A History of Physical Therapist Education Around the World
Marilyn Moffat
INTRODUCTION The roots of the physical therapist education reach back through ages. development therapy as an autonomous profession based on current scientific knowledge was in large part due to Per Henrik Ling Sweden. In 1813, he founded Royal Central Institute Gymnastics (RCIG) Stockholm for training gymnastic instructors. With founding RCIG, provided a professional identity therapist. Thereafter, evolved different ways around world. United Kingdom, it Society Trained Masseuses. Norway and Finland, influenced by work Ling, with emphasis massage training. States, result polio epidemics need treat those wounded during World War I. Confederation Physical Therapy (WCPT) has established standards guidelines entrylevel that are globally relevant available all its Web site. They include “WCPT Policy Statement: Education” 5 WCPT related entry-level (“WCPT Guidelines Therapist Professional Entry-Level Education”; Guideline Qualifications Faculty Entry-level Education Programs”; Clinical Component Curricula Therapists Delivering Quality Exercise Programs Across Life Span”; “Guideline Standard Evaluation Process Accreditation/Recognition Program”). Consideration across member organizations each regions clearly demonstrates major diversity exists THE ROOTS may have begun early 3,000 BC, evidence Chinese practiced massage. Hippocrates (460-377 BC) made reference friction massage.1 use therapeutic exercise 16th century occurred when Greeks realized health spiritual were inseparable. An Italian physician, Gerolamo Mercuriale, used both hygienically curatively 1500s.2 Sweden 19th century, Pehr combined rhythmic exercises benefits.3 17th, 18th, centuries, there references correcting childhood deformities splinting, massage, prosthetics; treating patients stroke reawakening weakened control brain motion; using regime gymnastics scoliosis.4 BEGINNINGS OF PHYSICAL THERAPIST EDUCATION IN SWEDEN developed first day (Figure 1), who been called “Father Swedish Gymnastics.” originally graduate Vãxjö gymnasium (1792) fencing master, went study theology at Lund Uppsala Universities. While traveling abroad after graduation, met individual (Ming) instructed martial arts tui na. acquired further England, Germany, France expanded Ming's special “gymnastics” or aimed enhancing stamina, strength, flexibility—requisites Ling's fencing. returned overuse injuries “rheumatism” healed himself had acquired. He appointed master Uppsala. Appreciating how restored his health, understood importance others. Thus, began studies anatomy physiology eventually completed doctor (meaning “physician” this time) curriculum. categorized system gymnastics, exercises, maneuvers into 4 specific areas: medical (physical therapy), military (primarily fencing), pedagogical education), aesthetic. then attempted garner support government approach, which not immediately forthcoming. Finally, instructors cooperation government.5Figure 1. LingAlthough other European contemporaries involved days therapy, is credited creating only therapist, but also formally state-sanctioned program. Until about 1827, RCIG institution offered mechanical treatments.6 examination students took upon completion program covered 3 areas medical, military, learning, these men capable working outside their regiments therapists educators. title given passed “Director Gymnastics,” they charge institute curing sick people therapy. 1887, Sweden's National Board Health Welfare officially sanctioned directors allowed them apply authorization from Board.6 Of interest fact one noblemen upper bourgeoisie, women did become until 1864. Male possess officer's degree equivalent admission whereas female complete compulsory school. addition, male years length, 2 since required take gymnastics. For qualified doctors, 1 year.6 Graduates spread out present new science cured prevented diseases disabilities lay audiences, physicians many countries, spas resorts throughout 20th century. This model “mechanical Medicine/medical Gymnastics” attracted including Lieutenant Jonas Kellgren London. His son-in-law, Edgar F. Cyriax, RCIG-trained physician London whose thesis titled, “The Elements Kellgren's Manual Treatment.” grandson James recognize founder orthopedic medicine.6 1864, underwent reorganization, led monopoly therapists. Even declared order practice anyone, MDs, pass official examination. specialist (doctors gymnastics/physical RCIG.6 It must be noted almost 100 (1830s-1940s), conflicts existed between physicians, especially orthopedists. overlap interventions apparent, resolutions really occur orthopedists “took up knife” place 1934, Patrik Haglund 2), divided 2: educators Carolingian Institute, name became responsible education. no longer received education, faculty medicine On hand, qualifications university. superior requiring 1½ years. basis minimized Haglund. surgeons held chair orthopedics 1913. group young broke away medicine. want men, particularly class, felt would same aspirations therefore act less autonomously. sad portion history probably than what happened parts Sweden, strong seemed lost.6Figures 3: Outpatient Polyclinic GymnasticsFigure 4. HaglundCurrently, association own department. There 7 schools country, graduating 550 per year. 3-year leads Bachelor Science Degree. Opportunities continuing exist, pursuit master's doctoral degrees.7 PT UNITED KINGDOM By late come Masseuses, composed trained nurses, certification exam consisted theory questions, practical living model. Along program, programs nurses primarily hospital-based programs. 1900, society Incorporated Masseuses (ISTM).8 As 1903, remedial course members ISTM Chelsea Training College. 1910, full under auspices ISTM. 1913, prepared actually see provide treatment hospitals, infirmaries, equivalent. New (including Clinque, College Massage Remedial Gymnastics, Schools Exercises Massage) opened doctors exercises.8 outbreak I, Britain's surgeon general corps 50 certified masseuses. ensuing years, maintained supply personnel, standard fraught difficulties. 1915, lectures demonstrations electricity added ISTM, June 1920, Chartered Medical Throughout 1920s, raise members. 1927, could sit alone, hold dual qualification Society.7 1930s, light, electrotherapy, hydrotherapy examination.8 During next decade, new, lengthened, more academic curriculum developed. Interestingly, some specialized time included maternity amputation, slings pulleys, chest conditions, paralysis, return-to-work programs, dexterity hands. 