THE BRAIN’S UNIVERSITY

DEPARTMENT OF
PHYSIOTHERAPY

HISTORY OF
PHYSIOTHERAPY
Pt. Azangue Aurelle

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 INTRODUCTION
In ancient Greece, Hippocrates, Galen, Celsus, and others often used a variety of exercises,
massage, hydrotherapy, diet to treat and prevent all sorts of diseases.
Greek surgeon Antilos was the author of works about the gym. In ancient Rome, usually
bodily exercise, massage and water procedures involved in the baths (baths).
Physicians like Hippocrates, Hector 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.
A very long time physical culture is used as a prophylactic and therapeutic agent in various
diseases. Even in ancient times was used for health promotion exercise, sauna (bath),
massage, hydrotherapy, diet and other means.
For example, in ancient India, China, Egypt in bad joint mobility used by stretching, massage
and water therapy. In ancient Indian surgeon Sushruta in his practice applies physical,
breathing exercises, as well as massage and hardening.
Chinese doctors were ground and pulled the joints with different symptoms. In the book
«Cong-fou» (3000 BC) describes the active, passive and combined exercises and massage,
that is, grinding.
Scientists suggest that preventive medicine is the birthplace of ancient China. Chinese
believed the most important aspect of disease prevention medicine.
Aphorism "This doctor is not he who heals the sick, and he who prevents the disease" came
up with the Chinese.
In ancient India, yogis have used at least 800 of breathing exercises, most of all - for holding
your breath, with the help of these exercises are prevented and treated disease.
Ancient Egyptian doctors were struggling with rheumatism with physical exercise, massage,
diet, gidroprotsedur.
The book Oribaza created in 360 AD, describes almost all the materials of the time, with
remedial gymnastics play a full book. K. Galen used the gym for the treatment and prevention
of diseases of bone and muscular systems, also at the wrong metabolism, sexual weakness,
etc., among other things, from a therapeutic purpose, he ordered the sports exercise (rowing,
walking outdoors, etc. ), picking berries, fruits and vegetables, besides excursions and
grinding.
Physiotherapy dates back in 250 AD, when gold fish-electric fish was used for pain relief in
gout and headache cases. Physiotherapists today use certain type of currents to give pain

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relief.

In prehistoric era, buddhists and hindus recognised "pain as a sensation" but gave greater
importance to its emotional aspects. Non-invasive methods were used for pain relief.
In the Middle Ages, occupations physiotherapy, massage and bath were given too little
attention and they were virtually forgotten.
In 1771 published a textbook in two volumes in orthopedics, which are described in detail
gymnastics, gidropIn 1780 the published work of Tissot "Medical gymnastics, or exercise of
human organs under the laws of physiology, hygiene and therapeutics, it sets out descriptions
of various physical exercises, massage (rubbing) as well as their use for treating all sorts of
diseases.rotsedury, massage, diet, etc
In 1864, the Swede T. Brandt developed a system of therapeutic exercise and massage to treat
patients with gynecological diseases.
In 1881 the German Ertel for the treatment of diseases of the heart and blood vessels
suggested a method of climbing in mountainous terrain (terrenkur).
In 1884, Schott developed exercises for heart patients, which was based on resistance
exercises.
In 1889 a Swiss doctor Frenkel proposed a set of compensatory gymnastics for the treatment
of ataxia, paralysis, paresis, and other diseases of the nervous system.
In 1894, there is the first evidence of a group of nurses in the history of physiotherapy with a
Chartered Society. Within twenty years, physiotherapy programs were set up in other
countries
The first American professionals in the history of physiotherapy were from the Walter Reed
College and Hospital in Portland Oregon. Rather than being called physiotherapists, they
were called reconstruction aides. These aides were nurses and they had a physical education
background. They were important in the recovery of many World War I veterans.
HISTORY OF MODERN PHYSIOTHERAPY
Research has been done throughout the modern history of physiotherapy. In fact, right near
the very beginning, a research study was done in the US. It was published in 1921 named PT
Review. Physiotherapy research continues today in a myriad of specialties.
Also in 1921, the Physical Therapy Association was formed by Mary McMillan (American
Women's Physical Therapeutic Association). This group later became the American Physical
Therapy Association(APTA), arguably the most influential organization in the American

