The many-sided physio

Jul 8 2004 By Hilarie Stelfox, The Huddersfield Daily Examiner

There's more to physiotherapy than helping people with back problems and knee injuries.To mark Physiotherapy Week HILARIE STELFOX talked to staff at Huddersfield Royal Infirmary

THE physiotherapists at Huddersfield Royal Infirmary work in virtually every department of the hospital.

"But," says senior physio Sally Robertshaw, who is based in the hospital's gym, "a lot of people think we just see patients with bad backs and sports injuries.

"We actually work with all sorts of patients, from intensive care to paediatrics."

There are more than 70 physiotherapists in posts in the hospital and many are specialists in their field.

Heather Moffat, for example, is a senior physio in rheumatology, working with thoracic patients. This can take her into the intensive care unit, following patients on to the wards as they recover.

"We treat people with breathing problems. It might be that they have been attached to ventilators and sedated and need to learn to breathe properly for themselves again. It's not like you see it on television.

"When someone comes off a ventilator they don't just sit up and start talking. They are weak and this affects their breathing muscles as well as their limbs.

"We also see patients who have had a stroke, MS or Parkinson's. The aim is to restore normal function," she explained.

Virginia Whiteley, another senior physio, is attached to the rheumatology department and finds herself working with patients of all ages.

"Patients may have lost some mobility because of rheumatic diseases but we also see teenagers with hypermobility because their joint tissue is too stretchy, which makes them vulnerable to injury," she explained.

Physiotherapists are also to be found in unexpected places.

They work in the fields of mental health - exercise has been shown to help patients with depression - and on oncology wards; they see people with incontinence and asthma; women recovering from breast cancer surgery and even newborn babies.

Physiotherapy is now a graduate profession and, says Heather, its members have increased responsibility.

"We have extended roles. For example, we can now order X-rays, something we would have had to ask a doctor to do at one time. We can also ,make our own assessments, draw up our own treatment plans and see a patient right through the whole thing," she said.

To mark Physiotherapy Week, senior physios from HRI are taking part in a health and lifestyle event at Holmfirth High School. "We'll be focusing on back care and posture, sitting positions, repetitive strain injuries and the problems carrying heavy bags," said Sally.

"This tends to be a difficult group to work with - the 14 to 16-year-olds - because they are all at different stages of growth but we are seeing more children coming through with postural back pain.

"We tell them to carry their school bags on both shoulders; to have their wrists horizontal when they are using computers; and to try to keep their knees and hips at 90 degrees when sitting," she added.

* Physiotherapy Week is also a time to highlight the recent moves to legally protect the title "physiotherapist".

The chartered Society of Physiotherapy campaigned for the legislation in order to safeguard the public and protect the skills and expertise of properly trained and qualified physiotherapists.

"Anyone could call themselves a physiotherapist and set themselves up in practice," said Sally, "now anyone who is not qualified and practising without being registered can be prosecuted."

Members of the public can check to see if their physiotherapist is registered by searching online at ww.hpc-uk.org

Patrick Fitzpatrick (55) of Aspley couldn't breathe properly after spending six weeks on a ventilator in the intensive care ward of Huddersfield Royal Infirmary. But with help from physiotherapist Heather Moffat he is now recovering on the thoracic ward and regaining his strength.

He was struck down with pneumonia 10 weeks ago and was so severely ill that he can remember nothing of his time in intensive care.

"When they first took out the tubes attached to the ventilator I had to have oxygen to help me breathe. Heather had to help me breathe again. The physios have been involved all the way through. It was like being a baby; I had no use of anything, my legs were like pieces of lead, I couldn't even feed myself.

"Now I've nearly got back to walking," said Patrick, who is hoping to return to work in a builder's merchants.

"I feel really fortunate to have recovered. I know I was really ill. I can't speak too highly of the way I have been cared for here (in hospital)."

Maria Gilling (43), from Golcar, thought physiotherapy was something offered to people with sports injuries and problems walking, until she experienced the entire range of what the profession has to offer.

In April 2004 she developed Guillian Barré Syndrome, a frightening and serious condition that renders the sufferer immobile.

"It came on very suddenly. At first I had some tingling feelings in my hands and feet but in 10 days I couldn't walk or move my arms," she said.

Thought to be an auto-immune disorder that starts with a viral infection, Guillian Barré can affect the lungs, as in Maria's case.

"I was in hospital for eight weeks in total, most of that in intensive care, where I spent 10 days on a ventilator. I couldn't speak, eat or do anything for myself. It was like being in a coma but conscious," she said.

Even when she was lying paralysed in intensive care the physiotherapy began, to move her limbs to ensure that her muscles didn't waste and to help her to breathe and use her vocal chords. "I even had to be taught how to cough again."

Maria, vice-principal at Calderdale College and the mother of twin teenage boys, says the physio team were with her through every stage of her illness. "You assume they are going to be there to help you walk again but they are involved much earlier. Their help was critical for my survival," she said.

Now well on the road to recovery, Maria still has physiotherapy and plans to return to work in October.