Physiotherapy in a time of pandemic

Landry et al make a good point in their recent editorial connecting the outbreak of infectious diseases with the need for rehabilitation (Landry et al., 2020). They suggest that ‘physiotherapy can mediate the deleterious pulmonary, respiratory, and immobility complications that are commonplace’ after the kinds of widespread infections we are now witnessing with the spread of Covid-19.

They also suggest that ‘rehabilitation can offer a cost-effective upstream strategy that can restore mental and emotional quality of life during and after medical intervention’ (ibid). Their editorial focuses on recent epidemics, and the importance of physical therapies to peoples’ recovery.

As is the norm these days, there has been a lot of hand-wringing on social media about the place of physiotherapy in the current crisis. But this is where history can help, not least because one of the greatest benefits of history is that it can show us what the future might look like in the wake of this present pandemic.

Firstly, we should remember that physiotherapy exists as a profession because it was able to respond to some of history’s cataclysmic moments. How our foremothers and forefathers responded shaped the way we think and practice today. So tomorrow’s physiotherapists may say much the same about the things that we do today.

Many physical therapy professions around the world came into being as a direct response to the polio epidemics of the middle years of the 20th century, and the treatment of infantile paralysis formed the basis for a lot of the neuromuscular and cardiorespiratory techniques we still use today.

Similarly, the 1918/19 flu epidemic, still the world’s most catastrophically fatal health event, contributed enormously to calls for comprehensive public healthcare that led to the development of the welfare state, and national health services that cemented physiotherapy as one of the leading professions allied to medicine.

The epidemic of industrialised killing that was World War I gave birth to the rehabilitation movement and gave masseuses the opportunity to show that they were more than capable of doing the gruelling work of physical therapy for amputees, people with empyemic lungs, fixed soft tissue contractures, and paralysed limbs.

And even before then, the cholera epidemics that gave us the first proof of the existence of germs moved medicine inexorably away from conservative physical remedies and created allopathic, doctor-led healthcare, creating a vacuum that physiotherapy soon filled.

Few of us can predict the seismic impact of Covid-19 on people’s perceptions of health and healthcare. What we do know, though, is that even without this epidemic, we would be facing perhaps the most exciting, challenging, and disruptive period in the history of the profession.

History has shown us that physiotherapists have adapted before, and they may well need to adapt again.

Reference

Landry, M. D., Tupetz, A., Jalovcic, D., Sheppard, P., Jesus, T. S., & Raman, S. R. (2020). The Novel Coronavirus (COVID-19): Making a Connection between Infectious Disease Outbreaks and Rehabilitation. Physiotherapy Canada, e20200019. doi:10.3138/ptc-2020-0019