MF Scientists on Physiotherapy: Beyond Physical Health Issues

Many people imagine that the only time they need a physiotherapist is when they have a physical injury or after surgery. This is, of course, a very important part of physiotherapy, but it is by no means the only part. Physiotherapy can help with the problems that many people don’t think much about, from minor back pain to diseases such as multiple sclerosis, pneumonia or even cancer. Physiotherapy is a term derived from the Greek kinesis, which means movement, and therapeia, meaning treatment.

“It seems to me that, as with any other medical professions, people choose the profession of physiotherapy primarily driven by altruism, the desire to help others,” believes Tomas Aukštikalnis (M.D., Ph.D.), Head of the Department of Rehabilitation, Physical and Sports Medicine at the Institute of Health Sciences of the Faculty of Medicine at Vilnius University (VU MF). Tomas Aukštikalnis and Ieva Eglė Jamontaitė (Ph.D.), a rehabilitation therapist and assistant professor in the same department, talked to us about what physiotherapy is and how beneficial it is.

Special treatment rather than simple exercise

Physiotherapy is one of the main tools for medical rehabilitation. According to Tomas Aukštikalnis, it is not a simple exercise but a structured, movement-based treatment supported by scientific evidence, providing special physical exercises which should or should not be applied in the case of a specific medical condition. A specialist, i.e. a physiotherapist, assesses the patient’s condition, identifies the impairment using special tests, and makes a physical therapy plan required to restore the impaired function. Through physiotherapy, the correct movement of the body helps to renew, improve and maintain the condition of muscles, bones, blood vessels and other systems of the body.

“Physiotherapy is actually a very broad field. In order to explain how physiotherapists treat patients, they must first consider the age of the patient, their condition or their pathology. For example, in neonatal physiotherapy, it is important to address developmental disorders or the factors that support them, which may be congenital or acquired. In the case of slightly older children, conditions are usually caused by trauma or functional impairment. In the case of adult patients (including the elderly), issues are usually the result of pathologies acquired or accumulated over a lifetime, for example, degenerative joint conditions or cardiological diseases. Physiotherapy should be the "gold standard" for reducing the negative impact of such conditions on daily activities or to prevent any exacerbation,” the rehabilitation specialist explained.

According to Aukštikalnis, the form of physiotherapy will also depend on where it is applied and the task of the physiotherapist. For example, therapeutic physiotherapy can be provided in a medical facility, rehabilitation centre, and palliative and long-term care centres. Sports physiotherapy, whether in a gym or the training of high-performance athletes, involves working with athletes to maximise their performance or to simply keep them in good shape. Working together with the general practitioner, a physiotherapist aims to improve the care given to seriously ill patients or for the purpose of prevention. Exercises that include strength, flexibility, endurance, balance and others, will be selected based on test results and the desired outcome. The physiotherapist will also choose the most appropriate form of exercise –therapeutic exercises in a gym, or the water, or perhaps one to one training.

“There are many areas in which physiotherapy is used. The only thing that matters is to apply it correctly, according to the scientifically based methods or methodological guidelines. This is the only way to achieve the desired result,” the scientist said.

A physiotherapist is an important part of a rehabilitation team

According to Tomas Aukštikalnis, a holistic, biopsychosocial approach is essential in medical rehabilitation, that considers all the patient’s functions and their interdependence. It is very rare that only one function of a patient is impaired.

“If we have an impaired motor function in childhood, it is likely that other developmental disorders will follow. Each case where medical rehabilitation reduces disability, dependence on help from others, and eases the need for daily support or care is a success story. In medical rehabilitation, we work as a team: each member has a clear role and performs actions according to their competence. Although the physical medicine and rehabilitation doctor is at the head of a team, the contribution of each member is essential for the successful rehabilitation of the patient. It is very difficult to single out the contributions made by individual members in a success story. But there is no doubt that the physiotherapist is a very important member of the team,” Aukštikalnis maintains.

When asked about the most common cases where physiotherapists play a key role, the rehabilitation therapist mentioned disease prevention.

“When things are done properly in the right place and at the right time, the significance tends to go unnoticed. This is also the case with the early prevention of diseases. We often think that insufficient daily physical activity leads to the development or exacerbation of one or another condition or pain. I believe that this is the exclusive success story of the physiotherapist, although it is often invisible, because patients recover before things become more serious. When we work with adolescents, we encounter a particularly common pathology – back pain. The most common cause is a functional disorder, where the muscle balance and tone are distorted, and there is an unequal load on the bones, muscles and ligaments,” Aukštikalnis noted.

According to the scientist, in the case of back pain, a physiotherapist can be particularly effective even without other members of the team.

“To avoid back pain, it is important to follow the daily work regime and ergonomic rules: when working at the computer for a long time, do not forget to take breaks, change your sitting position, do some stretching exercises, or simply take a walk for at least a few minutes away from your workstation – not only will your back and tired muscles rest, but also your eyes will rest, and your mind will be more productive after a break in activities,” he concluded.

Restored body – restored creativity

According to Ieva Eglė Jamontaitė, 181 students are currently studying physiotherapy at VU MF, and this autumn 87 first-year students will commence their studies. The researcher believes that young people choose the profession for various reasons.

“Some young people become interested in human anatomy at school, they wish to understand how human bones, muscles, the vascular, nervous and other systems function, and look for answers as to why a person gets sick and how they might be helped. These young people are curious, independent and responsible, they like to analyse things, solve problems and look for answers,” the physiotherapist said.

Others pursue the career of a physiotherapist driven by a strong interest in sport which emerges in childhood or adolescence, an understanding of the benefits of physical activity, and a desire to link their future profession to movement.

“Of course, the choice to study physiotherapy may also have been influenced by a past encounter with a physiotherapist after an injury or illness. Experiencing the course of treatment and understanding the consequences of injuries, such a young person might decide to pursue a career in physiotherapy”.

When we asked what Jamontaitė enjoyed most about being a physiotherapist, she replied: “The opportunity to interact with different people, to involve patients in the rehabilitation process in a way that makes them understand, one of the most important things – their responsibility for their own health. The charm of being a physiotherapist is learning to feel and analyse the signals sent by the body, and being able to work with the patient to celebrate good results, or to look for reasons and solutions if they have not yet been able to achieve them already. Physiotherapy is a very dynamic profession that responds to scientific and technological innovations, so it is important for the practitioner to keep up-to-date with these developments”.

According to Jamontaitė, the rehabilitation process varies depending on the patient – some patients are passive, others try to hold onto wellness as much as possible, some need to be pushed, others need to be slowed down.

“However, we have many more success stories than disappointments. The most memorable case was when, after a knee ligament surgery, a patient from the construction profession said after a physiotherapy programme: ‘Thank you, thanks to the exercises, I realised how I can overcome my technical problems in a construction project.’ In other words, the physiotherapy had "generated" something new in his thinking. So…it can certainly be said that restoring the physical functions of the body can also have a positive effect on creativity and intelligence,” the scientist concluded.