Physio or Kin? - Awareness of Profession

Physio or Kin? 

Awarenesss of Profession

Kathie Sharkey, OKA and Alexandre Paré, CKA VP Internal Communications, Qc 

Demystifying the differencesKathie Sharkey, OKA

Demystifying the differences between Physiotherapists and Kinesiologists is a challenge that should be mastered by Kinesiologist in our profession. I have practiced Kinesiology in Ontario for 20 years (the last 4 of them as a registered Kinesiologist) so my experience allows me to comment on Kinesiology in Ontario.   There may be some differences in other provinces but I feel that the information presented should still be relevant to the topic. 

One of the most significant differences between Kinesiologists and Physiotherapists is that Physiotherapists are able to communicate to an individual a diagnosis identifying a disease or disorder.

A Kinesiologist can explain how the client’s diagnosis may be influencing his or her movement and/or performance. You may be asked to provide your client’s with information about the disease or disorder. As long as the disease or disorder has already been communicated by the diagnosing practitioner it’s permissible to do this.

During your time with a client you may become aware of signs or symptoms that indicate that there might be a disease or disorder present. You can provide data to a diagnosing practitioner, so that they can to arrive at a definitive diagnosis. It will be your responsibility to make your client aware of the significance of the signs or symptoms and to suggest the appropriate action. This includes the referral.

A client may seek your services without having a diagnosis.  What you need to do is conduct an assessment and collect relevant health history information. You can provide treatment as long as you have determined that it is safe to do so. At this point, you need to explain to your client that you have made a clinical impression and they should see their physician to get further information. Continue to be aware of any changes in your client’s condition and alert your client to certain symptoms or warning signs.

Often times Kinesiologists find themselves working alongside Physiotherapists.  You may find yourself working as part of a health care team or your primary role may be a support role.  In a multi-disciplinary setting, you should strive to put the welfare of the client first.  Create and maintain a positive work environment that focuses on collaboration and discussion.  If you work in a support role, you are always accountable for the treatment you provide, even if it is prescribed by another regulated health professional. You should ensure that you have reviewed a patient/client’s assessment and you can confirm whether or not the diagnosing practitioner’s assessment is still valid.  You should always confirm whether or not the client’s condition has changed and always maintain clear and concise records.

Kinesiologists and Physiotherapists skills compliment one another’s abilities.  In my practice, I strive to maintain a positive relationship and open dialogue with Physiotherapists to provide optimal care to my clients.  

References

College of Kinesiologts of Ontario – Standards and Guidelines; Professional CollaborationArticle: Record keeping in support rolesInterpreting the Controlled Act of Communicating a DiagnosisScope of Practice, Controlled Acts and Delegation

Differences in CollaborationAlexandre Paré, CKA VP Internal Communications, Qc 

Two distinct professions, also sharing common areas, can sometimes lead to confusion about the roles of each professional. Indeed, kinesiology and physiotherapy have come a long way in the last few years. It is not uncommon to see physiotherapists structuring a exercise program for a patient as well as kinesiologists, adapting a training program for a client struggling with joint or postural pain, for example.

The question of the role of the kinesiologist, especially when he/she intervenes in a rehabilitation process, is very current and will certainly increase over the years.

There are interprovincial differences, supported by legislation or collaborative arrangements, which will naturally modulate the answer to this question, but let's briefly try to shed some light on it.

Figure 1 illustrates the continuum of successive interventions from professionals throughout a sport injury rehabilitation (the list is not exhaustive). It is in this long continuum that a kinesiologist, specialized in sports performance, shares the most common areas with the various therapists. We see that a whole range of players work with an athlete to bring him back to the level of sport performance.

The following figure divides rehabilitation into 7 general steps and identifies when the kinesiologist's skills will be preferentially required.

The first step, which is to take care of the person at the time of the injury, requires a medical team. Then there are 3 other steps where acute pain, inflammation, oedema and restriction of movement will be noticeable and require the presence of the physiotherapist. The reduction, and ultimately the disappearance of traumatic pain, the return to functional ramge of motion and adequate motor control opens the door to the transfer of the patient to the kinesiologist. The latter will use physical activity in the broad sense to improve the fitness composant through general training, first, then specific.

As long as the acute pain and other manifestations of the original injury are present, the kinesiologist's intervention is not required for this specific problem. His expertise will be appreciated in two facets parallel to the treatment; The elaboration of an alternative training program in order to maintain the physical qualities of the health structures and the improvement of the endurance to the treatment.

Note that this concept of acute pain limiting kinesiologist interventions does not apply as strictly with chronic pain. As such, some kinesiologists work in a context where their clients have been experiencing persistent and stable pain for several years, in which case the proposed exercise modalities are quite beneficial and greatly improve people's quality of life.

Respect for the fields of competence of each professional and work in multi-disciplinarity contexte will ensure a global, progressive and safe care for the patient. With its unique professional judgment, the kinesiologist must be an integral part of this new Continuum Rehabilitation-Performance so beneficial for the injured person.

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