October is National Physical Therapy month, so I thought I’d take this opportunity to write a series of informative articles on physical therapy- what is it, how long has it been around, who can benefit from it, etc. It only makes sense, that the first in this series should go back to the beginning of physical therapy to provide a brief history of how we got to where we are today!
Ancient History
The basic philosophy of physical therapy can be traced back as far as Ancient Greece as early as 460 BC when Hippocrates introduced the idea of manual manipulations for pain relief. Also during this time, Hector began promoting the practice of hydrotherapy which originally used the pressure and temperature of water to decrease a patient’s symptoms.
Fast forward to the early 1800s in Sweden. A man named Per Henrik Ling noticed improvements in his symptoms of gout when he learned to fence. He believed that the exercise is what helped him recover. He went through the full curriculum of training to become a medical doctor, then in 1813 he founded the Royal Central Institute of Gymnastics for massage, manipulation, and exercise. Many years later, in 1887, Sweden’s National Board of Health and Welfare gave physical therapists in Sweden official registration.
The first official programs to train physical therapists at the collegiate level came about in the early 1900’s. The School of Physiotherapy at the University of Otago in New Zealand was the first, starting its program in 1913. It still offers a physical therapy program to this day! They were soon followed by Reed College in Portland Oregon in 1914.
Polio outbreak advances the field
From 1916 to 1955, an average of 38,000 people per year in the United States were infected with polio- a contagious illness which caused varying degrees of paralysis in those infected. The high numbers of people requiring care and rehabilitation from polio during this time prompted the National Foundation for Infantile Paralysis to provide funding in various ways to help reduce the severe shortage of “qualified and university educated” physical therapists. This funding led to an increase both in the number of trained physical therapists as well as an increase in the research and published literature specific to the field of physical therapy.
In 1921, the journal Physical Therapy Review published its inaugural issue to serve as an educational medium for those in the field. This is also the year in which Mary McMillan established the American Women’s Physical Therapeutic Association, which would later (in 1946) be renamed the American Physical Therapy Association. This association still stands today as the most well known and influential professional membership organization for physical therapists in the United States today.
During the polio outbreak of the mid 1900s, the field of physical therapy changed and advanced rapidly. Originally, physical therapy was mostly provided in the hospital setting after surgeries or injuries. Physical therapists during this time even often helped in the ICU with many basic nursing and self care needs, including respiratory therapies and helping to wean patients off artificial ventilation. In treating patients of the polio epidemic some of the techniques that therapists still use today were developed including progressive resistance exercises as well as manual muscle testing.
Transitioning out of hospitals and into the future
World War II brought on more changes to the world of physical therapy. The numbers of soldiers returning home in need of therapy brought on the transition of physical therapy to settings outside of the hospital. It was during this time that outpatient clinics began opening to serve this population. The field of physical therapy began to look more like what we see today. In a 1954 edition of Physical Therapy Review it was stated that there were six major conditions on which physical therapy focused. These were the loss of flexibility, loss of muscle power, decrease in vital capacity, the potential for deformity, loss of skill, and loss of functional stamina. In essence, these are all still conditions which physical therapists help treat today.
In 1974, the orthopedic section of the American Physical Therapy Association was created. From the 80’s up until current day, the field has continued to progress in research, knowledge, and numbers. Today, most therapists who are in practice have at least a master’s degree, and many have a doctorate in physical therapy. All physical therapy programs offered at schools across the US now have transitioned to a doctorate level of education. This is to ensure that therapists are achieving high levels of education to provide the highest levels of care to our patients.
Spirit of helping people
As our field continues to move forward, I have no doubt that it will continue to shift and change. It will be interesting to see where it goes from here. It is inspiring to look back at where we have come from and see that the spirit of physical therapy, the spirit of wanting to help patients resume their normal, pain free lives, remains much the same today as it did back in its early days. I’m sure this spirit will continue into our profession’s future.
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