disabilities that needed the treatment. These physical therapy treatments were promoted and applied during the outbreak of polio in 1916.
Physiotherapy was institutionalised during the First World War, and women were recruited to help work with soldiers, providing physical therapy to help treat the injuries that they suffered from. In 1918, reconstruction aide then became the official term to refer to individuals practicing physical therapy.
With research serving as a catalyst for the physical therapy movement and with the outbreak of World War I, the first school of physical therapy was built at Walter Reed Army Hospital in Washington, D.C.
In 1921, the American Physical Therapy Association (originally Physical Therapy Association) was organised by Mary McMillan; the same year that “The PT Review,” the first physical therapy research, was published. Physical therapy was then pushed as a treatment for polio by Georgia Warm Springs Foundation in 1924. The treatment involved massage, exercise, and traction.
In the early 1950s, the British Commonwealth countries promoted the use of manipulative procedures to the spine and extremity joints. Simultaneous with the development of polio vaccines was the popularity of physical therapists rising across Europe and the North America.
Physiotherapists began to work outside the hospital premises in the late 1950s when they worked in outpatient orthopaedic clinics, local physio clinics, rehabilitation centres, medical centres, public schools, colleges/universities health-centres, among others.
It wasn’t until 1974 when specialisation for physical therapy began in the United States, and the Orthopaedic Section under the APTA likewise organised the physiotherapists to undergo specialisation in orthopaedics. The International Federation of Orthopaedic Manipulative Physical Therapists was likewise formed in the same year and has since then played a major role in the global development of the field of physiotherapy.