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Physical Therapy: past, present and future- a paradigm shift

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Physical
Therapy-
Past,
Present,
Future
Physical therapy: past, present and
future- a paradigm shift
Senthil P Kumar PT, (PhD)*
INTRODUCTION
“Learn from yesterday; live for
today; hope for tomorrow; the
important thing is not to stop
questioning.”
- Albert Einstein.
Welcome to the
second issue of Journal of
Physical Therapy. The aim of
this editorial in this issue of
Journal of Physical Therapy is
to enlighten our readers about
history of our profession, its
development from past to the
present whilst presenting
global challenges and rising
opportunities for the future.
The description of editorial will
include the historical note on
origin of the term
“Physiotherapy” and then the
paradigm shift that ensued
along the three well-
recognized roles of a Physical
Therapist; as an educator, a
clinician and a researcher.
Historical perspective-
Physiotherapy/ Physical
Therapy?
Development of a professionalism.
discipline owes to its ability for
a clear vision to “look back to
its roots” and to answer simple
questions directed on the very
name of the discipline.
Questions such as, “how did
the name originate?”, “who
invented the term?” and “when
Key points and pre-publication history of this article is available at the end of the paper.
Di stributed in Open Access Policy under Creative Com mons® Attributi on License 3.0
J Phys Ther. 2010;1:58-67.
Professional
discussion
ABSTRACT
Physical therapy as a profession has its roots to earliest
of time, when the techniques were used for treatment much
earlier than that of origin of the very term “physiotherapy” itself.
This professional discussion paper is a review of the past,
present and future of physical therapy as a profession in its
three roles- educator, clinician and researcher. The ensuing
paradigm shift in favor of advanced teaching methodologies and
pedagogies evolved the present situation of physical therapy
education. The shift from evidence-based practice to an
evidence-informed one witnessed clinical therapists to pursue
continuing educational programmes and professional
development. The growing evidence in terms of increasing
randomized controlled trials in physical therapy indicated
development of quality clinical practice guidelines to translate
evidence into practice. Professionalization in physical therapy
needs a shift towards professionalism to move physical therapy
forward in all three core areas of the profession.
Key words: Professionalism, physical therapy, history,
paradigm shift
Author’s information:
*- Corresponding author. Associate professor, Dept of Physiotherapy,
Kasturba Medical College (Manipal University), Mangalore, India.
senthil.kumar@manipal.edu
1
was it first used?” etc would
facilitate though-provoking A military physician Dr
efforts, the answers of which Lorenz Gleich (1798–1865)
indicate high levels of from Bavaria was the first to
professional integrity and use the term physiotherapy in
its earlier German language
version, “physiotherapie” in his
The word
3
article in the year 1851. As
“physiotherapy” in English
th
we step into 160 year of our
owes its origin to Dr Edward profession, the original French
Playter (1834-1909), way back term “physiotherapie” got
in 1894, when he reported in changed in English into
Montreal Medical Journal, on “physiotherapy” and then to
page 816; (figure-1).
1,2
physical therapy.
58
 J Phys Ther. 2010;1:58-67.
J Phys Ther. 2010;1:58-67.

