Talk:Physiotherapy

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[edit] First comments

I have added this article to healthcare professions. This is because there is not a physiotherapist article in particular. This would be in need of revision if the situation changes --Vincej 20:45, 23 Jun 2005 (UTC)

I was once a therapist and left to get into computers and pharmaceutical sales. I make better money, I work better hours, I get great benifits and I can now give fantastic workout advice to my co-workers. So my investment in PT school did not pay off and anyone getting into it better have the schooling paid for by someone else to make your life livable.

I am a physiotherapist and have used it to live very comfortably in 3 countries so far (South Africa, Ireland and England). I work 35 hours a week and get 4 weeks of holidays every year. I agree that physiotherapy is not a career for everyone, especially if lots of money is one of your priorities. However, if you think you might like the look on the face of a woman who you've just helped to walk again, give it a thought.
Michael Rowe 23:06, 25 Apr 2004 (UTC)
I agree with you Michael.If it is just as, the source of income that you are seeing physiotherapy,there can be lot of dissappointment but otherwise you are in a position do do good that no one else can.
Inaddition i tell you physiotherapists are responsible them selve also in not marketing and selling their services appropriately.
Sharad K.S .India -- 61.95.215.133 20:24, 3 February 2006


[edit] "to diagnose disease and disability"

i do not believe that diagnosis is within the scope of a physiotherapist. current education (at least in the UK) does not provide them with the skills to do so. —Preceding unsigned comment added by 82.13.30.118 (talk • contribs) 24 December 2005

The scope of practise of physiotherapy varies considerable across the world. Physiotherapists are primary contact practitioners in some juristictions and therefore require diagnostic skills. By way of example, diagnostic reasoning is expected of physiotherapists in Australia, at least within their fields of expertise, e.g. the ability to diagnose the cause of musculoskeletal shoulder pain and to recognise what is non-musculoskeletal (and therefore outside the physio's expertise and requiring referral). Cheers, --Daveb 15:32, 23 December 2005 (UTC)
Would have to agree. Diagnostic techniques such as special tests to differentiate different muscular conditions as well as diagnostic reasoning is also part of the curriculum in the Philippines. Eilu (talk) 01:29, 25 May 2008 (UTC)

To whom it may concern:

Physical Therapy Diagnosis is an important concept for preventing disability and may be useful in determining Medical Necessity for Physical Therapy.

Physical Therapy Diagnosis is the only sustainable competitive advantage that distinguishes physical therapists from other professions such as athletic trainers, osteopaths, chiropractors, etc.

Outcomes will not distinguish physical therapy since many other professions employ some of the same techniques that PTs use.

My references for Physical Therapy Diagnosis are numerous and are at this blog post:

http://physicaltherapydiagnosis.blogspot.com/2007_11_18_archive.html

I look forward to joining this discussion.

Tim Richardson,PT timrichpt@physicaltherapydiagnosis.com —Preceding unsigned comment added by 72.185.125.123 (talk) 16:52, 4 May 2008 (UTC)

[edit] "Massage" has got to go ! (message from spammer)

I would like to propose that the current definition of "massage" as it is stated, should be changed. If it is, as it remains, we should include in the "massage" section, physiotherapy, osteopathy, chiropractic, even possibly nursing, among others. What I propose is that all the so-called massage techniques become "bodywork" - "massage" is a type of bodywork, as is physiotherapy, as is shiatsu, as is soft tissue therapy etc., etc., as such, it should be listed among the types of bodywork, rather than being a specific category in itself. The term "massage" is pretty much defunct now, it seems to include ANY technique that involves touching a person, and that they not be a physio, osteo, or chiro. I will post this propsal about the various bodywork discussions for some feedback. I think that Wiki is a great starting point to delineate and structure the types of bodywork that exist around the world. (Euripides 03:05, 1 May 2006 (UTC))

[edit] Removal of large sections of the article

I am just reviewing an earlier edit made by 66.83.186.114. Was there any need to remove large sections of information from the article? Couldn't it have been more advantageous to move the excess information to a new article page? Right now it seems like the current version of the article is extremely pale compared to the earlier version, and lacking information that would make the article more useful - categories, related links, references etc. Anyone else agree or disagree? -- Permafrost 06:27, 18 January 2007 (UTC)

