From indication control to the eminence of life: Physical Therapy in Palliative Care

Physical therapy includes the identification and optimization of movement potential within the categories of promotive, preventive, and rehabilitative realms as one of its core subjects. Physical therapists are trained to care for a wide range of patients, including those who are housebound, hospitalized, and outpatients. Additionally, physiotherapeutic attendance encompasses palliative care and community-based multidisciplinary teams of care, where patients’ comfort and their individual functional dimensions are ensured to lessen suffering. (Kumar & Jim, 2010). Numerous clinical conditions affect how physically and consequently anatomically the affected people can operate normally. These life-threatening disorders include cancer associated ailments, amyotrophic lateral sclerosis, HIV/AIDS, idiopathic pulmonary fibrosis and other respiratory maladies, multiple sclerosis, neurodegenerative disorders and altered mental states among others. Nevertheless, there are a couple of physical therapy-based interventions to resolve such diseases and better the patient response to the pertinent chemotherapeutic regimen. The physiotherapeutic mechanisms entail actinotherapy, therapeutic exercise, thermal modalities, manual physical therapy, electrical modalities, mechanical modalities, as well as assistive devices (Cobbe, Nugent, Real, Slattery, & Lynch, 2013). The field of Kinesiology is very critical when it comes to the science of physical therapy because the two are interrelated and the former deals with the study of the functionality of the human anatomical body parts. Therefore, a lot of research and diversity is essential to harness maximum benefits from physiotherapy.

Physical Therapy in Palliative Care: From Indication Control to Eminence of Life

The scientific study and related scholarly research conducted on both the human and the non-human anatomical body movements. Both the biomechanical and the physiological actions as well as the psychological mechanisms of movement are core in the field of Kinesiology (Moritani, Kimura, Hamada, & Nagai, 2005). On the other hand, the application of Kinesiology when it comes to the human body entails segments like orthopedics and biomechanics; physical and mechanical therapy, exercise and sports, occupational therapy, physical therapy, methods of rehabilitation as well as sports psychology. Therefore, in combination with the indispensable insight from the field of physical therapy, Kinesiology deals with human health by covering segments like electro-physiotherapy, diverse approaches in monitoring physical functioning, cognitive and behavioral techniques, and the expansions on motion tracking systems.

Professionals in the disciple of kinesiology primarily study and gain competence in human movements. Therefore, all mechanical technics that pertain to human mobility are pertinent to the field. The human anatomical musculature is studied, and the complexity of function elaborated to the highest of insight (Clini & Ambrosino, 2005). On the contrary, physiotherapists deal with the provision of providing clinical services to individuals who have problems with movement and muscle mobility following diseases, accidents, or any other motion impairing injuries Therefore, physiotherapy[y primarily deals with providing restoration and development services to help patients cope with their health challenges (Moritani et al., 2005). The primary responsibility of a kinesiologist is to apply the related scientific knowledge and learned experience in helping a patient acquire fitness and be able to function in mobility (Montalvo, Cara, & Myer, 2014). On the other hand, the core purpose of the roles of the physiotherapist is to examine patients and identify their respective anatomical problems that attract particular physiotherapeutic services to aid in their healing process.

The practice of providing people with the ability to develop, restore maximum mobility and maintain functional capabilities in their livelihood defines the science of physiotherapy. Physiotherapy comes in handy when individuals in the population risk impairment as is threatened by disease and injury, either in childhood or as is circumstantial with aging. Functional movement at its best is a critical concept that defines the essence of healthy living. The patients of physiotherapy gain more in their rehabilitation, motion, and prevention needs, following the interaction with caregivers and related application of insight, knowledge, and skills by the physiotherapists (Kumar & Jim, 2010).

Physiotherapists play a very indispensable role in palliative care, especially so when attending to patients who need the physical therapy dimension of attendance for the enhancement of their physical functioning and the quality of life. The physical dimension is imperative because it deals with the needed patient comfort to allow them through the pathogenesis while the illness progresses for the perceived degree of anatomical distress. Physiotherapy in palliative care entails a couple of diverse segments of service delivery, including; endurance, flexibility, gait, breathing, balance, flexibility, deformity, exercise tolerance, mobility, co-ordination, and energy expenditure (Cobbe et al., 2013). Furthermore, physical therapy comes in handy when attending to patients with mundane physical weaknesses like for instance due to pain, breathlessness, and cough.

