Specialized Physiotherapy Areas

The Ordem dos Fisioterapeutas is at an early stage and although its attributions and competences include definition of Physiotherapy Specialties, and requirements for their recognition, at the present time this isn´t a priority for the Comissão Instaladora (CI).
There is, however, a process of reflection on this matter, particularly based on the experience already developed by APFisio Interest Groups, international examples, and at national level, the experience with other health professions.
Physiotherapists' specialization aims to improve the quality standards of physical therapy practice and to promote continuous professional evolution.
The WCPT Guidelines on this matter are considered essential (https://www.wcpt.org/policy/ps-specialisation), namely the following assumptions:

  • Physiotherapy specialisation are areas of study and practice in a specific area, within the scope of practice recognized as physical therapy, which allows physical therapists to acquire and demonstrate additional in-depth clinical knowledge and skills, in relation to those necessary for access to the profession and professional title.
  • There should be a fully documented formal process for specialization, acknowledging the skills, especially clinical.
  • Specialization shouldn’t be considered a practice limitation. The field of activity recognized as physical therapy will remain open to all appropriately qualified physical therapists.
  • A specialist physical therapist is expected to practice and/or teach in his clinical specialization area of practice, and also to contribute to education and evaluation of professional practice, with a view to improve the services provided. They are also expected to conduct research projects and contribute to the development and dissemination of knowledge in the respective area.

In essence, three substantial elements should be considered in specialization process:

  • Possession of an advanced graduate course, with academic recognition;
  • Demonstration of clinical skills and proven experience in the area of specialization;
  • Development of skills in scientific research. (Critical analysis of published research, supporting practice based on scientific evidence, with published contribute to the body of knowledge relevant in the area of specialization.

The Comissão Instaladora of the Ordem dos Fisioterapeutas considers that the physical therapist profile specialist fits the descriptors of master's academic degree, and is a potential path, not the only one, in the formal process of physical therapist specialist recognition.
The granting of specialist status assumes that his holder regularly demonstrates that he continues to deserve this status, through a formal process of renewing his clinical knowledge and skills.
It is considered prudent to recognise only a small number of fields of specialization, in line with international practice or countries of reference, if possible. Whenever there’s no justification for an autonomous field of specialisation, an alternative skills certification system should be created.
In APFisio Interest Groups context, it will be necessary to study those that may become embryos of specialisation areas.
The Ordem dos Fisioterapeutas is committed to the APFisio, even when it replaces APFISIO IN WCPT, to ensure necessary “endorsement” of Interest Groups that have affiliation in subgroups recognized by WCPT, so that continuity of representations already acquired is guaranteed, until the development of specialisation or advanced physical therapy practice skills are recognised.

Pedro Maciel Barbosa

Specialist physiotherapist at the Matosinhos Local Health Unit Sub-coordinator for Primary Health Care, Matosinhos Local Health Unit Visiting Assistant Professor at the Porto School of Health Member of the Board of Directors of the Foundation for Health - SNS Member of the General Council of the Order of Physiotherapists

Carlos Sand

Carlos Areia has been a physiotherapist since 2013, and has worked in various hospitals, clinics and clubs in both Portugal and the UK. He began his academic career at Oxford University in 2016, where he led a clinical trial comparing physiotherapy vs surgery in anterior cruciate injuries in 32 hospitals in England. In 2018 she moved to the neurosciences department, where she developed her own studies on remote monitoring of vital signs, which were implemented during the pandemic. Here he discovered his passion for data, and in 2022, he joined Digital Science as a Data Scientist. He completed his PhD earlier this year, and has more than 60 publications in journals such as The Lancet, BMJ, Cochrane, among others. He is also an honorary lecturer at Oxford Brookes University and a consultant in clinical research.

Eduardo José Brazete Carvalho Cruz

PhD in Physiotherapy from the University of Brighton, UK. Post-Doctorate in Epidemiology from the National School of Public Health at the New University of Lisbon.
Coordinator of the Studies and Planning Office of the Order of Physiotherapists. Coordinating Professor of the Physiotherapy Department of the School of Health of the Polytechnic Institute of Setúbal (ESS-IPS). President of the ESS-IPS Technical-Scientific Council. Coordinator of the Physiotherapy Department at ESS-IPS. Integrated Researcher at the Comprehensive Health Research Centre (CHRC) (a partnership between FCM-UNL, the National School of Public Health, the University of Évora, the Lisbon Institute of Global Mental Health and Santo Espírito Hospital, Terceira Island, Azores).

Sara Souto Miranda

Sara Souto Miranda has a bachelor's and master's degree in physiotherapy from the University of Aveiro, and a postgraduate qualification in adult respiratory physiotherapy from the same institution. In 2023 she completed her double doctorate in Rehabilitation Sciences/Health, Medicine and Life Sciences at the Universities of Aveiro and Maastricht (Netherlands) and is currently working as a technical-scientific advisor to the Studies and Planning Office (GEP) of the Order of Physiotherapists, and as a guest lecturer at the Piaget Institute in Vila Nova de Gaia. As a member of the Respiratory Research and Rehabilitation Laboratory at the University of Aveiro (Lab3R), she has carried out applied research in which she has assessed and treated patients with respiratory pathology, having taken part in 6 research projects. Throughout her career she has published 19 scientific articles in international peer-reviewed journals with an impact factor, 1 book chapter and more than 50 abstracts in conference proceedings. She was a research volunteer at the Ciro rehabilitation centre (Centre for expertise in chronic organ failure) in the Netherlands, and is currently a member of the Guideline Methodology Network of European Respiratory Society. She was honoured by European Lung Foundation e European Respiratory Society for carrying out patient-centred research, by the Directorate General for Higher Education with a merit grant for his master's degree, and by the Ciro Centre with a grant to support research abroad.

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