[edit] Removal PT & Science

This section was removed as it is biased and not balanced. While it may have several references they are not balanced. The intent of discusing evidenced based practice, or lack there of, appears to be to disparage an entire profession. The content isbetter plced in an article on evidence based practice not in one describing a profession. —Preceding unsigned comment added by 70.19.130.44 (talk) 15:10, 10 December 2007 (UTC)

Are you the same user who removed the content yesterday? I posted a message to the previous IP address. In any event you could find that message [[1]]There are established guidelines for adding and removing content from wikipedia. Some of the relevant guidelines can be found at WP:RS and WP:V. You are not allowed to remove text just because you don't like it. Please undo your edit. You might consider creating an account for yourself and adding source data to create balance were you believe it's lacking. But unilaterally removing text that is verifiable, pertinent to the topic, and from reliable sources is not allowed. --Anthon01 (talk) 16:09, 10 December 2007 (UTC)
The content is not pertinent to the topic as presented. As presented it appears to have an agenda of disparaging the profession. If the material is not neutral it should be removed. The guidelines regarding well referenced sources do not apply to content that is not neutral or not appropriate for the article. 24.63.148.5 (talk) 13:42, 11 December 2007 (UTC)
Do you have a sourced statement that refutes the text? On wikipedia we are allowed to add text that is sourced, verifiable and not original research. The text in question conforms to all three reqirements. The content is totally appropriate to the topic. If you have a source that refutes the claims made by my citations, you can add them to the text. But you cannot remove well sourced text. Wikipedia is not a brochure or a self promotional service. It is an encyclopedia. --Anthon01 (talk) 14:00, 11 December 2007 (UTC)

Historical note: Anthon01 was confirmed to have used a sock (Special:Contributions/JacobLad) to make the discussed article edits. That account was then blocked using this summary: "blocked "JacobLad (Talk | contribs)" (account creation blocked) with an expiry time of infinite ‎ (Abusing multiple accounts: anthon01, proven by cu)"

The matter is discussed here. -- Fyslee / talk 14:51, 31 May 2008 (UTC)

[edit] Content removed

I have removed a set of sections, none of which had any sources at all, which contained what appear to me to be personal opinion. Feel free to reinsert once it is correctly sourced, but not until, thanks. Guy (Help!) 22:51, 27 January 2008 (UTC)

  • Please stop reinserting it. Being "general" does not excuse being unreferenced. Guy (Help!) 19:26, 30 January 2008 (UTC)

I have removed this sentence in need of a citation. It has hanging on the page with a fact tag for the last 3 months. The move towards the Doctor of Physical Therapy (DPT) professional postbaccalaureate degree indicates increased awareness of and training in the sciences, research, and interventions.[citation needed] Anthon01 (talk) 15:21, 7 March 2008 (UTC)

Thanks Guy (JzG). Good call. --Eustress (talk) 15:06, 7 March 2008 (UTC)

[edit] Physical therapist management Section

Currently this section seems kind of pointless. Can it be elaborated upon or could it be merged elsewhere? --Eustress (talk) 15:13, 7 March 2008 (UTC)

No one has commented, so I am removing it. Thanks! --Eustress (talk) 22:05, 12 March 2008 (UTC)

[edit] Professional Organizations

I added a section on professional organizations in direct relation to the PT profession. I obviously have not added all - mostly egocentric additions except the Singapore PT association.

JlharrisDPT (talk) 22:46, 16 March 2008 (UTC)

What is the difference between this section and the National associations under the External links below? --Eustress (talk) 23:36, 17 March 2008 (UTC)
Can JlharrisDPT or anyone who can answer my previous question? Otherwise, the new section should probably be deleted, especially since JlharrisDPT has explained his conflict of interest. Thanks. --Eustress (talk) 19:19, 19 March 2008 (UTC)
User:Fyslee has removed the comments under discussion. --Eustress (talk) 14:16, 23 March 2008 (UTC)
I guess there was no difference. Just thought it deserved more prominence and not just an "oh, btw, rummage through these links if you like" that the "external links" seems to portray. Also, Eustress, please get off the COI thing. Is your point to drive away ANYONE with expert knowledge in this area? It would be like deleting anything Einstein would post on physics because of COI. Come on. JlharrisDPT (talk) 16:01, 25 March 2008 (UTC)

