Manual Therapy VS Electrotherapy

Manual therapy has been said to be skills that are more hands on whereas electrotherapy often involve having the patient positioned in a certain manner and be provided with a particular electrotherapeutic modality for specific purposes.

Joint Mobilisation

I have discussed with many physiotherapists about their stand of preferring to perform manual therapy or electrotherapy or a combination of both. One physiotherapist who is very experienced and plays a major role in the MPA has said that he is a strong believer of electrotherapy as it is effective in reducing the impairments patients have especially those concerning pain. He is also trying to revive the usage of electrotherapeutic modalities through a particular electrotherapeutic modality international association (I'm not able to recall the name of the association).

Therapeutic Ultrasound (US)

Shortwave Diathermy (SWD)

Another experience therapist I talked to feels that as physiotherapists, being able to perform manual therapy skillfully is vital to be an effective physiotherapist. He also mentions that patients are mainly cured by performing manual skills instead of the usage of electrotherapeutic modalities.

I agree with both to a certain extent. I believe that electrotherapeutic modalities is useful to reduce the impairments of patients ONLY FOR SHORT TERM. I did a research on the effects of SWD on knee OA and found that the group receiving SWD + exercises has no significant reduction in pain compared to the group performing only exercises. This too has been supported by abundance of literature.

I believe that being able to perform great manual skills sets apart a good physio from a great physio. Also, these electrotherapeutic modalities can be used by various other health personnel, such as the OTs now uses wax, the chiropractors uses SWD and US. So what sets us apart from them and what they can't steal from us is the usage of manual skills. Even simple manual skills like strengthening exercises could be performed by nurses. Therefore it is our duty to always protray the ability of performing ADVANCE manual skills to show that we are physios.

Also, in some clinical conditions, the usage of electrotherapy does not produce significant effects, therefore would consume extra finances and time for its application. Perhaps in some cases, these modalities can be omitted from being applied.

Myofascial Release

However I'm not here to deny the benefits of electrotherapeutic modalities. I'm here to say that electrotherapy is effective only for short term. I'm also here to say that to be a truly great physiotherapist, one is often judge by how one performs manual skills but not by how one sits and give ultrasound to a trigger finger patient.

Forum in UiTM, March 18, 2011

I was very blessed to have "stumbled" into a forum organised by the physiotherapy students association (PHYTAS) of UiTM last Friday, the 18th of March 2011. Distinguished guest speakers were invited and they were:

1. Datin Asiah Haji Hashim
Ketua Perkhidmatan Fisioterapi Malaysia (Former MPA president)

2. Mr. Marc Daniel
Physiotherapist from Prince Court Medical Center (Former MPA president)

3. Dr. Balwant Singh Bains
Current president of the MPA

Students were encouraged to voiced out their thoughts and questions for the panel to comment and answer. Since I came in long after the forum has started, I didn't manage to listen to the previously asked questions but these were some of the infos they provided upon further enquiries.

The panel upon being asked "What is the difference between a diploma and a degree graduate of physiotherapy?", Datin Asiah answered that a degree qualification would expect the physiotherapists to have had a research component in their studies. Therefore they would be expected to have a research-based or evidence-based practise. Also, with the researches that they have performed, a degree qualified physiotherapist should have a greater degree of clinical reasoning upon performance of assessments and interventions.

She also mentioned that with higher qualification of physiotherapists, we would not be bound to the prescriptions of doctors and able to provide own clinical reasons for the necessary provisions of assessments and treatments. Physiotherapists with a postgraduate qualification should take up higher responsibilities in gaining recognition for the field of physiotherapy from the different health disciplines as well as from other professions.

Not related to the previous question, my blog of course has been a bit of an issue in the forum and I justified my stand for my first blog post. The panel agreed with what I have said about the predicaments of studying physiotherapy in certain local institutions and Datin mentioned that these problems shouldn't have arise and she said "in paper it's good, but execution is not as in paper". I agreed with her.

Also, Datin announced that she would be retiring in March 2012 and Dr. Bains would love to have Datin as the advisor of MPA.



