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B.Sc. (Hons) Physiotherapy Degree Programme

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Physiotherapy is rapidly developing profession in health care with clinicians who expert in movement which develops, maintain and restore maximum movement and functional ability throughout the lifespan across the health spectrum.

The only pathway to becoming a physiotherapist in Sri Lanka is to graduate from a reputed University with a degree of B.Sc.(Hons) Physiotherapy.

In this degree, develop competent graduates in Physiotherapy who are able to assess the problems of individuals using core knowledge of medical and clinical sciences and evidence-based practice, identify interventions in physiotherapy to overcome such problems. It is focused on physical, psychological, social, cultural, and environmental factors on the corresponding problems of the individual. â€‹
 

Physiotherapists work at Intensive Care Units (ICU), wards, outpatient clinics, and community-based centers as well as private physiotherapy clinics. Not only that, the physiotherapists promote good health and the prevention of illness and disabilities.

The duration of the degree program is 4 years in English medium which are categorized in SLQF6 Sri Lankan Qualification System (The highest level in a basic degree) with 120 credits. The curriculum of the B.Sc. (Hons) Physiotherapy course is organized into five streams as, 

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  • Basic Science Stream

  • Applied Physiotherapy Stream

  • Clinical Science Stream

  • Behavioral Science Stream

  • Research Stream

Here, the undergraduates should study the following subjects.

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  • Anatomy

  • Physiology

  • Genetics

  • Biomechanics

  • Kinesiology

  • Electro Physical agents

  • Pathology

  • Pharmacology

  • Microbiology

  • Rheumatology

  • Orthopedics

  • Neurology

  • Cardiology

  • Respiratory sciences

  • Pediatrics

  • Geriatrics

  • Obstetrics

  • Gynecology

  • General Surgery and Medicine

  • Sports Physiotherapy

  • Psychiatry

  • Burns management

  • War injury management

  • Community-Based Rehabilitation

  • Occupational Health

  • Evidence-based practice in Physiotherapy

  • Electives

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Physiotherapy undergraduates gain their students to go through training in mandatory areas in scientific research, ethics and are expected to conduct a research project on a chosen topic, under the guidance of a supervisor and present research. 

The clinical training is given at National Hospital Sri Lanka, Ragama Rehabilitation Hospital, Chest hospital Welisara, Lady Ridgeway Hospital for children, Medical Research Institute (MRI), The Soyza Maternity Hospital, Institute of Sports Medicine- Ministry of Sports and Community Rehabilitation Centres.

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The Faculty offers its students first-class Physiotherapy programs that lead to achieving excellence in basic, applied, and clinical sciences, behavioral sciences, and researches that are required in producing competent, caring, and compassionate physiotherapists.

There are opportunities for postgraduate education after the completion of a B.Sc. (Hons) Physiotherapy degree such as, 

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  • Master of Physiotherapy (MPT)

  • Doctor of Physiotherapy (DPT)

  • Master of philosophy in Physiotherapy (MPhil)

  • Doctor of philosophy in Physiotherapy (Ph.D.), etc.

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The Bachelor of Science (Honours) in Physiotherapy degree is offered by the Faculty of Medicine, University of Colombo and Faculty of Allied Health Sciences, University of Peradeniya as well as Kothalawala Defence University. The students with higher z scores in Biological Science Stream in G.C.E.(A/L) examination is eligible to apply for this course. At present, the number of undergraduates has increased up to 100.


Further information


https://med.cmb.ac.lk/allied-health/

https://www.ugc.ac.lk/index.php?option=com_content&view=article&id=1156%3Asri-lanka-qualifications-framework&catid=97%3Anotices-to-universities&Itemid=109&lang=en

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Sanduni Thakshila

Role of physiotherapists in Sri Lanka

Role of Physiotherapists in Sri Lanka
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The physiotherapy degree program was commenced in Sri Lanka in 2006. It is a four-year degree programme. Currently, two state universities (University of Colombo and University of Peradeniya) offer physiotherapy degree programmes. Each year around 60 students entering to state Universities to follow the Physiotherapy degree program. In-State Universities, students are selected to physiotherapy programme mainly based on Z-Score. According to the ranking of Z-score, the physiotherapy program achieves 3rd or 4th position in each district.

