From the time it came to be known that Joe Biden, 81, was considering contesting the US presidential elections again, the discussion about his age and fitness started. Then, a team of specialists comprising an orthopaedic, a neurologist and a physiotherapist conducted tests and declared him “fit for duty”. But why was a physiotherapist a part of the medical team? “In the West, such is the importance of physiotherapists,” says Kamal Shaw, a Calcutta-based senior physiotherapist who has been in the profession for over two decades.
He continues, “In India, people always go to orthopaedics and neurologists for pain management. It is on the advice of doctors that they seek assistance from physiotherapists. In Western countries, the first stop for pain management is a physiotherapist. We prescribe exercises, use ultrasound therapy, ultraviolet rays and laser therapy, electromagnetic waves and extracorporeal shockwave therapies for pain management.”
Who is a physiotherapist
A physiotherapist is one who has a bachelor’s degree in physiotherapy (BPT). It is a branch of health science that promotes health and prevents disability. A physiotherapist assesses the neurological, muscular and skeletal systems for pain, injury or disease and then administers therapy that does not involve surgical intervention or medicine.
A physiotherapist takes into account structural and functional aspects of the human body. Structural issues involve the joints, muscles and tendon injuries. The functional aspect refers to the strengthening of muscles, the movement of the joints and so on. “But if the integrity of the skeletal framework is damaged, a medical practitioner such as an orthopaedic or a neurologist has to intervene,” says Shaw.
There are six areas wherein physiotherapists are required — orthopaedics, neurology, cardiopulmonary sports, gynaecology and urology.
The scope of physiotherapists ranges from paediatric to geriatric. Paediatric physiotherapy is a subject that is only now gaining prominence; it is especially used to treat children suffering from cerebral palsy. Then again, sports medicine started gaining importance in India only in the late 1970s.
The number of qualified physiotherapists is far and few in India. “Ninety per cent of physiotherapists are not qualified for the job. They are quacks, which means they are people who misrepresent their abilities as far as diagnosis and disease management is concerned,” says Shaw.
Training
In West Bengal, the SSKM Hospital is one of the institutes offering BPT. Other institutes are Burdwan Medical College; the National Institute for Locomotor Disabilities in North 24-Parganas; M.S. Ramaiah Medical College, Padmashree Institute of Physiotherapy and Oxford College of Physiotherapy in Bangalore; Indian Spinal Injuries Centre in New Delhi; Sancheti College of Physiotherapy in Pune and Indira Gandhi Technological and Medical Sciences University in Arunachal Pradesh.
What does training involve
In the first four years, students are taught anatomy, biochemistry, physiology, pharmacology, medicine, surgery and gynaecology. “The subjects are similar to that of the MBBS course. In the second year, you take up physiotherapy in orthopaedics, neurology, surgery or medicine. You learn biomechanics. In medicine, you learn to administer physiotherapy to patients suffering from asthma and COPD,” says Kaushik Guha, teacher-in-charge and professor at Calcutta’s Peerless College of Physiotherapy, Peerless Hospital. “The last six months is when you go to a speciality hospital for internship and practise under a senior therapist. You learn to analyse ways of handling a patient,” he adds. According to Shaw, it is during this time that therapists learn how to interact with patients; after all, therapy of the body is not entirely divorced from therapy of the mind.
Who can apply
Anyone who has studied physics, chemistry and biology can apply. “One has to appear for a joint entrance exam just like MBBS aspirants. In West Bengal, this exam is known as JENPAS-UG. The subjects they are tested on include English, logical reasoning, physics, chemistry and biology,” says Guha. The National Institute of Locomotor Disabilities, however, has an entrance test of its own.
What after
Once you complete the course, you can choose to train under a senior therapist for six months to a year or apply for a master’s in physiotherapy, which is a two-year course. A freshly minted physiotherapist earns Rs 15,000 to 20,000 per month and a senior physiotherapist between Rs 35,000 and Rs 40,000. Broadly, the different gradations are — fresher, junior physiotherapist and senior physiotherapist. Alternatively, you can start individual practice, wherein you attach yourself to a physician or a senior therapist, who refers cases to you. A senior physiotherapist charges Rs 1,000-1,200 for half an hour of home consultation.