1942, changed “Chartered Physiotherapy.”8 After II, extended teachers' revised. refresher courses returning battlefronts. Three approval, existing enter.8 evolution Kingdom parallels establishment Australia historically British colonies.3 School Physiotherapy University Otago Zealand Currently, 35 thrive 1,700 enrolled varies. length (with minimum hours). Scotland, Wales, Northern Ireland, resulting BSc (Hons) degree. Students opportunity PhD levels.7 OTHER EUROPEAN COUNTRIES linked closely aligned Norway. Simultaneous birth tradition Norway, graduates brought 1838. Approximately 9 later, third Stockholm, Under influence, Oslo paved way 1897 (written communication, M. Haneborg V. Rekv, 2011). remained important therapist's retained distinct designation “physiotherapists” masseurs. 1916, Norwegian Association council authorized 1936, public granted educated any approved Ministry. Legislation 1956 gave right “physiotherapists Mensendieck therapists.” 1976, state educational Bergen, Norway's second-largest city. institutions college status 1982 exist 300 diploma college. mandatory supervised clinical year required, elevating level Postgraduate degree.7 Finland beginning resembles significant differences. private started 1869 Helsinki educate teachers. 1882, elective later obligatory subject Helsinki. 1908, spanned K. Partanen Keskinen, May Surprisingly, abolished 1942; however, end Finnish Winter (1939-1940) ongoing II (1941-1944) rehabilitation war wounded. defense forces quick masseurs help meet pressing injured wars. Physiotherapists 1943, objective begin again. Development legislation 1945 1946 concerning improved therapists' duties, rights Finally 1945, Invalidisäätiö (a foundation 1940 organize treatment, rehabilitation, disabled War). re-establishing milestone time, shift university-level college-level Admittance least secondary school background. Key injuries. From 1960s on, cities. within nursing colleges moved polytechnic 1990s. strengthened position world independent discipline secured continuity universitybased education.10 2011. 17 380-420 higher schools. earn degree/diploma 3½ (5,600 hours), corresponds 140 credit units. follows planning, content, implementation ensure, among things, meets international criteria. Continuing levels available.7 US contrast elsewhere, States followed slightly developmental course. origins historical events: poliomyelitis 1890s effects I citizens, rehabilitation. latter, previously noted, impetus Europe. Prior growing gradually governmental levels. A report Division Orthopedic Surgery Department Army 1920s hospitals reconstruction soldiers disabilities.11 physiotherapy section indicated hydrotherapy, importantly, national personnel (therapists). report11 suggested drawn allied therapies. follow-up, several chosen: Boston Education; Haven Normal Connecticut; Battle Creek, Michigan; Posse Boston, Massachusetts; Teacher's Program Oberlin College, Ohio; Leland Stanford Junior California. develop trainees designated “physical aides.”12 entered Frank Granger, MD, (chief Massachusetts General Hospital) Joel Goldthwait, (chairman Reconstruction Committee American Association) studied disabled, largely conceived Robert Tait McKenzie, MD. Granger Goldthwait sent Europe investigate war-wounded being treated England France. Upon return plan needs over 200,000 troops battlefront. put together groups aides. One assist aides/physical modalities, patients. civilian insane asylums 1840s, aides/occupational therapists.4 Marguerite Sanderson, aides Walter Reed Hospital. Mary McMillan joined Sanderson head McMillan, born raised death her mother, bachelor's culture corrective exercises. Finding incomplete, she neuroanatomy, neurology, psychology, accepted children's hospital. States. 1918, leave absence train emergency classes Portland, Oregon, 1914.4 original 13 striving individuals wounds.4 Treatments passive sports, games), hydrotherapeutic assistive/adaptive equipment. organizational meeting Women's Physiotherapeutic York City January 15, 1921,4 elected president. women, 1922 (APA) recognition few helped effort 1919.4 APA's “active member” category (1) graduated nursing; (2) graduates; (3) year's graduation. 1946, decision call themselves “physiatrists,” change Association. Also section, Section, meet.4 role progressed increasingly technician practitioner. phase, characterized college/university-based post-baccalaureate certificate level, generally approximately months Beginning (Walter Hospital College), grew 6 1928 34 1955.4 1950s 1970s, environments, increasing curricular content increased hours affiliations. 1979, average 142 completion. 1977, 84 providing 1978, 92% 8% level.4 evaluative criteria bachelor 1978.13 following year, House Delegates adopted degree.4 Eight percent 85 level. published 1996 2002 159 28% baccalaureate 70% 2% Doctor (DPT) last converted 2001. transition DPT 2001 on. (Creighton University, Southern California, Slippery Rock University) accredited 1995 1998. 2004, 55% Commission Accreditation (CAPTE) stated preferred degree.14 2011, 207 212 Four yet process converting. CAPTE criterion that, 2015, award will accredited. WORLD STANDARDS includes similarities differences, sought establish guide attempt assure graduation highest quality practitioner To end, Declaration Principle revised 2003 Statement, minor revisions 2011 (Table 1).15Table 1: Revised Statement Regarding EducationWCPT charges meetings, Executive series facilitate delivery high-quality experiences input WCPT. intent countries where associations do currently represented. anticipates varying extents depending needs. Individual developers modify interpret context situation, while aiming maintain opportunities designed facilitate. developed: Programs; (4) Span; (5) Program. Education.16 motion presented North American/Caribbean Region Meeting 2003, undertook task developing Table presents introductory material purpose, background, target application guidelines.Table Education: Introductory MaterialThe document contains found 3, detailed information area (you can going http://www.wcpt.org/node/29550 clicking “download”).Table Outline(2) Programs.17 guideline produced document. puts forth bring
Journal, physical therapy education