Professional discussion

2
Figure 1- Cut out from the article by Dr Edward Playter in 1894.

There are a number of Physiotherapy involves the desires), competence (what

definitions of the interaction between one knows/one can do-
physiotherapy profession. The physiotherapist, patients or cultural, communicative, socio-
definitions vary across the clients, families and care cultural, linguistic, socio-
globe with associations and givers, in a process of ethical), world view
professional bodies adopting assessing movement potential (understanding of the field of
their own way of describing and in establishing agreed practice), and view of science
what WCPT defined below in a upon goals and objectives (comprehension of particular
comprehensive manner. using knowledge and skills strategies, methodologies and
4 5
unique to physiotherapists.’ ideals).
Definition of Physiotherapy/
Physical Therapy: The WCPT definition Physical Therapists
emphasizes the “action- have three basic functions as
The World orientedness” in the definition professionals in the
Confederation for Physical of the very term itself. For a professional paradigm-
Therapy (WCPT), the successful transformation and educator, clinician and
renowned global organization progressive growth, enhanced researcher. The three roles
for physical therapy for understanding of the coincidentally develop in
instance, defines profession and its basis is thus accordance with continuous
physiotherapy as:… ‘providing a need-of-the-hour in Physical and progressive wholistic
services to people and Therapy. The solution lies in development of knowledge,
6
populations to develop, studying the professional experience and skill. Now we
maintain and restore dimensions along lines of a take a look at each of them in
maximum movement and paradigm. detail, to observe and analyze
functional ability throughout the trend through the years so
the life-span. Physiotherapy A paradigm is defined that we can learn from the
includes the provision of a model that directs actions; past and aptly apply them for
services in circumstances that is, an action-strategy or use in the future. As one
where movement and function approach that guides activities paradigm shifts backwards to
are threatened by the process in a specific field. A the past improving our present
of ageing or that of injury or professional paradigm means understanding, there are the
disease. Full and functional that a person within a other paradigms that shift
movement are at the heart of particular profession has forwards into the future.
what it means to be healthy adopted a certain way of
…Physiotherapy is concerned thinking. Physical Therapy Physical Therapist as an
with identifying and professional paradigm Educator- past, present and
maximising movement includes four inherent future:
potential, within the spheres of components through which the
promotion, prevention, identity of physiotherapy can Fundamental to growth
treatment and rehabilitation. be defined- interest (what one of profession and its
Physical therapy- past, present and future
Kum ar S P

59

Professional discussion
level of education. Though
ancient times witnessed
manipulators, lay practitioners
and bone-setters leading the
way and setting a trail for the
others to follow, the initial
knowledge-transfer happened
mostly on one-one basis and
practical life situations with
patients during their treatment
processes. Though the
method was less scientific and
rationale, ancient education
relied on manual handling
skills for evaluation and
treatment. Through the years,
earliest forms of treatment like
manual techniques,
hydrotherapy and movement
therapies gained importance in
the field of education.
To present
knowledge, the first
documented development of a
professional school for
Physical Therapy education
(as was required to be entry-
level program) was seen in
1913, with the School of
Physical Therapy at University
of Otago, New Zealand and in
1914 at Reed College at
7
Portland, Oregon, USA. Now
there are approximately
schools in 80 countries
teaching Physical Therapy at
various entry-level
programmes recognized and
approved by their regional
governing bodies/associations
around the world. Wide
variation in the number of
Physical Therapy schools-per-
country ratio exists where
Slovenia has only one
Physical Therapy school and
USA having 202 schools
whereas a country like India
8
has 171 schools.
Kum ar S P
J Phys Ther. 2010;1:58-67.
Presently, the World
Confederation of Physical
Therapy (WCPT) recognizes
there is considerable diversity
in the social, economic,
cultural, and political
environments in which
physical therapist education is
conducted throughout the
world. WCPT recommends
physical therapist entry-level
educational programs be
based on university or
university-level studies, of a
minimum of four years,
independently validated and
accredited as being at a
standard that accords
graduates full statutory and
professional recognition.
WCPT acknowledges there is
innovation and variation in
program delivery and in entry-
level qualifications, including
first university degrees
(Bachelors/ Baccalaureate/
Licensed or equivalent),
Masters and Doctorate entry
8
qualifications.
Professional
education prepares physical
therapists to be autonomous
practitioners in collaboration
with other members of the
health care team. Physical
therapist entry-level
educational programs
integrate theory, evidence and
practice along a continuum of
learning. This begins with
admission to an accredited
physical therapy program and
ending with retirement from
active practice. The shift
towards Doctoral programs
offered by many institutions in
USA witnessed greater journal
publication productivity
(measured by number of
publications and their citation
index) which was also
Physical therapy- past, present and future
J Phys Ther. 2010;1:58-67.
associated with number of full-
time faculty in those academic
9
institutions. One of the highly
acclaimed education models in
the present day Physical
Therapy curriculum is
10
problem-based learning.
The future would be a
witness to curricular
developments and application
of an integrated curricular
model such as Client-Oriented
Research and Evaluation
(CORXE) best practice model
and CORXE clinical decision-
11
making model. The model
was formed by integrating-
Hypothesis-Oriented Algorithm
for Clinicians (HOAC);
collaborative clinical
reasoning; inter-relationships
of theory, clinical models and
research; and the Evidence-
Based Practice circle.
Clinical practice- past,
present and future:
Greek physicians
including Hippocrates (460-
370BCE) are believed to have
been the first practitioners of
physical therapy, advocating
massage, manual therapy
techniques and hydrotherapy
7
to treat people.
During the second half
of the 19th century, a period of
increasing specialization in the
field of medicine, terms like
“physical medicine,” “physical
therapy,” “physiotherapy,” and
the like came into use to
categorize the various healing
methods of exercise,
manipulation, and massage
(also collectively known as
mechanotherapy),
hydrotherapy, balneotherapy,
electrotherapy, light therapy,
air therapy, and heat and cold
60

