Rehabilitation falls within the scope of practice of a physiotherapist as laid out in the Health Professional Council South Africa (HPCSA) document entitled “Definition and Scope of Practice” which can be found on the HPCSA website. Physiotherapists work from injury prevention, injury treatment through the stages of rehabilitation and not only on to final phase rehabilitation, but the scope of physiotherapy continues up to “maximum potential” is achieved. In fact, rehabilitation not only falls within the scope of physiotherapy, but it is pivotal to the practice of physiotherapy.
The concept of ‘rehabilitation’ encompasses physiotherapy in its broadest and most comprehensive definition. “Physiotherapy is concerned with identifying and maximising movement potential within the spheres of promotion, prevention, treatment and rehabilitation” (SASP 2004).
Physiotherapy involves the interaction between the patient, families and sports coach, in a process of assessing movement potential and establishing agreed upon goals and objectives using the knowledge and skills unique to physiotherapists. Best-evidence based physiotherapy practice requires the use of the most recently published research to inform a suitable rehabilitation programme of a specific injury.
Physiotherapists use recent articles for reference with greater return to play (GRTP) protocols and to keep up with the most effective approach that the latest research recommends. The current Physiotherapy standard is to also individualise the rehabilitation programme by use of the STarT Back Tool amongst others which gives a clear direction on the expected number of treatment and rehabilitation sessions necessary for maximal recovery.
In short, Physiotherapists are involved in the ‘restoration of the individual to their optimal level of participation’ (WHO, 2000). From field side acute injuries to greater return to play (GRTP) we are passionate about rehabilitation on every level.
The New Zealand Sports Physiotherapy organisation defines what a sports and exercise physiotherapist’s scope is:
"A recognised professional who demonstrates advanced competencies in the promotion of safe physical activity participation, provision of advice, and adaptation of rehabilitation and training interventions, for the purposes of preventing injury, restoring optimal function, and contributing to the enhancement of sports performance, in athletes of all ages and abilities, while ensuring a high standard of professional and ethical practice.” (1)
Physiotherapy has become an integral part of the sports medicine team and has a crucial role in the management of injuries during major international events. (Chang JY et al 2021) At the London 2012 Olympic Games, physiotherapists formed the largest professional group working at the Olympic Games (Grant et al 2014).
The international group: The International Federation of Sports Physical Therapists (IFSPT) in their 2005 paper on the Sports Physiotherapy: Competencies and Standards, list the following abilities and skills required. These skills include:
· Manager of the client/patient for injury prevention, rehabilitation, and performance enhancement.
· Advisor of a safe, active lifestyle, promotion of fair play and anti-doping practices.
· Professional leader of lifelong learning and professionalism and management.
· Innovator of research involvement, dissemination of best practice, extending practice through innovation.
Physiotherapists work within a multidisciplinary team and should a practice or decision-making process be out of their scope, they are bound to and will refer on to the appropriate professional.
The patient’s recovery is always the priority.
References:
1. Sports and Exercise Physiotherapy New Zealand. What is Sports and Exercise Physiotherapy. Available from https://sportsphysiotherapy.org.nz/what-is-sports-physiotherapy/. (Accessed 5th March 2022).
2. The international Federation of Sports Physical Therapists (IFSPT) Sports Physiotherapy: Competencies and Standards. Available from https:// http://ifspt.org/. (Accessed 5th March 2022)
3. Grant ME, Steffen K, Glasgow P, Phillips N, Booth L, Galligan M. The role of sports physiotherapy at the London 2012 Olympic Games. Br J Sports Med. 2014 Jan;48(1):63-70.
4. Chang JY, Grant ME, Lee JH, Kim TG, Kim KS, Chang JS, Choi JY, Lee YH, Kong ID. Review of physiotherapy service for athletes of 2018 Olympic Winter games: Consideration of preparation for two polyclinics. Physical Therapy in Sport. 2021 May 1;49:106-11.
5. South African Society of Physiotherapy Position Paper: The Role of Physiotherapy in Rehabilitation (2004)
6. Health Professional Council of South Africa Scope of Physiotherapy https://www.hpcsa.co.za/
7.Health Professional Council of South Africa Scope of Biokinetics https://www.hpcsa.co.za/
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