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history of physiotherapy.
Another landmark in the history of physiotherapy was during the breakout of the polio
epidemic. These physiotherapists did groundbreaking work in the rehabilitation and treatment
of the polio patients. Although the primary procedures include massage and exercise during
the time, physical therapy benefited the polio patients to a large extent. The focus on joints
and use of manipulation started gaining popularity in the 1950's.
The Georgia Warm Springs Foundation was started in 1924 to deal with the ever-growing
epidemic of polio. The foundation offered physiotherapy for these patients. Sister Kinney
was known nationally for her work with polio victims. She practiced at the Mayo Clinic.
The polio epidemic was a turning point in the history of physiotherapy After the polio
epidemic had waned, the treatments of choice were massage, exercise, and traction.
In about 1950, chiropractic manipulations came on the scene in the history of physiotherapy.
This was most common in Great Britain
In 1921, a small group of masseurs in Cape Town banded together to form the Certified
Masseurs Association, primarily to rhabilitate the soldiers after WW1 as the patients affected
by the polio epidemic also hitting south Africa
Physiotherapy was introduced in Nigeria by two British physitherapists. They were employed
by the Nigerian government and attached to the Royal Orthopaedic Hospital, Ibobi,Lagos.
In Ghana another British Pt named Prince commenced physiotherapy in the early 1940.
Physiotherapy started in the nations’s Premier Teaching Hospital in Accra.
In Cameroon, physiotherapy was established in 1990. In 1999 they became a member of the
world physiotherapy as Cameroon association of Physiotherapy over 150 members to date.
Definition of Physiotherapy
According to the WHO, Physiotherapists assess, plan and implement rehabilitative programs
that improve or restore human motor functions, maximize movement ability, relieve pain
syndromes, and treat or prevent physical challenges associated with injuries, diseases and
other impairments with the use of techniques such as movement, ultrasound, heating, laser
and other techniques.
Physiotherapy according to world Physiotherapy is a health care profession concerned with
human function and movement and maximizing physical potential. It is concerned with
identifying and maximizing quality of life and movement potential within the spheres of
promotion, prevention, treatment and rehabilitation.
On the other hand, physiotherapy is defined by World Physiotherapy Europe region as a

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branch of medicine which promotes and prescribe physical programs in the areas of
prevention, maintenance, promotion and treatment across the life span

Role of Physiotherapy in health promotion and prevention

Health is a state of physical, mental, and social well-being, not simply the absence of disease.
Physiotherapists, as health care professionals who are experts in movement and function, have
the knowledge, abilities, and training to tailor physical exercise to the general public and to
people living with chronic disease in particular. Physiotherapists have the necessary
university education and experience to address the needs of health promotion and disease
prevention. The roles of the physiotherapist in health promotion and prevention among others,
include:
 Undertaking a comprehensive examination and determining objectives.
 Adapting a personal physical activity program, monitoring and following up progress.
Further training, advice and monitoring, as needed.
 Increasing movement ability, improving function and promoting physical fitness, thus
improving health and the quality of life.
 Physiotherapists understand the importance of the broader determinants of health and their
impact on individual and population health status.
As an integral part of a collaborative interdisciplinary primary health care team,
physiotherapists can assist in health promotion and disease prevention strategies, as well as in
the identification and remediation of a myriad of health condition.
Physiotherapists, being health care professionals who are expert in movement and function,
possess the knowledge, skills and training to adapt physical activity to the population in
general, and to persons who are coping with chronic disease in particular .As physiotherapy
professionals, they undertake lot of rehabilitative task and had proved their presence among
the medical fraternity and public as well.
Physiotherapy profession has seen some significant advances and gained the recognition as a
specialized field of medicine few decades ago. This practice has come a long way from the
early employed heat, electrical stimulation and water-based applications to aid movement and
function. Physiotherapy is the most commonly prescribed treatment to assist in the recovery
of many injuries and conditions, chronic pain, car and sports injuries, and challenges with
mobility can all be greatly improved with the use of physiotherapy .

