Physiotherapy/Physical Therapy

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Category: Allied Health Options

What is it?

Physiotherapy/physical therapy (PT) has its origins in ancient history involving massage and forms of manual therapy in China around 2500 BC. Typically physiotherapists consult for the management of medical problems or other health-related conditions that cause pain, and that limit locomotion or the performance of functional activities. Physiotherapists are also involved in various health conditions through prevention, restoration of function and through fitness and wellness programs to maximise healthy, active lifestyles.

How does it work?

The emotions associated with PTSD are thought to contribute to hyper-arousal. PT treatment aims to reduce hyper-arousal or the feeling of being ‘on guard’ all the time through such techniques as massage, acupuncture, reflexology, and various exercise prescriptions. This is thought to help develop ways for the individual to manage stress and bring about a form of relaxation.

Is it effective?

PT has been previously shown to help in the management of lower back pain. Exercise has been shown to help in the management of depression and physiotherapists frequently prescribe exercises as a form of treatment. However PT has not been researched adequately enough to give an effective measure in the treatment of PTSD.

Are there any disadvantages?

Common techniques used by physiotherapists include massage, mobilizations, manipulations, acupuncture and exercise. The disadvantages associated with these interventions have been documented under the individual techniques.

Where do you get it?

A directory of qualified physiotherapists can be found on the Australian Physiotherapy Association website. Physiotherapists can also be found in the yellow pages. While these strategies are pursued, it is also important that the person with PTSD is under the care of a certified health professional.

What are the evidence limitations?

There is currently no explicit evidence to support physiotherapy as an independent intervention for PTSD. Much of the evidence base is derived from lower levels of evidence such as expert opinion and clinical experiences. Therefore interpreting this evidence should be undertaken with caution.

Recommendations

Based on the current lack of high quality evidence, the use of physiotherapy for PTSD cannot be recommended based on the current research evidence. More research is required. It may be considered as an adjunct to other PTSD interventions, such as psychological and drug therapies.

Key References

Australian Centre for Posttraumatic Mental Health 2007, ‘Australian guidelines for the treatment of adults with Acute Stress Disorder and Posttraumatic Stress Disorder. Practitioner Guide’ National Health and Medical research Council, viewed 11 December 2008,
http://www.nhmrc.gov.au/publications/synopses/_files/mh13.pdf

Sjosten, N & Kivela, SL 2006, ‘The effects of physical exercise on depressive symptoms among the aged: a systematic review’, Int J Geriatr Psychiatry, vol. 21, pp. 410–418.

Van Tulder, MW, Koes, BW & Bouter, LM 1997, ‘Conservative Treatment of Acute and Chronic Nonspecific Low Back Pain: A Systematic Review of Randomized Controlled Trials of the Most Common Interventions’, Spine, vol. 22, no. 18, pp. 2128-2156.

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