When someone complete the B.Sc. Physiotherapy (Honours) degree, he/she should grant CMCC (Colombo Medical College Council) registration. Then he/she can apply for SLMC registration. No one can practice as a physiotherapist in Sri Lanka without the SLMC registration. It is a legal requirement in Sri Lanka. 

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Where to work in Sri Lanka?

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An SLMC registered physiotherapist has opportunities in different sectors including government, semi-government and private sectors. 

Recruitments in government will be notified through the gazette. Physiotherapists will be selected for the government service according to the effective date of the degree and the GPA score. Other sectors will follow vacancies and interviews for recruitments.

Mainly three state ministries recruit Physiotherapists regularly. Health ministry do recruitments for General Hospitals including all teaching hospitals, base hospitals, and provincial hospitals and for specialized hospitals (Women’s hospitals, Children hospitals, Rehabilitation hospitals, Respiratory care hospitals, etc.). Defense ministry (Air force, Army etc.) and Sports ministry also have Physiotherapists on a permanent or contract basis.

Physiotherapists can work in state universities as academic staff (Senior lecturers, Probationary lecturers, Assistant lecturers, Demonstrators, etc.)  not only in Allied Health Sciences Departments/Faculties but also in other faculties due to the qualification of B.Sc. degree.

Physiotherapists have vast opportunities in the private sector in all private hospitals, private physiotherapy clinics, NGO-based clinics, Sports teams (Cricket, Football, etc.), Specialized schools for differently able children, etc. Home visits can be done by any Physiotherapist who has SLMC registration. 

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In Sri Lanka, Physiotherapists are permitted to;

 

  • Act as first contact/autonomous practitioners 

  • Assess patients

  • Make a diagnosis

  • Offer preventative advice/services

  • Refer to other specialists/services

  • Treat (interventions, advice, and evaluation of outcome)

  • Provide telehealth services (Telehealth services were introduced with the Covid-19 pandemic situation.)

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What are the services Physiotherapists can provide?

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Physiotherapy is concerned with human function and movement. It is the process of using treatments to maximize the body's functional movement potentials. Therefore, it involves in almost all medical conditions such as;

  • Joints, bones, muscle, and nerves related health conditions

  • Respiratory and heart conditions

  • Surgeries (before and after)

  • Children’s health conditions

  • Women’s health problems

  • Sports injuries

  • Fitness and body figures

  • Rehabilitation etc.

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Physiotherapy was well recognized only in the Colombo district due to limited resources until the last decade. The number of graduates in Physiotherapy has improved in last few years and government and private sector recruitments have increased accordingly. Currently, physiotherapy is an island-wide service and it has a huge growing demand. 

Physiotherapy is a fast upgrading healthcare field. Currently, Continuous Professional Development (CPD) and Evidence-Based Practice are more popular than ever among Sri Lankan Physiotherapists. It helps them to maintain and develop professional skills and knowledge and provide a better service for our citizens. 


Physiotherapist P.W.Hashini Nimesha
Joseph Fraser Memorial Hospital (Colombo 05) 
SLMC Reg.No.0626

As a physiotherapist, you will be...

As a physiotherapist, you will be...
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Once you are graduated now you are fully equipped with knowledge and skills. First thing you have to do is to get registered as a Professional Physiotherapist. For this you have to take Ceylon Medical College Council (CMCC) registration.
Next you have to get registered in Sri Lanka Medical Council (SLMC). You will get an identity card with a professional registration number.
This ID is the valid license to treat your patients. Without this no one can perform treatment on patients.


There are so many sectors you can select.
Mainly 

  • Government Sector

  • Private Sector

  • Personal Sector

  • Overseas sector

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Government Sector 


If you are looking for  Government Sector
There are many sub categories.some of them include,

  • Lecturer (Ministry of Education)

  • Physiotherapist (Ministry of Health)

  • Sport Physiotherapist (Ministry of Sports)

  • Physiotherapist (Ministry of Defense - All Forces)

Ministry of Education will recruit Graduates (Preferably 1st Class Degree) as lecturers for the universities.
And also, there are opportunities to work as lecturers in private universities too.
Depending on your higher education you will be able to promote from a demonstrator, lecturer, senior lecturer, Head of the department and more. 