Physical therapy helps improve the functional mobility of patients, as is related to the knowledge borrowed from the field of kinesiology, to help in daily activity functioning, the adaptations and the expectation of the surrounding environment. The sensitive elements entail the sensorimotor nerve functioning which affects particular essential movements, activities, and actions like getting out of bed, lifting, climbing, riding, carrying a load, and even walking (Cobbe et al., 2013). All these examples of movement as basic in the daily functioning of the human anatomical body. Furthermore, the semi sensory actions like toileting, feeding, grooming, bathing and dressing are pertinent to the essential needs. In this capacity, physical therapy is portrayed an essential field that needs sharp, informed, reliable, and competent professional to help the increasing number of patients to cope (Chatterton, 1988). The challenge, however, is that most young people do not have much interest in pursuing physiotherapy averagely across the world, hence the need to enlighten professionals on the critical role physical therapy plays in complementing the health care services from other pertinent medical segments of specialty. Physical therapists as such remain to be highly valuable members of the healthcare profession, whose expertise is critical to palliative care services. Therefore, the need to challenge all health care providers that teamwork and collaborative care is necessary for palliative care remains a core objective of this paper. Furthermore, appreciating specialization and diversity is imperative in healthcare and medicine. A single professional cannot be able to efficiently deliver on the different need of the patients in palliative care (Montalvo et al., 2014). These are sensitive clinical circumstances which call for solemn decision making, a mess in any would result in either harmful outcomes or even instant death. Therefore, collaboration and specialization are necessary to create a platform of a different medical attendant to meet the needs of their patients with the ultimate care needed. As opposed to this, the limited number of physiotherapists remains to be a central challenge in attaining this objective, hence the need for all responsible stakeholders to take their rightful places and offer the needed responses to seal the gaps and unwanted seams in the healthcare system, especially so in palliative care.

Across decades, physical therapy has been confirmed to be as essential healthcare service delivery mechanism that has not only improved the palliative care needs but also critical in helping patients cope with diseases like cancer, mental illnesses, neurological disorders, HIV, and cardiopulmonary conditions among others. The effectiveness of the physiotherapeutic services offered is often determined by the ratio of patients to the corresponding number of specialists in the same field. Unfortunately, the physiotherapist is very low in number than the world population on average, for instance in India alone, every single physiotherapy attends to a population of 212 thousand people (Ahn, Kim, Bae, & Lee, 2015). Therefore, there is an urgent need to avail resource necessary for helping the training of more physiotherapists come in place to reduce the workload, consequently leading to an improved palliative care system. The increasing number of patient who needs palliative care across the world, especially in western countries and Asia, have made it necessary to consider a well-grounded professional corporation in the discipline of healthcare and medicine, so as to better the responsive of patients to the treatment and management programs in place.

There are three primary barriers to a well-functioning and patient-centered palliative system, whose solution can only be adequately met by incorporating the physiotherapists in the chain of critical approaches strategized. One is that there is need to integrate the creative skills and related experience from the discipline of physical therapy. Secondly is the need to change an understanding and the perception of physical therapy, so as to inculcate the whole practice as required into the system of functionality (Horne-Thompson & Bramley, 2011). Finally and most importantly, is the need to invest both structural attributes and the financial resources into the medical industry to enable strategizing and successful implementation of the set short term and long term goals. Furthermore, there is need to stay future oriented so as to meet the impending and the already existing challenges without much difficulty. One of the essential factors to ascertain to establish the attitudes, cultural, as well as knowledge, attitudes, beliefs, experience, and attitudes toward the segment of palliative care among the physical therapists. Secondly is the need to highlight adequately the field of evolving palliative care the therapeutic specialists. Thirdly, is necessary to research and come up with scientifically proven approaches to guide the discipline. Finally, it is imperative to consider the need for improving the caregiver and the patient experience in palliative care departments in partnership with the physiotherapeutic departments in health centers (Chatterton, 1988). Moreover, there are approaches that need to be improved for the efforts being made toward improving palliative care to be realistic; developing professional skills and knowledge, changing the understanding in both the patients and the medical attendants` attitudes toward end of life and needed care, as well as recognizing the essential role physiotherapists play in the segment of palliative care.

References

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Chatterton, P. (1988). Physiotherapy for the Terminally Ill. Physiotherapy, 74(1), 42–46.

Clini, E., & Ambrosino, N. (2005). Early physiotherapy in the respiratory intensive care unit. Respiratory Medicine. http://doi.org/10.1016/j.rmed.2005.02.024

Cobbe, S., Nugent, K., Real, S., Slattery, S., & Lynch, M. (2013). A profile of hospice-at-home physiotherapy for community-dwelling palliative care patients. International Journal of Palliative Nursing, 19(1), 39–45. http://doi.org/10.12968/ijpn.2013.19.1.39

Horne-Thompson, A., & Bramley, R. (2011). The benefits of interdisciplinary practice in a palliative care setting: A music therapy and physiotherapy pilot project. Progress in Palliative Care, 19(6), 304–308. http://doi.org/10.1179/1743291X11Y.0000000017

Kumar, S. P., & Jim, A. (2010). Physical therapy in palliative care: from symptom control to quality of life: a critical review. Indian Journal of Palliative Care, 16(3), 138–46. http://doi.org/10.4103/0973-1075.73670

Montalvo, A. M., Cara, E. Le, & Myer, G. D. (2014). Effect of kinesiology taping on pain in individuals with musculoskeletal injuries: Systematic review and meta-analysis. The Physician and Sportsmedicine, 42(2), 48–57. http://doi.org/10.3810/psm.2014.05.2057

Moritani, T., Kimura, T., Hamada, T., & Nagai, N. (2005). Electrophysiology and kinesiology for health and disease. In Journal of Electromyography and Kinesiology (Vol. 15, pp. 240–255). http://doi.org/10.1016/j.jelekin.2005.01.001