Physical therapy, like much of medicine, has continued to evolve over the last century.
From the elite athlete to the gentleman with low back pain to the elderly woman who has suffered a stroke, the profession of physical therapy has the unique ability to help each of these patients. Physical therapy, like much of medicine, has continued to evolve over the last century. We, as physical therapists, are able to treat problems better than ever before.
If you travel back in time, you will find that the interventions used by physical therapists today have been used throughout the ages. The first real evidence of physical therapy dates to 460 BCE. Ancient civilizations like the Greeks, Romans and Chinese used massage, exposure to the sunlight and water for healing the wounded. Exercise was used in almost all cultures and across time as a way to improve health.
The earliest documented origins of actual physical therapy as a professional group dates to 1894 when nurses in England formed the Chartered Society of Physiotherapy. In the United States, evidence suggests there were efforts at rehabilitation during the Civil War.
However, the profession really began to come into its own during the first part of the 20th century after the devastating effects of World War I. Then called "reconstruction aides," these nurses had a background in physical education and helped rehabilitate the injured returning from the war who were well enough to exercise.
The first physical therapists graduated in 1914 from Walter Reed Hospital and Reed Hospital in Oregon. Initially, physical therapy was very basic, covering wheelchair and crutch training. Very quickly, the focus was shifted to getting the wounded stronger and back to their prior level of function. No longer would an injured soldier be left to languish in a wheelchair at an old-soldier's home; he would be rehabilitated so as to be able to return home, perhaps even to get a job.
The development of the first true hospitals occurred between 1850 and 1900. The early 1900s brought formal rehabilitation to the hospital setting as well as the introduction of the scientific method to medicine.
By 1921, the Physical Therapy Association, now the American Physical Therapy Association, was formed. The goal of the association was to establish national educational standards for physical therapy students and to encourage research within the profession. The first physical therapy research article was published that same year.
For the next 20 to 30 years, both polio and physical injuries to war veterans would dominate the primary problems treated by physical therapists. In 1924, the Georgia Warm Springs Foundation was created to provide a comprehensive therapy treatment center for patients affected by polio. This, combined with the dramatic increase in patients affected by polio nationwide, brought additional exposure to the profession.
An Australian Army nurse named Sister Kenny revolutionized the treatment of patients with polio and came to the U.S. in 1940 to share her knowledge and techniques for not just treating patients, but providing true rehabilitation.
Instead of being put into plaster casts or braces for indeterminate amounts of time until they were declared "healed," patients with polio were now stretched, exercised and returned to prior levels of function previously thought to be impossible. Physical therapists even worked with medical researchers to develop the Salk polio vaccine trials.
Physical therapy was primarily provided at acute care hospitals or specialized rehabilitation centers until the 1950s when outpatient clinics, schools and skilled nursing facilities all began to hire their own therapy staff. Rehabilitation was now becoming widespread and accessible to the whole population.
The passing of the Civil Rights Act of 1964 did more than to reduce racism; it also allowed for those with disabilities to access the world in a way they had not been able to before. This was now an opportunity for physical therapists to assist patients in a very different way no longer just helping with rehabilitation from an injury or illness but in reintegrating into society, something therapists continue to do today.
Physical therapy now is a broad field of rehabilitation medicine, able to help patients in a variety of settings and with a multitude of injuries achieve a higher level of function. Physical therapists are found in acute care hospitals, rehabilitation hospitals, outpatient care centers, wound care clinics, holistic health centers, hospital urgent care clinics, schools and on staff with many athletic organizations.
They treat everyone from infants to the elderly and will continue to be a very important asset to the medical profession for many years to come.
Kerry Muldoon Blossfeld is a physical therapist at Spaulding Framingham and has a degree in physical therapy from Boston University. She treats patients with a variety of musculoskeletal dysfunctions and post-polio syndrome. For more information please call 508-872-2200.