Physical Therapy

Physical therapy (PT), also known as physiotherapy, is one of the healthcare professions. Physical therapy is provided by physical therapists who promote, maintain, or restore health through physical examination, diagnosis, prognosis, patient education, physical intervention, rehabilitation, disease prevention and health promotion. Physical therapists are known as physiotherapists in many countries.

History
Physicians like Hippocrates and later Galen are believed to have been the first practitioners of physical therapy, advocating massage, manual therapy techniques and hydrotherapy to treat people in 460 BC. 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. In addition to clinical practice, other aspects of physical therapist practice include research, education, consultation and health administration.

Education
Educational criteria for physical therapy providers vary from state to state and from country to country, and among various levels of professional responsibility. Most U.S. states have physical therapy practice acts that recognize both physical therapists (PT) and physical therapist assistants (PTA) and some jurisdictions also recognize physical therapy technicians (PT Techs) or aides. Most countries have licensing bodies that require physical therapists to be a member of before they can start practicing as independent professionals.

Specialty
The body of knowledge of physical therapy is large, and therefore physical therapists may specialize in a specific clinical area. While there are many different types of physical therapy, the American Board of Physical Therapy Specialties lists ten current specialist certifications. Most Physical Therapists practicing in a specialty will have undergone further training, such as an accredited residency program, although individuals are currently able to sit for their specialist examination after 2,000 hours of focused practice in their respective specialty population, in addition to requirements set by each respective specialty board.

Effectiveness
Physical therapy has been found to be effective for improving outcomes, both in terms of pain and function, in multiple musculoskeletal conditions. A 2012 systematic review found evidence to support the use of spinal manipulation by physical therapists as a safe option to improve outcomes for lower back pain. According to randomized control trials, a combination of manual therapy and supervised exercise therapy by physiotherapists give functional benefits for patients with osteoarthritis of the knee, and may delay or even prevent the need for surgery.