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History - Medical taping - Pain

Physiotherapy -  Physical Therapy
In the U.S.A. physiotherapy is called physical therapy.

History.
Massage and exercise therapy, even heat/cold/electro-therapy has been practiced since the beginning of  mankind. The Greeks, Romans and Egyptians all practiced these “cornerstones” of our profession.
In recent history we know that from the 1880´s, the first children with Cerebral Palsy were diagnosed and treated  by Dr. Little.
Physiotherapy as a profession, education departments and the professional organizations have all commenced at different times in various parts of the world. Some member organisations are more than 100 years old. The WCPT- World Confederation of Physical Therapy was founded in 1951 and currently has 101 member organisations.

Changes in our profession in recent times.
Physiotherapy was orthopaedic based in most countries to start with.
In the 1940´s the neurodevelopmental  approach became fashionable.
People like the Bobaths (NDT) , Vojta, Pëto, Kabat and Knott (PNF) , Brunnström , Temple Fay , Doman and Rood were pioneers of the neurological approach.
From the 1980´s, as more knowledge about the brain and nervous system was revealed, new approaches to therapy came into being. Because not all children had neurological complaints, it was obvious that therapist were searching for new ways of treating all their patients.

The new functional therapy, using the knowledge of motor control, motor learning, postural control, functional mobility and knowledge about the recovery of function is completely changing the way physiotherapists work.
It is not so much a method – it is a therapy concept.
It incorporates the ICF and takes parents and environment into account.
Many scientists and colleagues have contributed by bringing the available knowledge to our profession:
Amiel-Tison, Ayers, Bower, Brazelton, Brögren, Carr, Cioni, Damiano, Darrah, Dubowitz, Eliasson, Ferrari, Forssberg, Gorter, Guttmann, Hadders-Algra, -Isaacs, Jünger, Ketelaar, Maystone, Palisano, Piper, Prechtl, Rolf, Rosenbaum, Russel, Schacklock, Shepard, Shumway-Cook, Schleip, Tecklin, Thelen , Touwen, Ulrich, Vandermeeren, Verschuren and Volpe to name but a few.

Physiotherapy Worldwide.
Our profession is practiced in many ways.
Our education varies in content and study time.  Most scientific research is published in English. English is not everybody’s first language and misinterpretations can lead to misunderstandings. I have experienced this on the internet forums ( www.physiobob.com + www.sefip.org)
In many countries physiotherapists can work only after referral, and in other countries, they can be accessed freely.
The populations´ perception of our profession and the knowledge doctors have of our profession, can vary immensely.
Basically, the profession is the same but a country’s  culture is of great importance. Every culture has its own ideas about our profession and therefore what we do can differ considerably.
The country’s financial status and its  Medical Health System are of great importance as well. Some countries can afford  to have one therapist  for every 2000 inhabitants and other countries  cannot and the ratio can be 1:50000. Some have a lot of money and equipment at their disposal and others do not.
Some physiotherapists have been trained and are still practising  a certain method, whilst others are trying to implement the newest scientific information into their assessment and treatment choice.  
Some are using a mix of the old and the new.
Furthermore, therapy is also therapist dependant and  the experience and training of therapists can vary to a great extent.

The good news is that the evidence suggests that  the environment and parents or caregivers are of great importance to the effect of treatment. The  new therapy concept of goal setting can be done anywhere and everywhere in the world. You do not need money, you need expertise.
The NDT and PNF teachers are implementing the newest knowledge into their curricula. (websites).  
The WHO, in collaboration with WCPT and WFOT, has been educating many in a very functional way throughout the years. Their  guides for mid-level rehabilitation workers (1993) are very practical. However, in my opinion the theory in the guides is outdated. The Global-Help organisation also strives to educate large numbers. In these publications (2004) the authors emphasise the importance of how functional the therapy is and how happy your child is. They also strive to have their many publications translated.

How our colleagues in Russia, the Middle East  and China work, I’m afraid I do not know. One way to get to know and learn more is by sharing  knowledge through the worldwide physiotherapy forums.
The ones I know of are:
http://www.physiobob.com/forum  
http://www.wcpt.org/smfforum/index.php   
http://www.physiotoday.com   
www.somasimple.com  .com     
http://physicaltherapy.rehabedge.com
www.efisioterapia.net  
http://groups.msn.com/ElForumDeLosFisioterapeutas/pediatria.msnw


Many national organizations have their own forums,  in their own language, on their websites. However, these are not easily accessed by foreign colleagues.

