Wednesday, September 22, 2010

History of Physical Therapy


Physicians like Hippocrates and later Galenus are believed to have been the first practitioners of physical therapy, advocating massage, manual therapy techniques and hydrotherapy to treat people in 460 B.C.[13][verification needed] After the development of orthopedics in the eighteenth century, machines like the Gymnasticon were developed to treat gout and similar diseases by systematic exercise of the joints, similar to later developments in physical therapy.[14]

The earliest documented origins of actual physical therapy as a professional group date back to Per Henrik Ling “Father of Swedish Gymnastics” who founded the Royal Central Institute of Gymnastics (RCIG) in 1813 for massage, manipulation, and exercise. The Swedish word for physical therapist is “sjukgymnast” = “sick-gymnast.” In 1887, PTs were given official registration by Sweden’s National Board of Health and Welfare.

Other countries soon followed. In 1894 four nurses in Great Britain formed the Chartered Society of Physiotherapy.[15] The School of Physiotherapy at the University of Otago in New Zealand in 1913,[16] and the United States' 1914 Reed College in Portland, Oregon, which graduated "reconstruction aides."[17]

Research catalyzed the physical therapy movement. The first physical therapy research was published in the United States in March 1921 in The PT Review. In the same year, Mary McMillan organized the Physical Therapy Association (now called the American Physical Therapy Association (APTA). In 1924, the Georgia Warm Springs Foundation promoted the field by touting physical therapy as a treatment for polio.[18]

Treatment through the 1940s primarily consisted of exercise, massage, and traction. Manipulative procedures to the spine and extremity joints began to be practiced, especially in the British Commonwealth countries, in the early 1950s.[19][20] Later that decade, physical therapists started to move beyond hospital based practice, to outpatient orthopedic clinics, public schools, college/universities, geriatric settings (skilled nursing facilities), rehabilitation centers, hospitals, and medical centers.

Specialization for physical therapy in the U.S. occurred in 1974, with the Orthopaedic Section of the APTA being formed for those physical therapists specializing in orthopaedics. In the same year, the International Federation of Orthopaedic Manipulative Therapy was formed,[21] which has played an important role in advancing manual therapy worldwide since.


Physiotherapy treatment has evolved over the last 110 years in the UK. It commenced in 1894 when ‘The Society of Trained Masseuses’ was founded by four nurses from The London Hospital. In 1919, this society amalgamated with ‘The Institute of Massage and Remedial Exercises’ established in Manchester and in 1920 the Royal Charter was granted and the two bodies became ‘The Chartered Society of Massage and Medical Gymnastics’. In 1944, the Society in the UK adopted its present name as the ‘Chartered Society of Physiotherapy’. In 1964, Vidler stated that ‘You needed a good educational background to train as a physiotherapist, but when qualifi ed it is wit and observation that give you the ability to judge the effect of your treatment and report on it or discuss it with the doctor’ (Vidler 1964). It was not until 1977 that Chartered Physiotherapists became autonomous clinicians in the UK, with the ability to take selfreferrals, assess, diagnose and treat without a medical referral.

In 1964, Rule 2 of the Code of Conduct stated that registered physiotherapists should confi ne themselves to the recognised fi eld of physiotherapy (Gardiner 1964). Physiotherapy was extremely protective of its core skills of massage, exercises and electrotherapy (added in 1929). At this stage, it lacked the foresight and courage to develop new skills in other areas. Physiotherapists
were generalists and expected to undertake all types of physiotherapy treatment. Gradually, physiotherapy skills have expanded to cover many specialist areas, such as continence. Now, physiotherapists confi ne themselves to areas in which they have had training and in which they are competent. In 1992, the profession became an all-graduate entry profession in the UK.