Role of Physiotherapist in a Rehabilitation Team

Original Editors - Naomi O'Reilly and ReLAB-HS

Top Contributors - Naomi O'Reilly, Kim Jackson, Vidya Acharya, Rishika Babburu, Oyemi Sillo and Ashmita Patrao      

Introduction

Physiotherapists are experts in human movement and have a key role in prevention, identification, assessment, treatment and (re)habilitation of individuals when movement and function are threatened or affected by ageing, injury, diseases, conditions or environmental factors. Physiotherapists support people at all stages of life to recover from injury, reduce pain and stiffness, increase mobility and movement and maximise function and quality of life, incorporating physical, psychological, emotional and social wellbeing.

Governance

Physiotherapy is governed internationally by World Physiotherapy, which advocates that the profession of physiotherapy is responsible for articulating the profession’s scope of practice and defining the roles of physiotherapists, with National Physiotherapy Associations responsible for defining physiotherapy and the role of physiotherapists relevant to health service delivery needs specific to their own nation. Physiotherapy is an autonomous profession, which means they can operate as members of health service provider or rehabilitation teams or as independent practitioners who can accept referrals from a range of sources, including from an individual themselves (self-referral) or from other people involved with that individual.

Where Physiotherapists Work

Physiotherapy is practised in a wide range of public, private and voluntary sector settings;

• Hospitals - in outpatients, on medical and surgical wards and in specialised units such as intensive care, coronary care, burns and rehabilitation centres;

• Community and Primary Care Health Centres either in a dedicated Health Centres or visiting people in their homes, assessing and treating a wide variety of muscle, joint and ligament problems as well as women’s health, neurological, respiratory conditions and many more. Giving treatment, advice and appliances to help improve independence;

• Schools - helping children achieve their full potential;

• Workplace - providing ergonomic assessments, pre-employment screening, risk management and educating workers in correct lifting and handling techniques;

• Private Practice - assessing and treating a wide variety of muscle, joint and ligament problems as well as women’s health, neurological, respiratory conditions and many more.

Knowledge and Skills for Clinical Practice

After professional training in physiotherapy, physiotherapists should have the knowledge, skills and judgment to provide services related, but not limited to, musculoskeletal and orthopaedic function, neurological function, respiratory function, cardiovascular function, sexual function, visual function, vestibular function, and prescription of assistive devices to optimise function across the whole life span within a wide range of settings and contexts. Many physiotherapists also work in private practice and as educators and consultants within a range of settings.

In partnership with the individual, physiotherapists use their professional knowledge & practical skills, together with thinking skills & skills for interaction to identify what is limiting an individual’s movement & function, recognising the impact of physical, psychological, social & environmental factors to help that individual decide how to best address their needs.

Assessment and Identification

The examination of individuals or groups with actual or potential impairments, activity limitations, or participation restrictions by history-taking, screening and the use of specific tests and measures. Physiotherapists are required to

• Undertake a comprehensive examination/assessment of the patient/client /population or needs of a client group

• Evaluate the findings from the examination/assessment to make clinical judgments regarding patients/clients
• Implement a physical therapist intervention/treatment programme and education in agreement with the patient/client
• Evaluate and re-evaluate the outcomes of any interventions/treatments/education
• Make recommendations for self-management
• Collaborate with health professionals and other key stakeholders.
• Formulate a diagnosis, prognosis and plan
• Provide consultation within their expertise and determine when patients/clients need to be referred to another professional

Intervention and Treatment

Intervention and treatment may be aimed at prevention of impairments, activity limitations, participatory restrictions, disability and injury including the promotion and maintenance of health, quality of life, workability and fitness in all ages and populations. The physiotherapist determines the interventions and manages the needs of the individual based on the examination, evaluation, diagnosis, prognosis, plan, anticipated goals and expected outcomes of the planned interventions for identified impairments, activity limitations and participation restrictions and/or for prevention, health promotion, fitness, and wellness. Intervention is implemented and modified in order to reach agreed goals and interventions may include but are not limited to:

• Education
• Therapeutic Exercise
• Functional training in self-care, home management, work, community and leisure
• Manual therapy techniques (including mobilisation/manipulation)
• Prescription, application, and fabrication of devices/equipment (assistive, adaptive, orthotic, protective, supportive, prosthetic)
• Airway Clearance Techniques
• Breathing Techniques
• Integumentary repair and protection techniques
• Electrotherapeutic modalities
• Physical agents and mechanical modalities

Resources

1. World Physiotherapy Policy Statement: Description of Physical Therapy
   • Available in a wide range of languages this policy statement provides a detailed description of physiotherapy and the role of the physiotherapist.
2. World Physiotherapy Standards of Physical Therapy Practice Guideline
   • These standards provide the foundation for physiotherapy practice and represent the physical therapy profession’s commitment to society to promote optimal and function in individuals and populations by pursuing excellence in practice. These standards provide the basis for physical therapy practice in all settings, including but not limited to: clinics, hospitals, schools and commercial premises.