Information about the various methods.

 

Complementary therapies.
Some of these methods are provided by health professionals such as doctors or physiotherapist and some are not.

Functional Physiotherapy Concept.

Functional physiotherapy is therapy that is goal related.
Using the patient’s ( adult or child)  wishes and expectations.
Using our knowledge of functional possibilities  to help create realistic goals.
Using available guidelines, reliable assessments and tests, the current classifications, the knowledge of motor learning and motor control.
Using best practice and making sure the patients´ needs and objectives are included and part of current therapy.
Exercising in function if and when possible.
Using the old well-known  methods when experience has “proven” them useful.

Situation in Spain at this moment.

The new concepts ( goal setting, ICF ) were introduced at the SEFIP congress in Barcelona November 2007.  For many therapists it was the first time they were informed about the new concepts.
Every physiotherapist in Spain can start treating children when they have finished their University education.

There are various postgraduate education possibilities:
The NDT-Bobath course www.aetb.org
The Vojta course http://www.vojta.com/cgi-local/ivg_esp.cgi
Le Métayer Reeducación Cerebro-Motriz http://www.cdi-imc.org/index.html
Psicomotricidad -many universities  have postgraduate education courses

Various universities are also providing paediatric courses:
-  some specific for one disorder,
-  some with broader education including tests and measurements.

      www.aidimo.org

- valoración de la sedestación y taller de asientos moldeas pélvicos                    - valoración músculo-esquelética de splints y el proceso terapéutico del niño con alteraciones neuromotrices  fjfernan@um.es Universidad de Murcia

There are a number of postgraduate courses  under the umbrella of the SEFIP. www.sefip.org

 

The IPPEG  will  organize various courses:

      to Meridiaan -therapy Christel Heidemann ) revised.

 

On a personal note:
When treating patients ( adults and children) I  sometimes use some of the “older” methods mentioned above but I also try to use current evidence (knowledge of motor development, motor remedial teaching  and trainings schedules) as much as possible. I belief that a good assessment and explanation and discussion of therapy goals is essential before commencing therapy.

I have collected as much information about our profession as I could. My aim is to keep searching, making this list  as complete as possible. By roaming the internet and taking part in the IOPTP practice committee, I hope to acquire and distribute more knowledge in the future.

Abbreviations:
PNF- proprioceptive neuromuscular facilitation
NDT- neurodevelopmental therapy
WCPT - World Confederation of Physical Therapists www.wcpt.org
IOPTP - International Organisation of Physical Therapists in Paediatrics http://www.wcpt.org/
ICF- International Classification of Functioning, Disability and Health
WHO – World Health Organization www.who.org
Globalhelp - www.global-help.org
WFOT – World Federation of Occupational Therapists  www.wfot.org 
SEFIP - Sociedad Español de Fisioterapia en Pediatría  www.sefip.org   
IPPEG - International Postgraduate Physiotherapy Education Group www.estherderu.com

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Medical taping 

This taping technique was developed by Dr. KENZO Base over 25 years ago in Japan. I is now the gold Standard for therapeutic rehabilitative taping.
There are two ways of using the Kinesio tape:
Assist & support : this involves taping over and around muscles in order to assist them, to support them or to prevent contraction. It enables the individual ( adult and child ) to participate in normal physical activities maintaining their full range of motion.
Acute Support:  this helps prevent overuse and over-contraction and helps provide facilitation of lymph flow for an entire 24 hour period.                                        
The tape can be used in conjunction with other therapies including cryotherapy, hydrotherapy, massage therapy and electrical stimulation.

Kinesio Taping affects and activates the neurological system, the body’s information processor and the circulatory system.

Treatment conceps: there are two ways of applying it.
Unstretched or stretched. Kinesio Taping alleviates pain and facilitates lymphatic drainage by microscopically  lifting the skin.
It is being using in paediatrics as well now, especially in facilitating movement pattern and muscle use, increasing stability and improving alignment in function and in  pain relief.

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( source  http://kinesiotaping.com/what-s-kinesio.php )

For more information go to www.kinesiotaping.com  in English and
http://kinesiotaping.com.es  in Spanish.
Many treatment possibilities  can be seen on  www.youtube.com

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