An Introduction to Environmental Physiotherapy

Environmental Physiotherapy- Introduction

Environmental Physiotherapy (EPT) started as an idea that encompasses a new field of physiotherapy, where key aspects of the environmental impact is considered, and respected to mutually benefit the physiotherapist and the patient. EPT covers areas of clinical practice, research and education, and bridges the various clinical specialities within Physiotherapy (Musculoskeletal, Cardiology, Neurology etc.).

What EPT is About

The field of EPT is rapidly developing, and will expand greatly in the future, but a few key areas of EPT have been identified so far.

1.     Physiotherapy as an environmentally friendly practice

Environmentally friendly physiotherapy practice utilises a "low tech", hands on and interpersonal approach to managing patients. This minimises the negative impact on the enviromenment to make physiotherapy eco friendly.

2.     Environmental cost of Physiotherapy practices

The use of non renewable resources like paper records and disposable products being used to run a physiotherapy service may also contribute to the environmental cost. This also includes aspects such as the amount on unnecessary electricity being used, and ways to use less electricity (for e.g. Sun/air drying linen and towels instead of using a dryer).

3.     Transportation costs related to Physiotherapy.

Looking at how patients reach our services may be a simple way to reduce our environmental footprint. Incentives may be offered to patients who are able to walk or cycle to appointments where possible and appropriate. Patients may be ecouraged to adopt this principle with other appointments or errands too where appropriate. We also need to look at transportation for clinicians to attend meetings, congresses and functions relating to our own clinical ups killing, and implement and adopt ways of reducing the impact on the environment.

4.     Environmentally friendly clinical setup

Most physiotherapy practices are indoors and require additional lighting and air-conditioning, but what if there was a way to incorporate natural light and airflow into our setups, without compromising patient privacy and care?

Self-reflection on Current Physiotherapy practice

In order for us to change, we first need to look at our own current practices, and we need to reflect on ways that we can align ourselves with a more environmentally friendly way of practising. Change may take some time to occur, but the following basic steps may guide the process of crossing over into an environmentally friendly Physiotherapy practice.

1.     Step 1: A willingness to make a change.

2.     Step 2: Understanding the relationship between health and the environment.

3.     Step 3: Identifying the aspects of our Physiotherapy practice that needs to change.

4.     Step 4: Expanding on this new field of Physiotherapy, and inspiring others to do the same.

The Global Move Towards Change

Approaches such as EcoHealth, OneHealth, Planetary Health and Sustainable Healthcare are all based on the understanding that there is symbiotic relationship between human health and flourishing and sustainable environment. The UN Agenda 2030 Sustainable Development Goals are a closely related to these approaches in that human health and wellbeing cannot be achieved without a natural and social environment that supports it.

Possible Theoretical and Philosophical Foundations of EPT that may develop?

Philosophical and intersectional foundations for environmental EPT

In this section we hope to produce articles on possible philosophical and practical foundations for an environmentally aware and responsible physiotherapy. 

• Indigenous ways of life, the environment and physiotherapy (e.g.:)
  • Maori definitions of health and the body
  • Sami understandings of healthcare and related practices

• Philosophical perspectives
  • Environmental ethics and physiotherapy
  • Environment and gender in physiotherapy
  • Environmental justice and physiotherapy 

Environmental foundations of human health, function and wellbeing

• The ecological foundations of human life on planet Earth (Draw on earth evolution, nature’s contribution to people and ecological determinants of health)

• Anatomy and Physiology: The environmental composition of the human body: Oxygen exchange, Cell composition, Nutrients, Molecules, Microbiome

Environmental issues and their health impacts

• Global environmental issues and their health impacts: An introduction to global environmental changes and their health impacts
  • Biodiversity loss, Climate Change (NCDs)
  • Air pollution (COPD, Asthma)
  • Plastic pollution (Microplastics in food)
  • Extreme weather events (Climate migration and associated physical and mental trauma)

• Local environmental issues and their health impacts
  • Subdivide by country or similar depending on contributors context

The causes of global environmental change and related health issues

Beliefs and values, colonialism, industrialism, capitalism, racism… 

• How these relate to health and ill health
• How they relate to physiotherapy
  • How we perpetuate them, and
  • How we might help to address them directly

The environment in clinical practice

• Patient perspectives and experiences of engagement with natural environments (CLBP, MS, Quadruplegia)

• Nature-based interventions in physiotherapy (outdoor exercise, greenspace exposure): Benefits for mental and physical health

• Physiotherapy clinical environments 

• • Exclusion of nature
  • Natural environments as clinical setting

• Urban planning, work environments and physiotherapy

• Active transport as environmental physiotherapy intervention (Adam Toner)

• Environmental care and restoration as physiotherapy intervention 

The environment in physiotherapy specialty fields and related pathologies

• The environment and musculoskeletal physiotherapy, mental health, neuro, paedatric pt, cardio-pulmonary physiotherapy, occupational health and ergonomics

Physiotherapy and other-than-human

• Animals in Physiotherapy
  • Animal-assisted physiotherapy
  • Animal physiotherapy (physiotherapy for animals)

• Plants in Physiotherapy
  • Plants in clinic rooms and their role in physiotherapy and rehabilitation
  • Plants in client lives and living spaces and their contribution to health
  • Plants as nutrition, medicine, clothing, shelter, therapy

• Tools and other objects in physiotherapy
  • Their contribution to the clinical environment of physiotherapy
  • As used resources
  • Digitalisation and sustainability 

Physiotherapy and Sustainability

• An introduction to sustainability and its relation to physiotherapy 
• Environmental sustainability in physiotherapy
  • How PT is environmentally more sustainable than other approaches
  • How PT can be even more environmentally sustainable
    • In clinical practice
    • Education
    • Research