Aligning Physical Therapy practice with Brazil's leading Health priorities: a "call to action" in the 21st century

Abstract

INTRODUCTION: This article serves as a call to action for physical therapists in the 21st century with special attention to the needs of Brazilians. Compared with evidence-based practice supporting the use of specific interventions, practice that is informed by contemporary societal and priorities has seriously lagged behind over recent decades. The First Physical Therapy Summit on Global Health held at the 2007 World Congress of the World Confederation of Physical Therapy (WCPT) in Canada highlighted the discrepancy between current practice trends globally and contemporary definitions of Physical Therapy (that subsume words such as health, well-being, quality of life, health promotion and prevention); the leading priorities within the WCPT regions; the proportions of physical therapists practicing in these priority areas; and the proportions of entry-level Physical Therapy professional education devoted to them. In the 20th century, the profession strived to align itself with societal needs, for example the world wars and poliomyelitis epidemics. Over the past 50 years, lifestyle conditions including ischemic heart disease, smoking-related conditions, hypertension, stroke, obesity, diabetes and cancer have predominated. Despite a remarkable shift from communicable diseases to non-communicable conditions over the past century, the profile of lifestyle conditions within professional practice and education remains low and disproportional to need. This is particularly striking given the unequivocal data in the literature that supports the cost-benefit relationship of noninvasive interventions (primarily education and exercise) over the short and long-term, with regard to their prevention, cure and management. Often the outcomes from these simple inexpensive interventions for lifestyle conditions are superior to drugs and surgery, which are largely used to mitigate signs and symptoms rather than to address underlying causes. To enable physical therapists to address lifestyle conditions in all individuals and relieve the substantial societal and economic burdens of these conditions, we make several evidence-based recommendations for reducing their morbidity and mortality that can readily be integrated into daily practice. By systematically incorporating these into practice, physical therapists can make it possible for physicians and surgeons to use their time and expertise more effectively. CONCLUSION: We propose that the Brazilian Physical Therapy community should be strategically positioned to become a model and leader in addressing global priorities.