Manual Therapies (what I’m learning in Week 5
Answer both of the following questions:
- In your own words, describe two of the specialisations of physiotherapy
- Musculoskeletal Physiotherapy
- Neurological Physiotherapy
In 1906 therapists formed an association to differentiate trained and untrained practitioners. Today it is called The Australian Physiotherapy Association (APA). APA defines Physiotherapy as: ‘A healthcare profession that assesses, diagnoses, treats, and works to prevent disease and disability through physical means‘(Endeavour Lecture 5).In the early days of physiotherapy, practitioners worked under referral from doctors and hospitals. They had little autonomy, and less research backing than they do now. Over the years, physiotherapy has been increasingly backed by science. Along with this, Practitioners have contributed to scientific findings by developing their own specialised styles of practice, documenting results, and teaching these modalities (Endeavour Lecture 5).
Two noted events that saw the reliability and efficacy of physiotherapy techniques in treatment and rehabilitation are WW1, whereby musculoskeletal physiotherapy, and other forms, were used in treatment of injured soldiers. Another influence was the Polio epidemic in the 1950’s (Endeavour Lecture 5).
Geoff Maitland was a pioneer in musculoskeletal therapies. He developed modalities for Vertebral Manipulation of the spine, and Mobilisation and Movement for treatment applications. He wrote books including, ‘Vertebral Manipulation‘ and ‘Peripheral Manipulation’, and developed training courses including ‘Manipulation of the Spine‘. He also helped found the International Federation of Orthopaedic Manipulative Therapy (IFOMPT) (Endeavour College).
Robert McKenzie, was another pioneer, who treated the back, and extremity problems. He developed: ‘The McKenzie Method of Mechanical Diagnostics and Therapy‘, to treat musculoskeletal disorders (Endeavour Lecture 5).
Brian Mulligan was a physiotherapist who developed the ‘Mobilisation’s with Movement’ (MWMS), and the ‘Sustained Natural Apophyseal Glides’ (SNAGS) techniques. Mulligan combined MWMS for treatment in the extremities, and for the spine, the practice of SNAGS.
The above treatments are founded on the basic application of manual therapy techniques. They may be used by practitioners qualified in the given techniques. The underlying principle is to treat the clients condition in the best way, and to do no harm. For example clients with Parkinson’s disease and Multiple Sclerosis may still benefit from correctly applied mobilisation techniques, such as MWMS or SNAGS if the practitioner is both a Neurological Physiotherapist and is certified in the above techniques.
Another pioneer in integration of Neurobiology into clinical decision making, is David Butler, who wrote the books, ‘Mobilisation of the Nervous System, and The Sensitive Nervous System, and was a co-author of ‘Explain Pain‘. Again a physiotherapist with training in the specialisation of Neurological physiotherapy would normally work with clients with diagnosis of a Neurological disorder e.g. Parkinson’s disease, Multiple Sclerosis, Spinal Injury etc. (Endeavour Lecture 5).
- For each of the above specialisations, give two examples of conditions that could be treated
Musculoskeletal, and Neurological physiotherapy are two of the many different branches of the modality. The former treats postural issues, pain, soreness, injury, range of movement, joint and skeletal issues, and other problems, and focuses on prescribing the correct equipment required for movement, e.g. walking sticks, splints, or crutches (Endeavour). The later, treats specifically diagnosed neurological conditions including: ‘Upper motor neuron syndromes, cerebellar ataxia, cognitive impairments, post-stroke, post-traumatic brain injury, Parkinson’s disease, multiple sclerosis and spinal cord injury‘ (Endeavour) and prescribes corrective equipment for mobility.
Physiotherapy aims to improve mobility and structural movement, strengthen muscles, and assist in new muscle memories forming. This is done via various disciplines requiring ongoing and or additional training. The specialties in training undertaken by physiotherapists can include: Endeavour lecture 5:Sports injuries, Post-operative and Orthopaedic conditions, Spinal pain and/or injuries, Neurological conditions, Cardio-respiratory problems , Balance dysfunction, Women’s health complaints, Arthritis and aged care (Endeavour Lecture 5)