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Physical Therapy and Rehabilitation

The term physical therapist and physiotherapist are interchangeable. Physiotherapy is often one of the earliest approaches taken in a physical medicine setting.  The primary goal is to reduce inflammation.  It can also be used to improve flexibility, reduce pain, and promote greater independence.  It is commonly used to treat conditions that affect muscles and nerves.  Physiotherapy approaches include the use of heat, cold, electric stimulation, ultrasound, iontophoresis, traction and massage.  Physiotherapy is applied during the acute and subacute phases of spinal therapy.  Physical rehabilitation is often applied after a course of physical therapy. Physical therapy may include the application of physiotherapy modalities such as ultrasound, electrical stimulation, heat, cold and iontophoresis in an attempt to reduce pain and inflammation.  In some cases a combination of these approaches may be used. Manual approaches such as joint mobilization or joint manipulation may be applied during the course of physical therapy.  The patient may be referred to an outside facility for aquatic therapy.

Physical rehabilitation refers to the use of procedures and techniques used to increase a patient’s physical capacity or potential.  The patient’s response to a course of physical rehabilitation is commonly monitored by a physician experienced in the diagnosis and care of neuromuscular and orthopedic disorders.  Some physicians in these fields will have additional expert skills in manipulation.  The attending health care specialist will determine when spinal care must shift from a more passive approach such as physiotherapy to active care with progressive physical rehabilitation.

The implementation of a physical rehabilitation approach is preceded by a functional assessment to determine physical limitations.  This serves as a baseline of human performance for which to design the rehabilitative program.  It also serves as a baseline measurement to measure therapeutic outcome.  The goals of physical rehabilitation include improving strength, endurance, balance, coordination and reaction time.  Emphasis is placed upon spinal and non-spinal joint integrity and stability.  Physical rehabilitation may be used in conjunction with functional restoration techniques such as mobilization or manipulation of joints and massage of soft tissues.  Adjustive techniques often promote joint mobility during the healing process.