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 Branches of Physiotherapy
Physiotherapy is a complex specialty, as it deals with all disciplines of medicine.
Development in this field has resulted in a variety of sub-specialization which could be
carried to obtain a doctorate. These includes;
1. Physiotherapy in Orthopedics
Physiotherapy in Orthopedics also called musculoskeletal physiotherapy is a branch,
involved in the treatment of physical alligments concerned with structures surrounding the
joint region such as bones, muscles, ligaments and bursa.
It focuses on the correction of deformities or functional impairments to the skeletal system,
particularly the extremities and the spine or associated structures. Essentially, they focus on
the musculoskeletal system.
In this branch we study how to deal with conditions such; muscle pain, strain or tear, joint
stiffness, fractures, ligament strain, sprain or tear, inability to walk (gait problems),
inflammation of tendons( tendinitis) and bursa( bursitis), Joint pain, poor postures, joint
inflammation in case of osteoarthritis or rheumatoid arthritis
2. Physiotherapy in Neurology
Neurological physiotherapy is a specialist area of physiotherapy. Focusing on assessing and
treating people with movement disorders that have resulted from injury or disease to the brain,
spinal cord or extremities of the body. With an aim to improve quality of life by maximizing
your potential. Some of the pathologies here involves Stroke, Parkinson’s disease, multiple
sclerosis, head and spinal cord injuries and peripheral neuropathy.
3. Physiotherapy in Cardio-respiratory conditions
Cardiorespiratory physiotherapy is an area of physiotherapy that specializes in the prevention,
rehabilitation, and compensation of clients with diseases and injuries in the heart and lungs.
These conditions may manifest themselves as shortness of breath, persistent cough, increased
work of breathing or the reduced ability to exercise . Common cardiorespiratory conditions
include; Chronic Obstructive Pulmonary Disease( COPD) , asthma, bronchitis, congenital
cardiac failure, hypertension, angina, heart attack, pneumonia and heart or lung injuries or

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surgeries.
4. Physiotherapy in Sports
Sports physiotherapy is a special branch of physiotherapy that particularly deals with the
assessment, diagnosis, treatment, and prevention of injuries and problems related to sports.
Athletes are generally engaged in high level of physical performance, which puts a lot of
stress on their joints, bones, and muscles. In addition to injury management, sports
physiotherapy involves in helping athletes stay healthy and return to their optimum level of
function if not better. Some of the conditions managed under this are: any muscle spasm (pain
and tightness of muscle), muscle strain, ligament sprain, tear and all other sport injury
5. Physiotherapy in Obstetrics and Gynecology
The role of the Obstetric Physiotherapist is to promote health throughout the childbearing
period and to help the woman adjust advantageously to the physical and psychological
changes of pregnancy and the post-natal period so that the stresses of childbearing are
minimized. Antenatally and post-natally the obstetric physiotherapists advises on physical
activity associated with both work and leisure and are specialist in selecting and teaching
appropriate exercises to gain and/or maintain fitness including pelvic floor education. In
addition they are skilled teachers of effective relaxation, breathing awareness and positioning
and thus helps women to prepare for labour. Example of conditions include ; Pelvic pain, Low
back pain, osteoporosis, diastasis recti
6. Physiotherapy in Pediatrics
Pediatric physiotherapy is a branch of physiotherapy that deals with the musculoskeletal
problems of infants and adolescents who are between 0 to 18 years old. They help in the
diagnosis, management, and prevention of physical injuries and congenital medical
conditions. The main goal of pediatric physiotherapy is to help each child reach their full
potential by helping them function as independently as possible and promote active
participation in the community. The following conditions could be managed by a pediatric
physiotherapists; autism, cerebral palsy (CP), arthrogryposis, down syndrome, torticollis, club
foot, muscular dystrophy, developmental coordination disorder, Hydrocephalus and Spina
bifida.
7. Physiotherapy in Geriatrics
Elderly people often suffer from common medical conditions like arthritis, respiratory
problems, cardiovascular disease, vision impairment, weak muscles, and mental illness.
Geriatrics is a branch of physiotherapy that focuses on health care of the elderly. Geriatric
conditions usually include musculoskeletal problems, mental illness, incontinence, and