Professional discussion
therapy (thermotherapy) under
12
one heading.
Historically
documented description of
practice and development of
physical therapy did date not
th
earlier than late 19 century.
The techniques though were
used through the ages- some
of them were hydrotherapy,
massage, mobilization,
assisted functional training-
they were not recognized a
being apart of the field till the
term “physiotherapie” was
coined in 1851.
In 1894, The Society
was founded by four young
nurses: Lucy Marianne
Robinson, Rosalind Paget,
Elizabeth Anne Manley and
Margaret Dora Palmer. They
set up the Society of Trained
Masseuses to protect their
profession from falling into
disrepute as a result of media
stories warning young nurses
and the public of unscrupulous
people offering massage as a
euphemism for other services.
By 1900, the Society acquired
the legal and public status of a
professional organization and
became the Incorporated
Society of Trained Masseuses.
In 1920, the Society was
granted a Royal Charter. It
amalgamated with the Institute
of Massage and Remedial
Gymnastics. As the Chartered
Society grew in strength,
branches and local boards
were established all over the
country and in 1944 the
Society adopted its present
name, the Chartered Society
of Physiotherapy (CSP), being
more representative of the
13
field of work it covered.
Kum ar S P
J Phys Ther. 2010;1:58-67. J Phys Ther. 2010;1:58-67.
In 1916, there was an Treatments in this
epidemic of poliomyelitis or decade were mostly exercise,
most popularly known as polio massage and traction. During
in New York and New 1950s, physical therapists
England. Many cases of started learning and doing
poliomyelitis can lead to procedures in the spine and
temporary paralysis, but other joints. These
without proper treatment the manipulative procedures
paralysis can be lifetime effect. improved through continuous
During this period, there were research and studies. The so-
documentation of young happened adoption of manual
women treating patients of the therapy techniques into
“polio” epidemic using passive Physical Therapy thus forming
movements and this was also a specialty of Orthopaedic
the period when manual Manual Physical Therapy
muscle testing was revolutionized the
established in its use by development of the field itself.
physiotherapists. Until the early 1950s, physical
therapy was performed only in
It was during this time hospitals. It was only in the
that Mary McMillan, the first late 1950s that physical
physical therapy aide, therapists started treating the
established the American patients beyond hospitals.
Women's Physical Public schools, universities,
Therapeutic Association. The skilled nursing facilities,
organization's name was later medical centers and
on changed to the American rehabilitation centers were
Physical Therapy Association chosen by the
(APTA). Due to her significant physiotherapists to treat their
contribution in the patients.
reconstruction aide services,
Mary McMillan came to be
known as the 'Mother of Eventually in 1974, the
Physical Therapy'. International Federation of
Orthopaedic Manipulative
World War II prompted Therapists (IFOMT) was
another historical period where formed. This organization has
physical therapy became then played and is
widely used to care for continuously playing a major
patients. Physical therapy was role in the advancement and
used and showed impressive development of physical
results in veterans who have therapy. The history of IFOMT
been injured in the Korean and is inevitably intertwined with
Vietnam wars. This signaled the development and rise of
the start of using physical physical therapy. The growth
therapy in hospital and of physical therapy over the
medical programs. Physical last fifty years has been
therapists were getting phenomenal. Paralleling that
recognized as reconstruction growth has been the rise of
aides and rehabilitation manual and manipulative
specialists for the victims of therapy. Indeed much of the
14
war. vigor and ideas for growth
Physical therapy- past, present and future
61
 J Phys Ther. 2010;1:58-67. J Phys Ther. 2010;1:58-67.

