Quality in Primary Care Open Access

Introduction

Physical therapy (PT), also known as physiotherapy, is one of the healthcare professions. Physical therapy is provided by physical therapists who promote, maintain, or restore health through physical examination, diagnosis, prognosis, patient education, physical intervention, rehabilitation, disease prevention and health promotion. Physical therapists are known as physiotherapists in many countries. Physical therapy addresses the illnesses or injuries that limit a person's abilities to move and perform functional activities in their daily lives[1]. PTs use an individual's history and physical examination to arrive at a diagnosis and establish a management plan and, when necessary, incorporate the results of laboratory and imaging studies like X-rays, CT-scan, or MRI findings. Electrodiagnostic testing (e.g., electromyograms and nerve conduction velocity testing) may also be used [2]. There are strong recommendations for the intensity and frequency of physical activity that everyone should aim to achieve throughout the lifespan to maintain health. Being active and keeping active are important whether one is young or old, able bodied or disabled, male or female. Physical activity and exercise not only maintain fitness, they also improve mental health. The NICE guidance [3], for professionals in the health service, local authorities and the voluntary sector, focuses on four methods of getting adults to be physically active: (i) Brief interventions – advice delivered by GPs and other nonhospital-based health professionals (ii) Exercise referral schemes- referral to a tailored physical activity programme (iii) Pedometers – use of a device to measure how far you have walked (iv) Walking and cycling schemes. The focus of all these governments’ campaigns is public health, with increasing efforts on preventative measures and reducing the need for treatment of Non Communicable Diseases such as obesity, high blood pressure and diabetes. The increased incidence of such diseases has been seen in the context of changing lifestyles over time. A fundamental cause of this trend is believed to be that people’s everyday activity has been significantly reduced compared to previously. A study of health enhancing physical activity across Europe (2006) (using the International Physical Activity Questionnaire, (IPAQ) found that over two-thirds (71%) of the adult population are insufficiently active to acquire optimal health benefits. Sufficient physical activity for health enhancement ranged from 44% of the population in the Netherlands to 23% in Sweden [4]. One of the main challenges may be that linking health promotion with physiotherapy may require a fundamental shift in physiotherapists’ conceptualizations of what defines health [5] as well as what is their role relative to the role of the people who consult them, traditionally labelled as “patients”. Gaining knowledge in the field of health promotion may help physiotherapists to acquire a new understanding of the concept of health and of their role in intervening with people who present potentially complex conditions, such as LBP. LBP served as a clinical example to which the discussion could be applied in practice. However, linking health promotion with physiotherapy may also be very helpful for other conditions or populations, such as people with disabilities due to different causes.

References

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