Physiotherapy is defined by the World Physiotherapy as “providing services to individuals and populations to develop, maintain and restore maximum movement and functional ability throughout the lifespan”.
In order to achieve therapeutic outcome, physiotherapy adopts the beneficial effect of human physiological response to physical stimulation. For instance, the physical modalities which will be commonly used including electricity, water, cold, heat, light, magnetism, exercise, manual technique and … etc.
With the skillful practice of scientific evidence and the art of empathy, physiotherapy will apply the principle of physical, psychological, pathological and anatomical sciences, to achieve an ultimate goal of safe and effective clinical outcome on the patients.
In summary, physiotherapy will enhance patients’ physical activity and functional movement recovery, improve the muscle strength, prevent disease and improve quality of life.
Physiotherapy
vs
Chiropractic
Physiotherapist: A person trained to assess and treat physical disabilities by means of remedial exercises, manual therapy and mechanical, thermal or electrical energy (Supplementary Medical Professions Ordinance Cap. 359). 1
Professional Title
Chiropractor: A person trained and qualified in the practice of chiropractic including the practice of the prevention, diagnosis and treatment of functional disorders of the human body through manipulation of the joints, particularly of the vertebral column and peripheral joints, including the pelvis (Chiropractors Registration
Ordinance Cap. 428). 2
Developed from orthodox western medicine.
Origin
Developed as one of the complementary and alternative therapies. 3
- Health promotion
- Prevention of diseases/injuries
- Treatment/intervention
- Habilitation
- Rehabilitation
- musculoskeletal
- neurological
- cardiopulmonary
- Integumentary 6
Treatment philosophy
Adoption of the theory of vertebral subluxation as causes of body diseases or disorders. 4
- Exercise therapy
- Electrotherapy
- Manual therapy
- Functional training
- Acupuncture
- Other technologies
- Patient education (e.g., self-management, injury prevention) 6
Treatment methods
Primarily relying on vertebral manipulation to adjust spinal mal-alignment. 4
Other adjunctive treatments e.g. electrotherapy.
- Public, non-governmental, and private sectors
- Hospitals
- Out-patient clinics, ambulatory care/day rehab centres
- Elderly homes
- Residential facilities for disabled Schools (e.g., special schools)
- Sports on-field
Practice Setting (HK)
Private sector, mainly ambulatory care.
Differences between Physiotherapy and Occupational Therapy
Rehabilitation is “a set of measures that assist individuals, who experience or are likely to experience disability, to achieve and maintain optimum functioning in interaction with their environments” (WHO, 2011)5. Both Physiotherapy (PT) and Occupational therapy (OT) are integral to health care services.
Physiotherapy
vs
Occupational Therapy
Professional title & service
Occupational Therapist A person trained to assess and treat disabilities caused by diseases or injuries using mental, physical or social activities to enable the disabled to achieve the maximum possible independence in daily life (Supplementary Medical
Professions Ordinance Cap. 359). 1
Occupational therapy is a “client-centred health profession concerned with promoting health and well- being through occupation”, which includes life roles and leisure activities (WFOT Resource Manual: Occupational Therapy for Displaced Persons, 2019). 7
.
Treatment focus
Occupations: defined as any type of meaningful activity in which one engages in order to “occupy” one’s time (e.g., work, activities of daily living, sleep, leisure, socialparticipation) (AOTA, 2014; WFOT, 2019). 7,8
- Public, non-governmental, and private sectors
- Hospitals
- Out-patient clinics, ambulatory care/day rehab centres
- Elderly homes
- Residential facilities for disabled
- Schools (e.g., special schools)
- Sports on-field
- From in-patient care to ambulatory and community care
- From acute, subacute, extended and rehabilitative care 6
Practice Settings (HK)
Similar to physiotherapy, but the private sector is smaller.
Case Example
Using patients with total hip replacement as an example, both physiotherapists and occupational therapists are involved in providing pre-operative and post-operative rehabilitation to these clients. PT focuses more on airway clearance, range of motion and strengthening exercises of the operative leg, gait training, exercises for improving balance and endurance, and prescription of walking aid (e.g., cane) to facilitate independent walking function. On the other hand, OT focuses more on cognitive function, psychosocial support, home modification (position and height of furniture, grab bars for bathroom) and prescription of assistive devices adaptive equipment to facilitate independent ADL (e.g., dressing sticks), as indicated (Riddell, 2013).12
References
- Supplementary Medical Professions Ordinance, Chapter 359, Laws of Hong Kong.
- Chiropractors Registration Ordinance, Chapter 428, Laws of Hong Kong.
- Coulter ID, Shekelle PG. Chiropractic in North America: a descriptive analysis. J Manipulative Physiol Ther 2005; 28: 83-89.
- Chiropractic: history and overview of theories and methods. Clin Orthop Relat Res 2006; 444: 236-242.
- World Physiotherapy (2011). World Physiotherapy guideline for physical therapist professional entry level education. Retrieved from https://world.physio/sites/default/files/2020-07/G-2011-Entry-level-education.pdf
- World Physiotherapy (2019). Policy statement: Description of physical therapy. Retrieved from https://world.physio/sites/default/files/2020-07/PS-2019-Description-of-physical-therapy.pdf
- World Federation of Occupational Therapists [WFOT] (2019). WFOT Resource Manual: Occupational Therapy for Displaced Persons. Retrieved from
https://www.wfot.org/resources/wfot-resource-manual-occupational-therapy-for-displaced-persons - “Occupational Therapy Practice Framework: Domain and Process (3rd Edition)” . American Journal of Occupational Therapy. 68 (Suppl. 1): S1–S48. March–April 2014.
- World Federation of Occupational Therapists [WFOT] (2013). Definitions of occupational therapy from member organisations. Retrieved from
https://www.wfot.org/resources/definitions-of-occupational-therapy-from-member-organisations. - World Health Organization [WHO] (2011). World Report on Disability. Retrieved from http://whqlibdoc.who.int/publications/2011/9789240685215_eng.pdf
- Fernando, M., Hellman, T., & Josephsson, S. (2014). A Shared Viewpoint but Diverse Focus: A Case Study About Teamwork Within Geriatric Home Rehabilitation.ati
- Riddell, J. (2013). Occupational therapy for adults undergoing total hip replacement. Practice guideline. British Journal of Occupational Therapy, 76(6), 291-292.
