How to cite this article: Md Mizanur Rahman, Md Monoarul Haque. Multidimensional Application of Physiotherapy in the Context of Bangladesh. Ortho & Rheum Open Access 2018;11(2): 555809. DOI: 10.19080/OROAJ.2018.11.555809
Physiotherapy or physical therapy is a clinical and applied branch of medical science deals with every age group i.e. birth to death. It is an independent profession works as first contact practitioner from acute to chronic condition; prevention to rehabilitation. Acceptability, accessibility, affordability, affectivity, necessity and popularity of physiotherapy gears up in every part of the globe as time flies. We are now living in technology dependent life (from day to night) which results alteration in mechanics of body followed by prone to develop mechanical pain particularly in spinal area i.e. neck to lower back. Undoubtly we can say that these mechanical problems have to be solved mechanically and physiotherapist is the best medical professional to manage these mechanical pains because s/he knows biomechanics of the human body.
Risk of stroke and other non-communicable diseases are increasing day by day as a result decreases quality adjusted life year, increases disability adjusted life year but physiotherapist can play vital role either promoting physical activity and fitness as preventive measure or applying rehabilitative approach in order to reduce distressful life. Moreover neuro-developmental disorders like autism, cerebral palsy, down’s syndrome, intellectual disability is also going upward in our country. Actually they need lifelong physiotherapy, occupational therapy, speech and language therapy, counseling and behavior change of caregivers. Physiotherapy has crucial application in case of intensive care patients because of their immobility. Chest physiotherapy is vital to clear heart lung function. Recently ICU facilitated hospital is increasing in our country. So working opportunity in ICU adds new window for physiotherapy professionals. Physiotherapy has immense role in cardiac rehabilitation. Specifically designed exercise regimen for cardiac patients need to be cautiously handled.
Therapeutic exercise program should be individualized instead of generalized. Besides physiotherapeutic approach should be prescribed, guided and implemented by physiotherapists though in Bangladesh some other medical professionals are interfering physiotherapist’s activity which spreads misleading information on physiotherapy to patients. Gynecological physiotherapy is considered as another important area where physiotherapists can focus. Physiological alteration of musculoskeletal conditions makes pregnant women vulnerable. Physiotherapy is the unique solution in this period because of contra-indication of non-steroid anti-inflammatory drugs but special caution is needed to handle these subjects because s/he has to think two lives. Considering huge number of patients, physiotherapy in gynecology and obstetrics can be another super specialty. Physiotherapy is a part and parcel in sports. Physio has to work both in in-field and out-field. S/he is the first contact healer while game is going on.
Immediate diagnosis as well as treatment is the key to manage players in field. Contracture development is usually seen in case of burn patients. It is physiotherapist’s duty to prevent contracture development. At last but not least physiotherapy plays prime role in pre and post orthopedic surgery. To maintain or increase muscle power, joint range, gait training, posture training, life style modifications- physiotherapists have to work both in indoor and/or outdoor. Some medical doctors are trying to introduce electrotherapy as physiotherapy but they do not know electrotherapy is a part of physiotherapy. They should bear in mind that physiotherapy is an evidence based therapeutic exercise oriented medical treatment and to be a physiotherapist you have to know clear anatomy, physiology, biochemistry, pathology, biomechanics, movement science, therapeutic exercise and many more subjects.
In nutshell physiotherapists are doing good in Bangladesh because patients are accepting this treatment, both undergraduate (5 years) and post graduate (2 years) physiotherapy professional course is running under University but challenge is that still no council is formed for regulation physiotherapy profession in Bangladesh, no Govt. post is created for physiotherapist even no single Govt. physiotherapy separate college is established yet. It is high time to think about physiotherapy profession for betterment of huge number of patients. The highest health authority WHO can interfere on this burning issue, concern ministry can come forward, professional body can do advocacy and negotiate.