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impaired senses, balance problems, chronic pain, and sleep deprivation.
8. Occupational physiotherapy
Occupational therapy (OT) is a branch of physiotherapy that help people of all ages who have
physical, sensory, or cognitive problems to regain independence in all areas of their lives.
Occupational therapists help with barriers that affect a person's emotional, social, and physical
needs. To do this, they use everyday activities, exercises, and other therapies.
OT equally helps kids play, improves their school performance, and aids their daily activities.
It also boosts their self-esteem and sense of accomplishment. OT can accompany patients
with cancer, autism, CP, learning problems, birth injuries or birth defects, mental health and
behavioral problems, developmental delays, post-surgical conditions, burns, multiple sclerosis
and other chronic illnesses.
Community based rehabilitation physiotherapy
Community based rehabilitation physiotherapy is a strategy within general community
development for the rehabilitation, equalization of opportunities, poverty reduction and social
inclusion of all people with disabilities. It is implemented through the combined efforts of
people with disabilities themselves, their families, organizations and communities, and the
relevant governmental and non-governmental health, education, vocational, social and other
services
Types of physiotherapy modalities
1. Manual Therapy
Manual therapy involves the application of the hands to the body with a therapeutic goal.
Chiropractic, osteopathy, physical therapy, massage therapy, and touch therapies are all
examples of manual therapy approaches used to treat musculoskeletal diseases. Manual
therapy includes mobilization and manipulation of joints which helps to relief pain, increase
the flexibility of the joint, increase venous return, ease synovial fluid flow, activate
mechanoreceptors found in the joint capsule and induce relaxation.
2. Exercise therapy
Exercise improves mobility and balance. It also increases flexibility, while building strength.
It improves mental health, Help manage weight, reduce the risk of disease, strengthen bones
and muscles and improve once ability to do activities of daily living. The choice of exercises
is based on once injury or condition, and the degree of severity involved. Done under
guidance at the physiotherapist’s rooms, they are highly likely to also be included in a home
program during treatment, and as part of a management regimen afterwards in order to

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prevent a recurrence of pain.
3. Cryotherapy
Cryotherapy is a physical therapy approach used to treat acute musculoskeletal system
injuries and to improve athletic performance. cryotherapy or ‘‘ice therapy’’ has the effect of
constricting the blood vessels which helps combat inflammation and swelling after injury.
Cold packs also improve joint mobility, which can increase the effectiveness of manual
therapy.
4. Thermotherapy
Thermotherapy is also known as heat therapy and is the oldest way to treat injuries/pain relief
by the use of heat in therapy. Its use is spread worldwide because of its effectiveness. It
reduces the pain by rising the temperature of the soft tissues, metabolic rate and also increases
in the blood flow by vasodilatation. Deep heating helps to reduce the sensitivity of the sensory
nerves, decrease in muscle spindle, root to muscle relaxation and also increase in flexibility.
Physiotherapy can take in the form of hot cloth, hot water bottle, infrared, ultraviolet rays,
shortwave diathermy, heating pads, whirlpool bath and sauna bath.
5. Electrotherapy
Electrotherapy modalities also known as electrophysical agents are types of physical therapy
that aim to reduce pain and improve function via an increase in energy (electrical, sound,
light, or thermal) into the body. Examples include therapeutic ultrasound, low‐level laser
therapy, transcutaneous electrical nerve stimulation (TENS), and pulsed electromagnetic field
therapy.
6. Hydrotherapy
Hydrotherapy is a procedure where water at different temperatures are used to relieve pain
and treat illness. Hydrotherapy can help treat a variety of conditions, including arthritis,
stomach problems, sleep disorders, stress and depression. The theory behind hydrotherapy is
that water has healing properties that can mitigate various ailments and conditions. Different
states of water such as ice, liquid, and steam is used in the treatment of various conditions.
Water cure therapies comprise enema therapy, gel therapy etc. Cryotherapy, cold water
immersion or ice bath is a treatment method that is used by physical therapists, sports
medicine facilities and rehab clinics)
7. Kinesio taping
Kinesiology tape is a thin, flexible tape that was developed to aid muscle movement and
enhance athletic performance. Therapeutic tape is applied to certain areas to encourage
recovery and provide support to joints and muscles.

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The history behind physical therapy has grown and evolved a lot over the years and its
evolution is an ongoing process. With each new innovation, technique and procedure, the
capability of the craft that therapists use to treat t heir patients keeps getting better. Physical
therapy has come a long way since its beginning and with a lot of success.

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