Overall, good job to PHYTAS for organising this informative and eye-opening forum!

The Truth As I See It

I am very pleased that I have people reading this little, simple and crawling blog of mine regarding physiotherapy. Some responses were positive but there will never be a continuous rosy responds would it? So definitely I have caused abit of a stir in expressing my opinions in my first post and guess what people, MORE CONTROVERSIAL OPINIONS COMING!


Here's what I believe in. Doing things as how people used to do doesn't mean it is the best way. Doing things how the people newly do might not also be the best way. I'm not smart, nor am I experienced, worse still I'm just a student, not even fully licensed. However, with this little brain of mine and with the limited credentials to my name, I think I can see ways physiotherapy can improve in Malaysia, and perhaps in the world as well.

So here I am writing my ideas and opinions, and perhaps some informations that I could share with the rest of you. Do drop comments if you like, and perhaps with your name as well because it would be slightly difficult for me to leave a comment as such:

"To anonymous 1: fjwo;efjwo

To anonymous 2: sjwfwj

To anonymous 3: fwfjwfwj"





Looks weird huh?

Well, people have known me to be assertive and known me for always speaking my mind. It might not be the best trait in a person surrounded by the Malaysian culture, but I guess things gotta change.

So as the name of my blog goes, PHYSIOTHERAPIST SPEAKS coz I ain't shutting my mouth people.

This is Abang Monyet and he too ain't shutting his mouth

Peace to all and enjoy reading!

Required Improvements For Studying Physiotherapy Locally

We are very familiar with the predicaments the students of many institutions taking physiotherapy. Here are the common issues:

1. Non-conducive population of students

Various institutions have many intakes a year and I know of one college that takes up to 6 intakes a year. What's more "remarkable" is the amount of students per intake is simply abundant. Some institutions takes in as many as 500 students per intake.

How would the authority of the institution expect to create a conducive learning environment for the students? These students would be divided into probably 4-5 groups of approximately 100-150 students per group for practical classes. With just 1 lecturer per group, how would they expect the students to be able to see what the lecturer is teaching?

For example when a lecturer teaches spinal mobilisation, that would require students to get very close to the lecturer and observe the demonstration. But with the great amount of students, how would the student to even have a chance to see where the hands are palpating on the back?

2. Lack of equipments

Many of these institutions have such inadequate equipments. Can you imagine I have heard that many have not even seen a peak flow meter! They even wondered how a spirometer looks like.

Students had to pay huge amounts to finish their diploma or degree in some institutions, ranging between RM45k to RM80k for a 3-year diploma course. Imagine getting RM60k per students, with 3000 students per year. The institution gets a total of RM1800000000 (that's RM1.8 BILLION!) yet they can't even purchase enough peak flow meters for the students? I seriously wonder what they do with the money.

Some students have never even heard of the isokinetic machine. Personally, having studied in a particular university, with only 34 students in my batch and divided into 2 groups of 17 students, we got to practise with spirometers, peak flow meters, isokinetic machine and many other equipments that are necessary for a holistic and complete assessment and treatment.

3. Places for clinical placements

In my 4 years of doing my degree, we're very lucky that the students of my university have always been placed in local government hospitals. Students of other institutions, due to their huge numbers are always placed in homes like mentally handicapped homes or old folks homes. It would be a great exposure with placement in homes however how would they be able to learn if there are no physiotherapists at the homes to guide them? How would they know they are doing things wrongly if there are no physiotherapists to correct them?

Also, these students wouldn't have enough exposure to cardiorespiratory (CR) patients as majority of CR patients can only be found in hospitals. How would they be able to assess and treat CR patients upon fully graduated if they have handled none? Many have NEVER EVEN STEPPED INTO THE ICU.

I'm sure the Malaysian Physiotherapist Association (MPA) and the Ministry of Health (MoH) as well as the Ministry of Higher Education are making efforts to overcome these problems. We hope and pray to see the outcomes of their effort ASAP.

We can't have many more students being CHEATED!