Physiotherapists for government hospital will be recruited by an annual gazette. Most of graduates will select this path and become government Physiotherapists.
Once you are selected you have to follow a 6 months internship (paid). After the internship you will get a list of hospitals to mark your choice. Depending on your degree’s date and your Grade Point Average (GPA) you will be selected to a government hospital.
Then you will become a state sector worker and you start working.While you are working you have to pass 9 months’ probation period where your discipline, attendance and behavior will be evaluated as every other government worker.
After 3 years you will be a permanent government worker and obtain the benefits. (This is the basic procedure for every government worker)

Ministry of sports and ministry of defense will also recruit Physiotherapists for their sport teams and hospitals.
These vacancies will be published in newspapers and gazettes.
When you were selected as a Physiotherapist to a sport team you will ultimately specialized as a sport Physiotherapist.
While when you were selected to forces you will become a member of the certain force. (Army/Navy/Air Force/Police)

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Private sector 


If you are looking for a carrier in the Private Sector,
there are many fields in private sector too.

  • Private Hospitals

  • Private Clinics

  • Sport Clubs

  • Nursing Homes

  • Schools

  • Special needs children centers

  • NGOs

  • Researcher / Research Assistants

  • Community Projects 

  • Volunteer projects

  • Veterinary Physiotherapy clinics

Are some of them.

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Personal sector 


If someone wants to start their carrier in personal Sector,  After getting registered as a Physiotherapist you can plan to start your own clinic.
You have to follow few easy steps to register your clinic under Private Health Services Regulatory Council (PHSRC) and you are ready to go.
Then you have to buy relevant treatment equipment which are not too expensive.
Now your clinic is ready for services.

Apart from that you can start home visits or clinic visits or personal appointments where you will visit the patients and treat.

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Overseas sector


Overseas based carrier pathway is also one of the main pathway after Graduation in B.Sc. (Hons) Physiotherapy . 
Many countries prefer to recruit Physiotherapists from Sri Lanka for their hospitals.
There are so many opportunities around the world mostly in UK, Australia, Singapore, Middle east and Asia.
You can become a foreign employed Physiotherapist easily if you follow the correct guidance.


In the government service Physiotherapy is considered as an essential service.

In the government service Physiotherapy is considered as an essential service.
Physiotherapy is considered as an essential service as it plays a major role in health and fitness in people.
Physiotherapy management along with the medical management is very essential for most of the diseases and disabilities.
And for some conditions Physiotherapy plays the major role.

  • Musculo skeletal conditions like Arthritis, Muscle strain, osteoporosis etc

  • Neurological conditions like stroke, spinal cord injuries etc

  • Orthopedic conditions like fractures, dislocations etc.

  • Pediatric conditions like Cerebral Palsy, Torticolis, spina bifida etc

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Physiotherapy has an important and essential part in Intensive Care Unit (ICU) patients management too.
Patient recovery is much faster when the Physiotherapy management is involved.

As a Physiotherapist you have to upgrade your knowledge throughout your service in order to update your treatment in sake of the patients.Various programs, seminars, workshops, conventions, symposiums and many more will be there locally and internationally to improve your Continuous Professional Development (CPD) 


Considerable number of Physiotherapists involved in research and Evidence Based Practice (EBP) in order to enhance and upgrade the Physiotherapy profession by uncovering new fields.
And this new knowledge is being shared locally and globally and new techniques and methods are introduced very frequently. Hence, Physiotherapy has a dynamic and active development. 


Physiotherapists have to enrolled in professional organizations, associations and unions to discuss and take important decisions regarding the profession.
Government Physiotherapy Officers Association (GPOA), Sri Lanka Society of Physiotherapists (SLSP), Colombo Physiotherapy Alumni Association (CoPAA) are some of those professional organizations.