[edit] Musculoskeletal Physical Therapy

I'm unsure the full reason for removing this section. It is by far the most common practice area of physical therapy. References have been given. Please do not just eliminate the whole section if one disagrees with one part of it. Leave feedback here as to why so it can be openly discussed. Thank. JlharrisDPT (talk) 02:28, 9 April 2008 (UTC)

It appears that JzG deleted the section because there were previously no citations to support it, so thank you for your additions; however, there are a few things regarding your additions that I'm hoping you can address. For example, the first statement, "Musculoskeletal (Orthopaedic) physiotherapists are able to diagnose, treat and help with prevention of pain/pathology, using the range of techniques outlined below[1]," is not even mentioned directly in the citation you've referenced--at least not directly to musculoskeletal PT. Can you refine this phrase to match the reference or find another one?
Also, the next two statements do not have any references: "A number of therapeutic modalities are available in physical therapy. These include exercise prescription (strength, motor control, stretching,proprioception training, and endurance), manual therapy techniques like joint mobilization/manipulation, and soft tissue massage. Also, various forms of "electrophysical agents" are utilized (such as cryotherapy, heat therapy, iontophoresis and electrotherapy)." I will tag them accordingly for now, but I'm hoping you can provide some more clarification and citations--Wikipedia is not a forum for original research and opinions. Thank you! --Eustress (talk) 03:45, 9 April 2008 (UTC)

Okay, well it looks like User:Fyslee and User:JzG too had issues with your addition and it has been removed. If you would like to propose it be re-added, please rework the section on this talk page and get approval before adding again, because it appears that a few users have objections with the addition. Hope this is reasonable. Thanks! --Eustress (talk) 15:11, 9 April 2008 (UTC)

Frustrating. Would like to see User:Fyslee and User:JzG post in the discussion as to what their problem is (with the info in the section). "A number of modalities are available..." statement is a Common_knowledge statement and therefore requires no citation. It's like saying the sun in bright. As a physical therapist, educated at a doctoral level, practicing in the musculoskeletal realm, I can tell you that those (in the US) are commonly used modalities. Now, from the first part regarding "diagnose, treat, prevent.." the citation provided states first line "Physical therapists (PTs) are health care professionals who diagnose and treat individuals" (emphasis added) and "..develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability.."(emphasis added). You're nitpicking regarding "..at least not directly to musculoskeletal PT" as we are all musculoskeletal PT's. So, I will restore the section (minus the initial section intro that I believe User:Fyslee removed. I thank User:Fyslee for helping fix the editing (eg technical) errors I made. —Preceding unsigned comment added by JlharrisDPT (talk • contribs) 02:57, 10 April 2008 (UTC)
My fault, I missed were you asked that I post the reworked version here. I ended up editing and reposting on the PT page. I apologize for doing so. I do hope I've addressed your concerns. Although would like JzG to post his specific concerns (if any remain) here before wiping out THE WHOLE section. Thanks for the understanding. JlharrisDPT (talk) 03:31, 10 April 2008 (UTC)
I think I can see part of the problem now. If all PTs are musculoskeletal PTs, then musculoskeletal physical therapy is not a specialty and does not belong in this section. (And if you make a posting mistake in the future, Jl, remember that you can (and should have in this case) undo your own edit!) --Eustress (talk) 14:47, 10 April 2008 (UTC)
No, it is a "specialty". The point is that all people have muscle and bones. It's kind of a all squares are rectangles but not all rectangles are squares. It's hard to strictly work ONLY in one area. Actually, in the PT profession, it would be impossible. I work in Orhopaedics which includes Musculoskeletal physical therapy. I also see a lot of patients that fall into neurological and integumentary (wound care). In fact, in all these "specialties" or as they are called in the profession "Practice Patterns" diagnose, treat and prevent. So, maybe this referenced statement should be placed somewhere more appropriate instead of just in the musculoskeletal section. What is everyone else's thoughts?JlharrisDPT (talk) 01:21, 11 April 2008 (UTC)

[edit] PT pictures?

