Physical Therapy

physical therapy or physiotherapy, treatment of disorders of the muscles, bones, or joints by means of physical agents—heat, light, water, manual and electronic massage, and exercise. Stroke, arthritis, fractures, and nerve damage are common conditions treated. The type of treatment needed is prescribed by a physician and carried out by trained physiotherapists. The therapist attempts to prevent pain or further damage and may also train different muscles to compensate for ones that have been damaged. Whirlpool baths are valuable in treating injuries and chronic inflammatory conditions. Ultrasound and short-wave diathermy may be employed for some disorders. Massage (a passive form of exercise) provides stimulation of nerves and prevents muscular atrophy in body areas disabled by paralysis or rheumatic disorders. Active exercises are also prescribed as treatment for various conditions. Physiotherapy is important in sports, not only as part of the conditioning program but also in treating injuries.

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physical medicine and rehabilitation

 or physiatry or physical therapy or rehabilitation medicine

Medical specialty treating chronic disabilities through physical means to help patients return to a comfortable, productive life despite a medical problem. Its objectives are pain relief, functional improvement or maintenance, training in essential activities, and functional testing of areas such as strength, mobility, breathing capacity, and coordination. Physical medicine may use diathermy, hydrotherapy, massage, exercise, and functional training. The last can mean learning to work with a guide dog or a prosthesis or learning new ways to carry out everyday activities with a limb missing, sometimes by using assistive devices. Physician specialists head rehabilitation teams including a physical therapist, rehabilitation engineer, rehabilitation nurse, psychological counselor, and sometimes a respiratory or speech therapist. See also occupational therapy; orthopedics.

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physical therapy [′fiz·ə·kəl ′ther·ə·pē]

(medicine)

The treatment of disease and injury by physical means.

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Physical Therapy 

therapeutic exercise, the method of treating and preventing illness that involves the use of physical exercises and natural factors and includes mechanotherapy, occupational therapy, and massage.

A variety of therapeutic exercises is used in physical therapy, including calisthenics (the simplest and most convenient for sick persons), sports (walking, skiing, terrain cure, swimming, hiking), and games (rowing, skittles, badminton, volleyball). Therapeutic exercise is a method of general, nonspecific, active, functional therapy. Every exercise is a nonspecific stimulant. Graduated physical training is the characteristic feature of the therapy. In hospitals and polyclinics, the exercises are performed individually and in groups.

The indications for physical therapy usually coincide with the beginning of convalescence (mostly in patients suffering from chronic diseases). The therapy is advised for patients who have had to remain bedridden and for persons in a weakened condition, with poor physical tone. The use of exercise for children’s diseases is warranted because of the growing body’s need of movement. In the elderly, exercise maintains and builds the functional capacities of the main systems and prevents premature aging. It plays an important part in the treatment of internal diseases, especially of the cardiovascular and respiratory systems. It is also used with neurological diseases, traumas, and diseases of the locomotor apparatus, as well as after surgery (thoracic, abdominal, restorative, neurosurgery).

The theoretical principles of physical therapy are based on modern physiological and clinical concepts. Physical exercises have been systematized and the methods of their use have been defined. Various specific methods of exercise therapy have been developed for many diseases and traumas and are now in use.

REFERENCES

Moshkov, V. N. Obshchie osnovy lechebnoi fizkul’tury. Moscow, 1963.
Lechebnaia fizicheskaia kul’tura. Edited by V. E. Vasil’eva. Moscow, 1970.

V. N. MOSHKOV

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Physical Therapy 

(Russian, fizioterapiia), a branch of medicine that studies the therapeutic properties of physical factors and develops methods of using these factors for therapeutic and prophylactic purposes.

In a number of foreign countries the term “physical therapy” is applied only to exercise therapy. On the other hand, the terms “physiatrics” (fiziatria) and “physical medicine” (fizicheskaia meditsina), which are sometimes used in the modern literature as synonyms for physical therapy, embrace all physical therapeutic agents and methods, including exercise and massage.

According to the terminology adopted in the USSR, health resort science, that is, the study of natural health resort factors, is a distinct branch of medicine. This field includes such areas as balneotherapy, climatotherapy, and pelotherapy. Health resort science and physical therapy together constitute a single scientific discipline. Exercise, massage, and mechanotherapy (excluding vibrotherapeutics) are part of kinesitherapy (lechebnaia fizkul’tura). Thus, physical therapy in the USSR embraces (1) fizikoterapiia, which includes phototherapy, electrotherapy, aeroionotherapy, and aerosol therapy and consists in the study and therapeutic use of physical factors produced by the transformation of certain kinds of energy into the energy of biological processes and (2) the use of natural factors—such as fresh water, peat, clay, and ozokerite—outside of health resorts, that is, in physical therapy hospitals, polyclinics, and centers.

Natural factors, especially water and sun, were used for therapeutic purposes in Greece, Rome, and the ancient East. The discovery of electricity and advances in physics were responsible for the development of fizikoterapiia, chiefly electrotherapy, beginning in the 18th century. Subsequently, as new physical factors were discovered, they were introduced into medical practice. These factors included static electricity (franklinization), direct current (galvanization and drug electrophoresis), asymmetric alternating current (faradism), and high-frequency currents (d’arsonvalization and diathermy). Modern physical therapy also includes the use of low-, high-, ultrahigh-, and superhigh-frequency magnetic, electric, and electromagnetic fields in such procedures as inductothermy and ultrahigh- and superhigh-frequency therapy. In addition, present-day physical therapy uses artificially produced light ranging from the infrared to ultraviolet (including monochromatic coherent radiation) and mechanical vibrations ranging from the infrasonic to the ultrasonic. Physical therapy became a separate branch of medicine at the beginning of the 20th century; the first international congress on physical therapy was held in Liège in 1905.