Physiotherapy is a stress-free job where you can always work with happiness by seeing your patients improving day by day. 
Physiotherapist is a person who always happy and present with a pleasant smile.
Decent behavior and empathy towards every human is an absolute part in Physiotherapist’s life.

As a Physiotherapist you have to work with many professionals. You will earn respect through your profession among colleagues, fellow professionals and among public.
All Physiotherapists are team workers and always tend to help each other.
Health care workers in every level tends to get advices and treatments from Physiotherapists for their own diseases and disabilities. By treating them Physiotherapists help to maintain the health and fitness among the health care community too.

And also, we usually spent more time with patients because of our treatments. Hence, we will be able to understand our patients fully and work accordingly towards their improvement.
We explained the treatment and the exercises to the patients and help and guide the patient to do it successfully.
You will be delight to see them improve fast. And their love and blessings will be always with you.

Physiotherapist do lots of social work and also public awareness campaigns where we deliver important messages to the public. Physiotherapists fulfill this immense service through mass media like television, radio, newspapers and through social media.

Physiotherapist maintain their physical fitness and health properly as we need to advice our patients and public on those.

You will become a respectable and important personality once you become A Physiotherapist.

A Physiotherapist is a person who has a brain of a scientist heart of a humanitarian and hands of an artist.


Physiotherapist Nuwan C Rodrigo,
Secretary,
Sri Lanka Association for Child Development
B.Sc.(Hons)(Col) Physiotherapy
Lady Ridgeway Hospital for Children
SLMC Reg.No.0504

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ROLE OF PHYSIOTHERAPY IN ICU.....

Role of physiotherapists in ICU
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Intensive care is the specialized care of patients whose conditions are life-threatening and who require comprehensive care and constant monitoring, usually in intensive care units. 

Critically ill patients frequently suffer long-term physical and psychological complications due to prolonged stays in the intensive care unit and long-term mechanical ventilation. 

  • In the intensive care unit,

  • Patients who have undergone various surgeries.

  • Patients with respiratory complications. 

  • Patients with paralysis.

  • Cancer patients.

  • Patients with severe infections.

  • Patients with cardiovascular disease.

  • Patients who undergo accidents

Receive treatment.

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Adverse effects of ICU stay

  • Physical Inactivity leading to muscular atrophy and generalized weaknesscomplete bed rest causes young adults to lose about 1% of muscle mass per day, the elderly may lose up to 5% per day secondary to age-related decreases in growth hormone.

  • Diaphragm weakness due to prolonged mechanical ventilation

  • compromised cardiorespiratory function

  • Deep vein thrombosis 

  • Pressure Ulcers 

  • Infections 

  • Onset of contractures 

  • Pneumonia  

  • Increased mortality 

Therefore, they require a multidisciplinary approach to manage patients in critical care. 

The role of the physiotherapist in this multidisciplinary team is very important. This is because they are key in determining the quality of life of a critically ill patient in the intensive care unit. 

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Early intervention by physiotherapists in the ICU helps, 

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  • Prevent ICU related complications

  • Stabilization and improvement of pulmonary function 

  • Reduce the patient's stay in the ICU and overall hospital stay.

  • Improve function and quality of life in the long term

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Goals of routine ICU physiotherapy

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  • Optimization of cardiopulmonary function.

  • Assisting the weaning process for patients utilizing ventilatory support and oxygen therapy.

  • Instigation of an early rehabilitation/mobilization program to assist in preventing the consequences of enforced immobility.

  • Advice on positioning to protect joints and to minimize potential muscle, soft tissue shortening, and nerve damage.

  • Alter body position to reduce negative effects on the muscle tone in patients with traumatic brain injury.

  • Optimization of voluntary movement to promote functional independence and improve exercise tolerance.

  • Management of presenting musculoskeletal pathology. 

  • Advise and educate family and carers.

  • Liaison with medical and nursing staff for the continuous monitoring of ongoing physiotherapy-devised care plans.

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The role of the physiotherapist in the intensive care unit can be divided into two main parts.