Can anyone get some pertinent pictures to put on this page? Maybe of a client doing some exercises, a patient receiving ultrasound treatment, etc. Thanks. --Eustress (talk) 01:44, 14 April 2008 (UTC)

Will look for some pictures. Definitely NO ultrasound though, LOL. Please. The "magic wand" as I call it has been shown only to do 3 things 1. Heat tissue, 2. Help with Carpal tunnel 3. Help with calcific tendonosis. Does nothing for pain, which it tends to be widely used for by non evidence based practicioners. JlharrisDPT (talk) 12:53, 18 April 2008 (UTC)
I've placed the best that I could find on Wikicommons on here at the top. Unfortunately, it's a little 'dated'. Regards, CycloneNimrodtalk? 09:37, 19 April 2008 (UTC)

[edit] ref improvement

There is a ref in the Physical therapy#Evidence-based practice. I would like to gain consensus to format the ref. Which ref template do Wikipedians prefer for this ref.[2] QuackGuru 03:20, 10 May 2008 (UTC)

Yeah, all the refs in the article pretty much need to be reformatted according to WP:Cite. I think Template:Cite web will be most applicable to this page. If we all pitch in, it wouldn't take too much effort and the article might get closer to GA status. --Eustress (talk) 14:49, 10 May 2008 (UTC)
Bridges PH, Bierema LL, Valentine T (2007). "The propensity to adopt evidence-based practice among physical therapists". BMC Health Serv Res 7 (103). doi:10.1186/1472-6963-7-103. PMID 17615076.  For journals, I think this template works best. QuackGuru 17:48, 18 May 2008 (UTC)
I went through and templated the citations, using Magnus' and Diberri's tools for generating cite web/journal/etc. style citations. I did remove one reference which is unclear, as it is just a link to a whole series of references itself Real Time Ultrasound - Resources. It was already one of four citations in the Orthopedic specialty area, and wasn't really a meta-analysis, and was specific itself so I pulled it. -Optigan13 (talk) 05:52, 3 June 2008 (UTC)

[edit] Comment

This article is obviously written by someone with an interest in denegrating Physiotherapists. (Perhaps a Chiropractor?) Physiotherapy has higher levels of evidence based practice than most other health care professions. Refer to the Australian Physiotherapy Association guidelines my friend. —Preceding unsigned comment added by Natrick76 (talk • contribs) 01:35, 17 May 2008 (UTC)

[edit] Geographic scope: Title change

Shouldn't this article be called physiotherapy, if that is the most widespread name for the field? I don't understand how something should be renamed because of one country. Either way it is quite clear that this article needs work to be expanded to address physiotherapy in the entire world, not just the united states. cyclosarin (talk) 15:43, 18 May 2008 (UTC)

I'd support that once the article does scope for the whole world. At the moment it's almost entirely US based meaning it should be called physical therapy. Regards, CycloneNimrodTalk? 15:50, 18 May 2008 (UTC)
I think the physio vs. physical therapy point is a valid one. One thing to consider is that this is posted in the English version of Wikipedia and therefore seems as though the focus would be on physio/physical therapy in the English speaking world (English national language). This would include (not all inclusive) US, Canada, Australia, Great Britian. Of course, again, the US is the only one that names this profession as "physical therapists". Side note, originally it was physiotherapy in the US, but changed for unknown reason to me. JlharrisDPT (talk) 04:19, 19 May 2008 (UTC)
If no one objects by tomorrow, i'll move the page to Physiotherapy and change the article to fit accordingly. Regards, CycloneNimrodTalk? 08:21, 19 May 2008 (UTC)
I don't see how I could complain about that. A question, though: Could the current "Physical Therapy" page remain or redirect to the "Physiotherapy" page?JlharrisDPT (talk) 03:42, 21 May 2008 (UTC)
Philippines uses both; "Physical Therapy" is the official and more widespread term but some PT's prefer to use "physiotherapy" because it sounds better (and also because the layman tends to think of physical therapy = massage) Eilu (talk) 11:34, 29 May 2008 (UTC)
I have amended the title to reflect the title change discussion. It came as a shock that the article's title had been changed. Such an important change should have been the subject of an RfC. -- Fyslee / talk 14:39, 31 May 2008 (UTC)