In Russia physical therapy techniques, chiefly hydrotherapy and certain types of electrotherapy, were used from the beginning of the 19th century. Electrotherapy was pioneered by A. Bolotov (1803), hydrotherapy by A. Nikitin (1825), and phototherapy by A. Maklakov (1889). G. A. Zakhar’in, S. P. Botkin, A. A. Ostroumov, among others, used physical therapy in combined treatment of many diseases. Three research institutes in physical therapy were founded, in Sevastopol’ and Petrograd and near Moscow, early in the 20th century. Physical therapy developed as a separate theoretical and practical medical specialty after the Great October Socialist Revolution. The physiological work of I. M. Sechenov, N. E. Vvedenskii, and I. P. Pavlov form its theoretical basis. Such Soviet scientists as A. E. Shcherbak, P. G. Mezernitskii, S. A. Brushtein, and A. V. Rakhmanov made major contributions to the scientific development of physical therapy. The Institute of Physiatrics and Orthopedics, now the Central Institute of Health Resort Science and Physical Therapy, was founded in Moscow in 1921.

Physical factors have affected man through his entire evolution. For this reason, physical therapy procedures have a greater physiological effect than many drugs. Such procedures may produce nonspecific and specific responses. The latter are dependent on the nature of the therapeutic factor and on the pathological process and are responsible for the main therapeutic effect. The aim of physical therapy is to achieve maximum therapeutic effect with minimum stress on the body by intensifying the specific components of the action of the physical factors and by reducing the nonspecific components. The factors are consequently often used intermittently and in small doses. The choice of factor, dosage, and method of application is determined by the form and stage of the disease and by the condition of the patient. If the situation so warrants, a combination of factors may be used. The procedures are most effective in the initial period of the disease, when functional impairment is present. In the course of treatment, physical therapy procedures are also used in other stages of therapy and rehabilitation in order to affect certain processes at different levels, including the cellular and molecular levels. The great variety of available factors and techniques makes possible an individualized course of treatment and the use of techniques that are specifically directed against the pathological process and do not cause adverse side effects.

Research in physical therapy in the USSR is conducted in 14 research institutes of health resort science and physical therapy and in departments of medical institutes and of institutes for advanced training of physicians. The basic principles of physical therapy are taught in the clinical departments of medical institutes, and specialized and advanced training are provided in institutes for advanced training. The All-Union Scientific Medical Society of Health Resort Scientists and Physical Therapists was founded in 1951 for specialists in physical therapy and health resort science.

The International Society of Medical Hydrology and Climatology was organized in Rome in 1922, and the International Federation of Physical Medicine and Rehabilitation in London in 1952. International congresses of these societies are held every four years.

In the USSR papers dealing with problems in physical therapy appear in the journal Voprosy kurortologii, fizioterapii i lechebnoi fizicheskoi kul’tury (Problems of Health Resort Science, Physical Therapy, and Kinesitherapy; since 1923). Foreign journals include the Czechoslovak Fysiatrický věstnik (Prague, since 1953) and the Bulgarian Kurortologiia i fizioterapiia (Sofia, since 1964). In addition, Zeitschrift für Physiotherapie is published in the German Democratic Republic (Leipzig, since 1949), the American Journal of Physical Medicine in the USA (Baltimore, since 1952), and the Annals of Physical Medicine in Great Britain (London, since 1952).

The use of physiotherapeutic procedures is also called physical therapy.

REFERENCES

Anikin, M. M., and G. S. Varshaver. Osnovy fizioterapii, 2nd ed. Moscow, 1950.
Spravochnik prakticheskogo vracha po fizioterapii, 2nd ed. [Moscow] 1964.
Prakticheskoe rukovodstvo po provedeniiu fizioterapevticheskikh protsedur, 3rd ed. Moscow, 1970.
Uchebnoe posobie po fizioterapii. Moscow, 1975.
Spravochnik po fizioterapii. Moscow, 1976.
Physical Medicine in General Practice. New York, 1946.
Therapeutic Electricity and Ultraviolet Radiation. New Haven, Conn., 1959.

A. N. OBROSOV and V. M. STRUGATSKII

Physical therapy in veterinary science. Physiotherapeutic procedures are used primarily in the treatment of pareses, paralyses, metabolic disorders, and diseases of the joints, ligaments, skin, and respiratory organs. Electrotherapy, phototherapy, heat and mud therapy, hydrotherapy, and massage are among the procedures employed. Galvanization, d’arsonvalization, diathermy, ultrahigh-frequency therapy, and apparatus for muscle stimulation are used in electrotherapy; ultraviolet and infrared radiation are employed in phototherapy; sapropel, ozokerite, paraffin, clay, sand, and hot air may be used in heat and mud therapy. Hydrotherapy includes swimming, showers, and various kinds of baths.
Physical therapy for the treatment and prevention of animal diseases came into wide use in the 1930’s. I. D. Medvedev, I. Ia. Demidenko, M. N. Kirillov, and N. A. Barsukov were among those who made an important contribution to the development of physical therapy in Soviet veterinary medicine. Physical therapy, as a branch of therapy, is included in the curriculum of veterinary educational institutions.

REFERENCE

Medvedev, I. D. Fizicheskie metody lecheniia zhivotnykh, 3rd ed. Moscow, 1964.

V. A. LIPIN