By Gibron Rahim

THE medical field offers a wide range of career options. As it has evolved, the field has become increasingly specialised to provide the highest quality of medical care to patients. One of these growing fields is physical therapy.

In physical therapy, also known as physiotherapy, practitioners aim to reduce pain, restore function and promote the mobility of their patients. Neil Barry is among Guyana’s practising physical therapists. He told the Pepperpot Magazine that he was interested in science since nursery school before he even knew the word “science”.

“I was always thinking scientifically,” he said. When he grew up, the decision to study physical therapy felt only natural considering Neil’s background in sports. His athletic ability allowed him to represent Guyana at cricket and track and field. “In trying to improve myself I started to get injuries and through injuries, I learned about rehabilitation,” he related. Practising physical therapy allows Neil to combine sports and science, more specifically medicine.

Neil is presently employed by the Ministry of Public Health. He and his colleagues see a variety of patients on a daily basis in Vreed-en-Hoop where he is currently stationed. He explained that they handle orthopaedic cases twice a week. These include patients who have common fractures or are suffering from degenerative diseases, such as osteoarthritis. Another two days a week are dedicated to patients who have suffered a stroke or spinal cord injury. “I also see quite a few athletes,” Neil said. He also noted that there is a day set aside for seeing children who might have developmental delays with the goal of helping them to achieve their developmental milestones and lead normal lives.

AWARENESS NEEDED
A lack of awareness is the challenge that Neil identified as currently facing physical therapists in Guyana. He noted that a physical therapist is not usually the first choice where he is currently stationed as there are usually persons that villagers seek out for complaints that require massages or cracking bones, for example. “However, I think we’re really starting to make an impact because quite a lot of persons have had good results,” he pointed out. He explained that he and his colleagues have been able to help individuals suffering from common conditions, such as osteoarthritis and stroke, and were taken in by their family members for treatment.

Neil noted that medicine is moving towards becoming more evidence-based than ever before. He explained that high-level evidence has been finding that physical therapy specifically is more effective than surgery in treating lower back pain and damaged shoulders. Additionally, “Physical therapy is extremely important in helping a person recover from a stroke,” he said. He cited additional evidence that pre-operational physical therapy increases a surgical operation’s chances of success. He explained that it is knowledge of this kind that he and other physical therapists are trying to get out to the public. “For most conditions, as long as you have any form of disability, physical therapy quite often is the first stop.”

TECHNICAL DETAILS
While physical therapy is a very hands-on field, practitioners also use a wide variety of tools to help patients. There needs to be an assessment before any of those tools are applied, however. Neil explained that a physical therapist’s assessment can be very similar to a doctor’s. “Except that we are very conservative so we do not deal with internal medicine,” he said. There are tools that enable measurement of the amount of joint movement and mobility through various parts of the spine. In terms of treatment, physical therapists utilise electrotherapy modalities which Neil clarified is essentially the use of electricity to stimulate pain relief or sometimes, healing.

Physical therapists also make use of magnet therapy and kinesiology and other forms of orthopaedic tapes. “We might prescribe braces and other forms of assisted devices to help somebody with their mobility and ambulation,” added Neil. Among the practitioner’s tools that may sound unusual at first are low-level lasers and therapeutic ultrasounds. He explained that, while ultrasounds are better known for being used for scans, they can also be used for healing. Hot and cold therapies, as well as hydrotherapy, are also used to help patients.

In addition to lack of awareness, Neil noted that there are numerous other challenges to be dealt with. He pointed out that many of the challenges he and his colleagues face are similar to those faced by other medical professionals who work in public health and are exerting efforts to get the public healthier. “We are also trying to challenge the burden of chronic diseases –

diabetes and hypertension,” he related. Physical therapists, he said, stress movement and physical activity which he noted are very effective in preventing chronic diseases, as opposed to relying on medication. He pointed out that, even as lifespans have increased, health spans have not. Neil explained that there is physical therapy available that can help with the prevention and management of chronic conditions.

BENEFITS OF PHYSICAL THERAPY
Physical therapists need to work closely with doctors. In addition to working alongside doctors every day, Neil explained that physical therapists also work in hospital wards. He related that physical therapy can help in-patients with numerous problems they may have. This includes helping them to move their limbs around and change their positions. Inactivity can also lead to the development of deep vein thrombosis which physical therapy can help prevent. Physical therapists also handle referrals from orthopaedic personnel, both before and after surgical procedures.

In addition to physical therapy, Neil is very passionate about the similar field of sports therapy. He is currently pursuing sports medicine at the graduate level and has taken a number of advanced sports training and sports therapy courses. “I believe I have a lot of knowledge that I can share to help athletes,” he said. “The only way I can really be impactful is to get the word out there. It is his intention to educate as many persons as he can with regard to sports therapy and perhaps even inspire others to become involved as well. He related that Guyana is behind the world in the way we prepare athletes along with our overall mindset to sports.

Physical therapy has its hurdles, just as other fields do. To handle those hurdles, Neil related that he is very self-motivated, adding that motivation comes from one’s goals. He would emphatically recommend the field of physical therapy to others. He pointed out that there is currently a very low ratio of physical therapists to patients in Guyana. “It’s a very exciting field,” he said. “[It’s a] very broad field and it’s a growing field, one of the fastest growing fields in the world so it’s highly recommended.”