Roots of Physical Medicine, Physical Therapy, and Mechanotherapy in the Netherlands in the 19_thCentury: A Disputed Area within the Healthcare Domain

Abstract

Abstract:Physical medicine, which in the context of this article includes mechanotherapy, hydrotherapy, balneotherapy, electrotherapy, light therapy, air therapy, and thermotherapy, became a new field of labor in the healthcare domain in the Netherlands around 1900. This article gives an account of the introduction and development of mechanotherapy as a professional activity in the Netherlands in the 19 th century. Mechanotherapy, which historically included exercises, manipulations, and massage, was introduced in this country around 1840 and became one of the core elements of physical medicine towards the end of that century. In contrast to what one might expect, mostly physical education teachers, referred to as "heilgymnasts," dedicated themselves to this kind of treatment, whereas only a few physicians were active in this field until the 1880s. When, in the last quarter of the 19 th century, differentiation and specialization within the medical profession took place, physicians specializing in physical medicine and orthopaedics began to claim the field of mechanotherapy exclusively for themselves. This led to tensions between them and the group of heilgymnasts that had already been active in this field for decades. The focus of attention in this article is on interprofessional relationships, on the roles played by the different professional organizations in the fields of physical education and medicine, the local and national governments, and the judicial system, and on the social, political, and cultural circumstances under which developments in the field of mechanotherapy took place. The article concludes with the hypothesis that the intra-and inter-occupational rivalries discussed have had a negative impact on the academic development of physical medicine, orthopaedics, and heilgymnastics/physical therapy in the Netherlands in the first half of the 20 th century.

Chiropractic Legal Challenges to the Physical Therapy Scope of Practice: Anybody Else Taking the Ethical High Ground?

“…Whereas we place the beginning of the physical therapy profession in the US with the founding of the AWPTA in 1921, in Great Britain and Australia the national physical therapy associations, i.e., the Society of Trained Masseuses and the Australasian Massage Association, were founded in 1894 and in 1906, respectively 21,22 . In the Netherlands, such professional organization occurred even earlier when in 1889 physical therapists founded the world's fi rst professional association, the Society for Practising Heilgymnas tics in the Netherlands 23 . Founding this professional association occurred with the establishment of a standardized entry-level competency examination 24 .…”

“…Evidence of the continuous practice of physical therapy in the Netherlands and other European countries-albeit under names such as remedial gymnastics-dates back to the beginning of the 18 th century 24 . In this same issue, Terlouw 23 provides a description of the application of manual therapy interventions by these early physical therapists.…”

“…In reality, direct access is not new to the physical therapy profession. For example, in the Netherlands, therapists started out as a direct-access providers only to give up this right to gain support from medical physicians in their drive for governmental and societal recognition of the profession 23,25 . Nor was the association between medical physicians and the physical therapy profession always as amicable as one might assume from the development of the profession out of allied health professions such as nursing in Great Britain and from rehabilitation aides in the US, both with a role traditionally subservient to the medical profession.…”

Als Orthopäden noch Physiotherapeuten waren, oder warum es Physiotherapeuten an Geschichtsbewusstsein mangelt – Verhältnis von Orthopädie und Physiotherapie in Schweden im 19. Jahrhundert

“…Jahrhundertsaus dem Geschichtsbewusstsein entfernt wurden. Obwohl es dabei zu einem großen Teil um eine sehr spezifische Angelegenheit geht ("Clash" zwischen schwedischen Orthopäden und Physiotherapeuten) besitzt nach der Überzeugung des Autors die beschriebene interprofessionelle Spannung eine gewisse Allgemeingültigkeit und ist in vielen westlichen Ländern zu beobachten [17]. Der "Fall Schweden" fällt jedoch insofern ein wenig aus der Reihe, als die Spannungen und Konflikte zwischen Orthopäden und Physiotherapeuten Ausmaße annahmen, wie sie zuvor noch in keinem Bereich der Medizin stattgefunden hatten.…”

“…Zu den erfolgreichsten Therapeuten zählte der in London ansässige Leutnant Jonas Henrik Kellgren (1937 -1916 Somit lässt sich ohne Übertreibung festhalten, dass die Physiotherapie in Schweden ihre tiefsten und kräftigsten historischen Wurzeln hat und für alle Zeiten als einer der wichtigsten schwedischen Kulturexporte zu betrachten ist. Auch wenn es in Europa Zeitgenossen gab, die ebenfalls Beiträge zur frühen Entwicklung der Physiotherapie leisteten, "erschuf" letztlich doch Ling den Physiotherapeuten (zu anderen Pionieren der Physiotherapie siehe [17]). Als er das RCIG gründete, gab er dem Physiotherapeuten sowohl eine berufliche Identität als auch seine erste formale, vom Staat sanktionierte Ausbildung.…”