Professional discussion

have come from this group. In was considered synonymous for others to view and follow
each country there have been to patient’s problem solving. and that is the basis of
leaders who have seen the Earliest report of problem- science. Therefore, the art and
future and striven for it. solving model in clinical science of medicine are
Manual therapists have been patient management dated inextricably intertwined and
19
foremost in that leadership back to 1980s. The you do not have art without
and whether pushing for therapeutic decisions though science nor science without
25
physical therapy or for manual initially relied on anecdotal art. Reproducibility is difficult
therapy they have elevated the evidence of personal in both art and science.
standing and maturity of both. experience and expert opinion, Documentation is the only
Today, therefore, physical later realized the importance direct path to appreciate “art”
26
therapy can look with pride on of hypothesis-generation by and to understand “science.”
the accomplishments of application of hypothesis-
manual and manipulative oriented algorithm for Changes in health
15 20,21
therapists. clinicians. This model was policies, prioritization and
Several physical therapists modified and organized with a funding continue to influence a
who made notable much better and globally great deal, on the practice
contributions through manual recognized clinical reasoning issues and patterns, if not
22,23
therapy in the field of model. Recent amassment therapists’ attitudes and
27
physiotherapy were members of research findings and decisions. There are two
of the IFOMT organization are publications witnessed proposed solutions to this
detailed in historical paper by application of evidence-based issue- the need for improved
Peter Huijbregts in our first practice model and the ICF methodology in workforce
issue of Journal of Physical (International Classification of development research to
16
Therapy. Functioning, Disability and explore patient outcomes as
24
Health) model. The future much as outputs; and the
Three macro- would definitely support an potential for physical
paradigms exist in Physical integrated problem-solving interventions (including
Therapy clinical profession. model for successful clinical physiotherapy) to be
They are science (actions management and patient- enhanced by a better
aimed at describing and centered clinical outcomes. understanding and response
explaining functions), art to how people think, respond
(aesthetic factors) and religion In clinical Physical and behave. Scope of
(ideology, values and ethical Therapy practice, though Physical Therapy practice-
5
factors). The American documentation is widely The scope of physiotherapy
4
Physical Therapy Association practised, an audit revealed practice is influenced by the
emphasized this in its National 86% cases lacked other ratio of qualified
Physical Therapy month for aspects of documentation physiotherapists to the
October 2007 in its logo- except of initial day of population. The number of
Physical Therapy: science of assessment, lacked physiotherapists per head of
17
healing and art of caring. objectivity, limited range of population varies enormously,
Physiotherapy has measurement parameters particularly within the AWP
been subject to considerable used, and absence of region, ranging from 1:1,750 in
18
criticism for its lack of research functional assessments. The Australia to 1:212,000 in India,
and its sparse evidence-base. above issue also raises with the average ratio for the
It has often been perceived as serious questions about both region being 1:60,000
4,28
a profession that bases its critical aspects of the people. In Ethiopia there
practice largely on anecdotal professionalism of are approximately 14
evidence, and uses treatment physiotherapists in the hospital physiotherapists for 60 million
4
techniques that have little environment, and the people.
18
scientific support. effectiveness of their
treatments. Art is testing the With the emergence of
Clinical decision- limits and leaving a thorough, patient-centered care,
making in Physical Therapy logical, and reproducible trail consumers are becoming
Physical therapy- past, present and future
Kum ar S P
62

