What is the cost of veterinary physiotherapy and where can I find a physiotherapist?

In my last article I explained the terms physiotherapy and rehabilitation. To rehabilitate means to return the body back to normal after an illness or injury, or to get as close to that state as possible. Physiotherapy is a part of comprehensive rehabilitation that deals with the diagnosis, treatment and prevention of disorders of the human (and nowadays animal) musculoskeletal system. It uses manual and movement therapy and various physical methods. It is interdisciplinary with many medical fields such as surgery, orthopaedics, internal medicine, gerontology, psychiatry, etc. Veterinary medicine is copying human medicine, which is developing by leaps and bounds. This has also happened in physiotherapy. The person who performs physiotherapy is called a physiotherapist. Most of you have met this person in the course of recovery from an injury of a prolonged illness, after a specialised orthopaedic or neurological procedure, or parents with children who suffer from a musculoskeletal or even nervous system defect undergo regular rehabilitation. The physiotherapist's job is to diagnose the problems the patient is experiencing and then treat them. To do this, he or she also uses a variety of aids and modern equipment. In practice, it is usually the case that the orthopaedic or neurologist of a given patient decides on the indication for physiotherapy in human medicine. The latter writes a request for rehabilitation. In some cases, a physiotherapist can be visited directly with a specific problem and, on the basis of his examination, he will decide whether he can afford to suggest certain exercises and procedures directly or whether he will first need a specialised examination by the aforementioned specialists. The physiotherapist can analyse movement patterns and develop a rehabilitation plan for amateur and professional athletes. The professional qualification to practice as a physiotherapist is obtained by completing an accredited medical bachelor's (B.Sc., 3 years) or master's (M.Sc., 5 years in total) degree at several Czech colleges and universities. You can also meet a doctor who has his specialty - certification in Rehabilitation and Physical Medicine. Among the public, physiotherapists are sometimes mistaken for massage therapists. A person can become a massage therapist after completing a long weekend, passing a final exam and registering with the trade office. Massage is suitable for relaxing the tired body of ordinary people or athletes. Even within the field of physiotherapy, an interested person can take a course in massage. However, the study of medical subjects, such as anatomy and physiology, examination methods, basic neurology, orthopaedics, surgery, internal medicine, etc., is also included in the course of study. A large part of the study is the practical part, both in the form of practicing individual physiotherapeutic actions and in internships in hospitals. After graduation, whether it is by the final examination of the Bachelor's or Master's degree, the physiotherapist is a specialist in musculoskeletal issues. He is not a doctor, a nurse or the aforementioned massage therapist. Any proper physiotherapist will first carry out a comprehensive kinesiological examination, which consists of, for example, an examination of standing, gait, movement stereotypes or perhaps a basic neurological examination. Only on the basis of the findings from this examination can he or she draw conclusions and set a goal to help. The physiotherapist can often instruct the patient for home treatment/exercise. Every physiotherapist becomes part of a lifelong learning programme, where knowledge must be continually acquired or expanded as part of postgraduate study.Start of formEnd of form How does veterinary physiotherapy stand? For a long time in the world, physiotherapy existed as part of the field of veterinary orthopaedics or neurology. America and then Western Europe created the veterinary medical specialty for individual disciplines more than 30 years ago, similar to the second professional certification in human medicine. This is how the first certified internists, surgeons, radiologists, neurologists, ... All of these people had to and must undergo a 3-year residency program at a high-level institution under the mentorship of an already expert in the field who mentors them. After passing the final exam, they are given a degree, e.g. DipECVS (Diploma of European College of Veterinary Surgery). Another option, now not only for veterinarians but also for other medically educated people interested in obtaining a physiotherapy education, was the possibility to attend a renowned foreign course. The really advanced ones are under the auspices of the University of Tennessee (you will recognize the specialist with the title CCRP - Certified canine rehabilitation practitioner) or for example under the Swiss Association of Animal Physiotherapy (SVTPT). Finally, ten years ago, the College of Veterinary Physiotherapists (ACVSMR, ECVSMR) was established in America and in 2018 in Europe. Over the last few years, due to further demand, other courses of greater and lesser seriousness have been established in the world and in our country. For the time being you can find and count similarly foreign educated people in our country on the fingers of your one hand, at most add two more fingers of the other hand. So what is the situation in our country at present? How do I know the physiotherapist for my pet? The Veterinary Act states that physiotherapy within the Czech Republic can be carried out by veterinarians and also by veterinary technicians (persons with secondary vocational or higher vocational veterinary education). Unfortunately, the reality is different in my own experience, as there is no comprehensive curriculum in physiotherapy provided by real subject specialists at veterinary university or herd veterinary schools. Veterinary students and graduates themselves admit that they have no idea about animal physiotherapy. In 2016, the Association of Animal Physiotherapy and Rehabilitation (AFRZ ČR, z.s.) was founded in the Czech Republic, which, in addition to the goal of bringing together those interested and expert in veterinary physiotherapy, has set itself the task of creating a comprehensive educational system in the Czech language for animal physiotherapy. The Association does not want and cannot accept that dogs with polio are rehabilitated by a person with a weekend course, without further control by a specialist, or even without any prior diagnosis! That is why the Association is calling for better professional training in our country as well, as foreign certified courses are not available for all, for example for language or financial reasons. The Association was able to start a professional course in Physiotherapy and Rehabilitation of Small Animals already in 2017. In order to comply with the standard of foreign education, the syllabus for this course consists of a comprehensive acquisition of knowledge in anatomy, physiology and pathology of the musculoskeletal system; students must have knowledge of radiology, neurology and orthopaedics. Only then, in the second part of the course, do they learn individual procedures suitable for small animal rehabilitation. Specialists in their field are assigned to each subject. The AFRZ CR course ends with an authorized examination. What does this mean? In cooperation with the Ministry of Education and the Ministry of Agriculture, the qualification Physiotherapist and Rehabilitation Worker for Small Animals (code: 43-001-R) was created. This qualification has become part of the National Qualification System (NQS). The qualification Physiotherapist and Rehabilitation Worker for Small Animals has been assigned a qualification level corresponding to the attainment of a Bachelor's degree (level 6). This year, the first graduates have been released and their list can be found on the Association's website (www.asofyrez.cz). These AFRZ-certified veterinary physiotherapists undergo further supervised education. Therefore, I must be careful not to request physiotherapy for my dog with a musculoskeletal health problem from a person who is not legally or professionally qualified to do so. The situation may be different for massage therapy for my dog as part of recovery after a sporting event, for example, where a healthy individual is involved.

MVDr. Aleš Tomek, DipECVN