“Oh, you’re a physiotherapist? You know, my back has been killing me these last days – a massage would be awesome…?”
The reaction I get when telling people about my profession is, unfortunately, very predictable. Yet, a physiotherapist is so much more than a masseuse. The fields we are trained for and work in include not just muscle relaxation and injury rehabilitation.
Physiotherapy is a profession as variant as the patients that constitute our clientele and is an integral component to the field of Global Health.
Physiotherapy has been a central pillar to recovery from many diseases in Intensive Care Units (ICUs), in clinics, and in private practices for a long time. Since the COVID-19 pandemic hit, its necessity has recently gained recognition through the increased need of lung training for infected patients. Yet, respiratory therapy is not the only reason why physiotherapists are an essential part of the daily work in ICUs where severely ill or comatose patients spend days, sometimes even weeks or months lying in bed, often too weak to move by themselves. For those patients, moments of movement are crucial to laying a foundation for their future despite their illness. When physiotherapists support them to sit up, stand up, and get their circulation going, they feel their body again. Often, these are the moments where they experience a feeling of lucidity, which can be a first step into overcoming the disease.
Sticking to the current example of health effects of the COVID-19 pandemic, let’s look at another timely health issue. In many parts of the world, the lockdown and it’s social and economic consequences caused high burden of depression and other mental health problems. Sometimes these cases become so severe that patients need to get treated in a psychiatric clinic. An essential, yet often overlooked field within the physiotherapy profession, are psychiatry wards, where the work of physiotherapists is very much valued. Here, with body awareness therapies and physical activity, the therapists aim to find an outlet or a coping strategy to complement their patient’s psychological treatment. The significance of a holistic treatment for psychosomatic illnesses is becoming more apparent because more and more people realise that the mind and the body are not separate entities. Drawing up a holistic view of a patient is an essential part of the physiotherapy training. An integrated understanding of the body – mind – construct imbedded in an persons’ social and economic environment is what physiotherapists are trained to consider when commencing the journey of a patient’s individual healing process.
These were very specific examples. The most common aspect, that most of us experienced in the last months, however, was that sport and physical activity massively declined during the lockdowns due to the COVID-19 pandemic. I think it is safe to say, that many of us have realised during this pandemic how critical our daily activities and sports are to our mental health. The necessity of sufficient physical activity has become suddenly very apparent, also in relation to the higher risk that overweight people face when contracting the disease.
This is a specialty of the physiotherapy profession – prevention, rehabilitation and curation through physical activity both in relation to physical and mental health!
There is a clear link between the threat of communicable diseases and non-communicable diseases, which both influence the landscape of Global Health. The burden of disease shifting from communicable to non-communicable and lifestyle diseases, which is one of the major concerns in the future of Global Health, the need for more physical activity and health awareness is clear. The demographic change, which accelerates this shift, further increases the need for health professionals who can assist the elderly in maintaining an autonomous and active life as long as possible. However, lifestyle and non-communicable diseases need to be tackled with prevention measures. The subordinate position that sports and activity have been pushed into as a result of industrialisation, urbanisation and digitalisation, is not sustainable. Physical activity is just as much a basic need as food, water and sleep. There is no profession that focuses more on harvesting the many health benefits from movement and activity more than physiotherapy.
Current challenges in Global Health include the direct impact of the COVID-19 disease on affected patients, the overall health consequences the pandemic’s lockdown is causing for the population, and the impact that the growing burden of non-communicable diseases are having on the world’s population. Physiotherapists are needed to take on the part of promoting physical activity in health system approaches, policies, prevention programmes and research projects.
To get a little more specific on how these aspects of the physiotherapy profession can be valuable in the field of Global Health, let’s look at the five targets of the United Nations’ Sustainable Development Goals which concretely have a need for physiotherapists:
Goal 3: Good Health and Well-Being: This one is quite obvious since physiotherapy is a health care profession that not only promotes physical rehabilitation, but also ‘quality of life and movement potential’.
Goal 4: Quality Education: Since physiotherapy does not only include rehabilitation, but also promotion and prevention, therapists have a special role in health education, e.g. in lifestyle disease prevention or promotion of awareness and knowledge about one’s body. Health education, especially for children and young girls, is imperative to develop a healthy relationship to one’s body all over the world.
Goal 5: Gender Equality: Maybe a bit more indirectly, this goal can be influenced by physiotherapists. Around two thirds of physiotherapists are female. Strengthening the role physiotherapy plays in the field of preventative and rehabilitative medicine therefore positively impacts a female-dominated profession. Additionally, a full recovery from pregnancy and birth-related impairments is a crucial step in a woman’s life to being able to become an autonomous and strong mother – physiotherapy can assist with that.
Goal 8: Decent Work and Economic Growth: Physiotherapy is a profession that focuses on retaining and regaining physical health and with that impacts one’s ability to work. It is directly impacting economic growth by fostering a fast recovery after an impairment that caused inability to work. This also influences Goal 1: No poverty since full rehabilitation is often a necessity to still being able to make a living for a patient and its family after an injury or illness. Additionally, corporate health has become of interest for companies all over the world, realising that maintaining their employees’ health comes with a multitude of benefits for their enterprises.
Goal 10: Reduced Inequalities: Inequalities e.g. concerning gender, disabilities and economic status can be improved or even overcome when improving one’s physical capacity, which can positively influence one’s self-consciousness, autonomy and ability to master daily activities.
In the field of Global Health, where one of the main goals is to foster (Health) Equity all around the globe, interdisciplinarity is crucial to success.
Since the landscape of challenges in Global Health is as variant as the world’s population, professions that help to address each persons’ needs specifically to improve their daily life are essential and need to strongly collaborate with each other. Physiotherapists are trained to improve their patients’ life individually tailored to fit their prevailing situation and are therefore needed now more than ever.