Professional discussion
effective managers of their
care- in other words, "effective
consumers." To support
patients to become effective
consumers, a number of
strategies to translate
knowledge to action (KTA)
have been used with varying
success. The use of a KTA
framework can be helpful to
researchers and implementers
when framing, planning, and
evaluating knowledge
translation activities and can
potentially lead to more
successful activities. Using the
framework, tailored consumer
summaries, decision aids, and
a scale to measure consumer
effectiveness were created in
collaboration with
29
consumers.
Research- past, present and
future:
Journals are
acknowledged as crucial
sources of evidence-based
information relevant to
30
physiotherapy practice. The
first research about physical
therapy in the United States
was published in March 1921
14
in The PT Review. The first
RCT in Physical Therapy
evaluated Ultra-Violet radiation
therapy and was published in
1929 by Dora Colebrook in
Medical Research Council
31,32
Special Report Series.
Initially the RCTs were
published in medical journals
and not until 1967, for the first
time an RCT evaluating
physical therapy intervention
was published in a physical
therapy journal. This unique
credit goes to author- Landen
B whose study evaluated
superficial heat vs. cold in LBP
and was published in Physical
Therapy journal.
Kum ar S P
J Phys Ther. 2010;1:58-67.
The first systematic
review was published in 1975
by Kolind-Sorensen which was
on lateral ankle ligament
injuries in a Danish journal
Ugeskr Laeger. The first
evidence-based clinical
practice guideline was
published in the year 1987, a
report of the Quebec task
force on spinal disorders
which was on activity-related
spinal disorders by Spitzer W
31
in Spine. In the recent past,
systematic review
systematic reviews also came
to be published, on Spinal
33
Manipulation in Chronic
34
LBP.
The rapid growth of
evidence as witnessed by the
presence 1 record in 1929 to
100 records in 1972, to 1000
records in 1986, 5000 in 1999
and to 10,000 in 2005 is an
indicator of a rapid shift
towards research and
29
evidence-based practice.
Presently as on March 2010,
there are 15,920 records in
Physiotherapy Evidence
35
Database which includes
2257 systematic reviews and
13,096 randomized controlled
trials and 567 clinical practice
guidelines in physiotherapy
alone. As we observe the
growth of evidence when
analyzed specialty-wise,
Musculoskeletal holds the
highest position with more
than 2,000 records followed by
Cardiothoracic with less than
31
1,250 records.
Region-wise, 1,037
studies were on treatment of
lumbo-pelvic disorders and
condition-wise, there were 173
records “surprisingly” for
incontinence alone. Regarding
dissemination of “this”
J Phys Ther. 2010;1:58-67.
evidence, it is a rare
occurrence that only 3% of this
number (340 out of 11,494
records as on September 3,
2007) was published in
31
general medical journals. It is
not a matter of pride that 97%
of physiotherapy evidence is
published in physiotherapy
journals like Physical Therapy,
Physiotherapy, Journal of
Physiotherapy (formerly
Australian Journal of
Physiotherapy) and
of Physiotherapy Canada. It is
indeed a matter of question
and uncertainty why
physiotherapy evidence is not
published in general medical
journals. The need of the
present hour to improve inter-
disciplinary awareness and
multi-disciplinary collaboration
in clinical practice is
achievable only if Physical
Therapy scientific community
works in liaison with other
medical community towards
solving this issue, if we really
mean to aim global
professional autonomy in
practice.
The existing
researcher-clinician gap
should be minimized in order
that- improved application of
best research findings and
evidence into practice; and
also for generation of best
research evidence from expert
clinical practice- can go hand-
in-hand towards betterment of
our society and our
36
profession. Research or
science in Physical Therapy
has changed from positivism
(verifiable by observation) to
hermeneutics (based on
understanding) and then finally
to pragmatism (based on
5
actions). Physical Therapy
research was based upon two
Physical therapy- past, present and future
63
 J Phys Ther. 2010;1:58-67. J Phys Ther. 2010;1:58-67.

Professional discussion

supposedly different Professionalization which are in the best interests

philosophies- positivism and occurred in physical therapy in of customers, clients and
phenomenology. Positivism its practice areas in diverse patients, as well as in the
relied on quantitative research fields of medicine (from advice-giving, lobbying and
methods and phenomenology obstetrics to geriatrics and sometimes oppositional
37
relied on qualitative ones. palliative care) directed aspects of professions’
Combining science (which is towards patient care from relations with states,
objective and is based on the before birth till after death legislative bodies, and regional
40
body) and art (which is (bereavement care). and local administrative
subjective and is based on the agencies.
mind) using an inextricably Professionalization in
blended mixed model of physical therapy research was 41
Herbert Swick outlined nine
quantitative-qualitative witnessed by the growth in main attributes of
16
research is essential. number of journal publications professionalism as;
added every year. Whilst • Subordination of one’s
Professional journals such as Physical own interests to the
autonomy is achievable Therapy, Journal of Physical interests of others
through the following five Therapy, Physiotherapy, • Adherence to high
steps outlined by Professor Journal of Physiotherapy, ethical and moral
Stanley Paris in his keynote Physical Therapy Reviews, standards
address at Biennial Physiotherapy Research • Responding to
conference of New Zealand International, Physiotherapy societal needs
Society of Physiotherapy Canada, Physiotherapy
• Evincing core
(NZSP) in 2008, as- definition Theory and Practice existed,
humanistic values
of scope of practice; research; journals of specialty-oriented
• Exercising
clinical doctorate programs; names- Pediatric Physical
accountability for
marketing; and, maintenance Therapy, Cardiopulmonary
themselves and for
and advancement of our Physical Therapy Journal,
38 their colleagues
autonomy. Journal of Neurologic Physical
• Demonstration of a
Therapy, Manual Therapy,
continuing
Summary- Journal of Manual and
commitment to
professionalization to Manipulative Therapy, Journal
excellence
professionalism: of Orthopedic and Sports
Physical Therapy, Physical • Demonstration of a
Therapy in Sport, Journal of commitment to
It is extremely scholarship and to
essential to transform the Geriatric Physical Therapy,
Journal of Women’s Health advancement of their
physical therapy profession field
from professionalization into Physical Therapy added value
to identification of various • Dealing with high
professionalism. levels of complexity
Professionalization areas of research as domains
of development together with and uncertainty
and professionalism, as • Reflection upon one’s
distinct entities according to technique-based journal
39 names- Journal of Aquatic own actions and
Julia Evetts; decisions
Physical Therapy and
Professionalization is a series International Journal of
Mechanical Diagnosis and Professionalism is the
of diverse and variable, social
Therapy. key to move physical therapy
and historical processes of
forward, in all the three core
development, of how work
Professionalism as defined by areas of education, practice
sometimes becomes an
Julia Evetts;
39 and research. Studies on
occupation, and how
Professionalism includes professional development and
occupations achieve various
those aspects of the impact of professional
forms of occupational control
occupational control of work development programmes
of work sometimes called
professional.
Physical therapy- past, present and future
Kum ar S P
64
 J Phys Ther. 2010;1:58-67. J Phys Ther. 2010;1:58-67.