<outdent> I was the one who moved the page (or requested that Jfdwolff moved it) and did so out of quite a clear consensus that it should be moved. Physical therapy, by anyone's standards, is an inappropriate name for the article since it only addresses a few nations. Physiotherapy is by far the more used title and as such it should have been moved. I'm sorry if you felt this was inappropriate. Regards, CycloneNimrod talk?contribs? 14:46, 31 May 2008 (UTC)

[edit] Yay

This article was selected at the WP Medicine Collaboration of the week. It will be nice to get some outsider help hopefully! --Eustress (talk) 03:58, 28 May 2008 (UTC)

[edit] Evidence Based Practice

Quackguru: There is no need to have the evidence based practice language in 2 sections of the page. You did not give a reason for reverting the deletion of one of them. The duplication will be removed again. If you have an issue discuss it here. —Preceding unsigned comment added by 24.218.131.73 (talk) 18:35, 28 May 2008 (UTC)

Per WP:LEAD, the lead should reflect the body of the article. If you have an issue with the material, then rewrite the deleted text and we can improve the article. QuackGuru 08:13, 29 May 2008 (UTC)
Quackguru - An introduction should serve as an overview, you are correct. However, the introduction and EBP sections contained a lot of the same content and not just "EBP is an issue" then cover that in the specific section. One or both need to be trimmed down as to not be redundant. JlharrisDPT (talk) 21:21, 1 June 2008 (UTC)
The lead should summarize the article. We have an entire section on Physiotherapy#Evidence-based practice. The lead should discuss edidence=based. QuackGuru 05:58, 3 June 2008 (UTC)

[edit] Modalities and Techniques

it was mentioned during voting that they should be briefly listed and discussed, with links to other articles as needed. Since there are a LOT of techniques, I think we should go with broader categories, maybe something along the lines of:

A PT may use several methods and techniques in treating a patient depending on condition
* Thermal Modalities (HMP, diathermy, cold packs, US)- used in controling pain and swelling
* Massage, manipulation- for muscle spasms, nodules
* Other modalities (traction, TENS, ES)
* Exercise- stretching to improve ROM, strengthening to correct mm imbalance; also sport/activity-specific training
* Major schools- McKenzie, Williams, Mulligan, Motor Learning, Brunnstrum, Bobath...

I'm just rattling things off the top of my head at the moment, though I have sources at hand (Braddom, DeLisa, Kisner & Colby, Carr & Shepherd). What do you guys think? Eilu (talk) 11:34, 29 May 2008 (UTC)

[edit] Direct access

The question of direct access (without medical referral by an MD) in the US needs to be addressed:

I don't have the time right now. -- Fyslee / talk 14:51, 31 May 2008 (UTC)

In what way do you think it needs to be addressed? Mention that the majority of states allow it in some form? or that MDCR requires a MD/DO signature on plan of care to proceed? or how access to PT in the states differs from other countries? JlharrisDPT (talk) 21:24, 1 June 2008 (UTC)
Those all sound like legitimate options. There should be enough good sources to make a short paragraph of 2-3 sentences, or something like that. I'm not familiar enough with the American PT scene to do it justice, but I think it should be mentioned. -- Fyslee / talk 02:37, 3 June 2008 (UTC)

[edit] patients vs people wording

The medicine manual of style directs articles not to use the word 'patient' but rather 'person' etc. I was going to apply this to the article and reword accordingly, but since this is an article on a type of therapy and patient may be apt would like a second opinion before I go ahead ? LeeVJ (talk) 12:24, 2 June 2008 (UTC)

Patient in this context would be no more 'apt' than in any other medical context, so go right ahead :) Regards, CycloneNimrod talk?contribs? 13:34, 2 June 2008 (UTC)
✓ Done LeeVJ (talk) 12:30, 3 June 2008 (UTC)