  1. Respiratory physiotherapy  

  2. Rehabilitation 

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 Respiratory Physiotherapy

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The role of the physiotherapist in respiratory physiotherapy is to assist in clearing the airways of the patient, and to maintain/improve the integrity of the respiratory system.

It will help,

  • Prevent ventilator-associated pneumonia 

  • Wean off from mechanical ventilation 

  • The recovery process 

  • Promote secretion clearance

  • Maintain or recruit lung volume, in both the intubated and spontaneously breathing patient.


Techniques for optimization of cardiopulmonary function

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  • Manual hyperinflation (MHI) (mechanical ventilation only)

  • Oral or nasal suction (mechanical ventilation only)

  • Manual techniques: chest shaking and vibration, chest wall compression, chest clapping/ percussion

  • Positioning, gravity-assisted positioning (GAP)

  • Active cycle of breathing technique (ACBT)

  • Intermittent positive-pressure breathing (IPPB)

  • Continuous positive airways pressure (CPAP)

  • Non-invasive ventilation (NIV)

  • Nasopharyngeal/oral suction

  • Positive expiratory pressure (PEP) mask, flutter valve

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One thing we have all heard is that when it is difficult to breathe, it is connected to an artificial respirator (ventilator). Connecting to a mechanical ventilator for a long time compromises respiratory function and induces diaphragmatic weakness. Hence the physiotherapist will help to strengthen these muscles. The physiotherapist will work closely with other medical teams to make a daily plan to reduce the patient's reliance on the breathing machine (weaning off the ventilator).

In the intubated patient, physiotherapists commonly employ manual and ventilator hyperinflation and positioning as treatment techniques whilst in the spontaneously breathing patients there is an emphasis on mobilization.

Important Physiotherapy evidence of ICU management in recent years showed,

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  • Physiotherapy Improves quality of life, physical function, peripheral and respiratory muscle strength.

  • Physiotherapy helps to increase ventilator-free days.

  • It decreases the hospital and ICU LOS(Length Of Stay)

In brief, physiotherapy was found to confer "significant benefit in improving quality of life, physical function, peripheral and respiratory muscle strength, increasing ventilator-free days, and decreasing hospital and ICU stay". 


 Rehabilitation (Mobilization)

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  • Level of mobilization during invasive ventilation

  • Turning in bed passive/active

  • Sitting over the edge of the bed

  • Transferring from the passive/active

  • Standing up passive/active

  • Walking with mobile ventilator

  • walking with or without modified walking frames or walker

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Rehabilitation can take place in two settings

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  • Within hospital 

  • After discharge from the hospital 

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ICU- acquired weakness (ICUAW) is common and begins in the first few days of critical illness.

It is plausible that early mobilization (exercising patients while they are still receiving mechanical ventilation) may protect against ICUAW and limit long-term neuromuscular dysfunction. 

The importance of exercise following intensive care treatment ( stroke, major surgeries, orthopedic surgeries ) is to improve quality of life and maximize physical and emotional well-being.
                              
Some of the benefits of exercise following critical illness include:

  • increased muscle strength and joint movement 

  • improved stability and balance

  • improved exercise tolerance and fitness

  • improved circulation

  • improved well-being; and

  • increased functional ability.

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Following critical illness physiotherapy can feel very demanding, but by participating in regular exercise as early as possible you are more likely to achieve your goals. This may feel like a long process but you must discuss these goals with your physiotherapist so that you can get the most out of your rehabilitation.

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References

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Beers, M.H., Porter, R.S., Jones, T.V., Kaplan, J.L. and Berkwits, M., 2006. The Merck Manual of Diagnosis and Therapy. 18th. Whitehouse Station, NJ: Merk Research Laboratories.

Kayambu, G., Boots, R. and Paratz, J., 2013. Physical therapy for the critically ill in the ICU: a systematic review and meta-analysis. Read Online: Critical Care Medicine| Society of Critical Care Medicine, 41(6), pp.1543-1554.

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Chief Physiotherapist W.M Pavithra Ruwanjith Wickramasinghe 
B.Sc(Hons)(Col) Physiotherapy 
Master in Business Management (col)
Nawaloka Hospital - Negombo
SLMC Reg.No.0480

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