Professional discussion

Core values of Description

professionalism
Accountability Accountability is active acceptance of the responsibility for the
diverse roles, obligations, and actions of the physical therapist
including self-regulation and other behaviors that positively
influence patient/client outcomes, the profession and the health
needs of society.
Altruism Altruism is the primary regard for or devotion to the interest of
patients/clients, thus assuming the fiduciary responsibility of
placing the needs of the patient/client ahead of the physical
therapist’s self interest.
Compassion/ caring Compassion is the desire to identify with or sense something of
another’s experience; a precursor of caring. Caring is the concern,
empathy, and consideration for the needs and values of others.
Excellence Excellence is physical therapy practice that consistently uses
current knowledge and theory while understanding personal limits,
integrates judgment and the patient/client perspective, challenges
mediocrity, and works toward development of new knowledge.
Integrity Integrity is steadfast adherence to high ethical principles or
professional standards; truthfulness, fairness, doing what you say
you will do, and “speaking forth” about why you do what you do.
Professional duty Professional duty is the commitment to meeting one’s obligations
to provide effective physical therapy services to individual
patients/clients, to serve the profession, and to positively influence
the health of society.
Social responsibility Social responsibility is the promotion of a mutual trust between the
profession and the larger public that necessitates responding to
societal needs for health and wellness.

Table-1: Seven core values of professionalism according to American Physical Therapy

42
Association (APTA)

though plenty, do not Such a professionalism- Article pre-publication

adequately reflect the based paradigm shift is history:
knowledge, attitudes, beliefs evidently the need of the hour
48 Date of submission: 4th April 2010
and experiences of therapists to weather the storm of Reviewer: Peter A Huijbregts
in seven core values of challenges and opportunities Sent for 1st revision: 8th April 2010
professionalism namely facing us. Come on, Date of 1st resubmission: 11th April
accountability, altruism, therapists, let’s embark on the 2010
49 Reviewer: Prof Maureen Simmonds
compassion/caring, noblest role of mentorship. Sent for 2nd revision: 18th April 2010
excellence, integrity, Date of 2nd resubmission: 20th April
professional duty, and social ACKNOWLEDGMENTS 2010.
42,43 Date of acceptance: 24th April 2010.
responsibility (table-1).
Date of publication: 27th June 2010.
None.
WFIN: JPT-2010-ERN-101-1(2)-
Development of
professionalism is solely CONFLICTS OF INTEREST
dependent upon curricular
44 REFERENCES
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46 47
doctoral and post-doctoral Physiother Res Int. 2005;10:123-124.
degree levels.

Physical therapy- past, present and future

Kum ar S P
65

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Key points:

Past- The techniques used in Physical Therapy were used well

before the name “Physical Therapy” came into existence.
History is filled with moments of milestones and of pride.

Present-The recent developments are owed mainly to

international collaborations especially in research and its
dissemination.

Future- We need to perform a thorough reflection and strategic

planning in our doctoral programmes, practice autonomy and
imparting professionalism among therapists. Impact analysis of
such paradigm shift is thus warranted.

Physical therapy- past, present and future

Kum ar S P
67

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