Kinesitherapy
The masso-kinesitherapy (or simply “kinesitherapy”) is a paramedical profession.
The masseur-kinesitherapists belong to the professional body of the rééducateurs and have very a large range of competences. The France, the Belgium, the Luxembourg and the Chile are the four countries in which one employs the term of kinesitherapy. At least the masseur-kinesitherapist or Physiothérapeute (in English) uses the movement or on the contrary corrects and reduces the movement by the installation of an application ( kinêsis means the Greek “movement” in ) and that to return to the body a function which deteriorated (to find the use of a hand after a repairing surgery for example) or to learn how to him to adapt in its new state (to learn how with a patient amputee to go with a prosthesis). The most known act of the public is the Massage, i.e. the request of the fabrics (subcutaneous muscles, tendons, fabrics…) of the patient by the hands of the kinesitherapist, but it is only one small portion of its profession, the kinesitherapist uses various physical means (heat, cold, of the electric currents…) to reduce the pain or the ignition, it reinforces the muscles and readjust their operation by the means of exercises adapted to each need, Certains kinesitherapists make also prevention, while working on the Ergonomie in the activities of the everyday life, adapts the work stations for example (prevention of the occupational diseases), or then form the personnel handling of important loads… etc
One of the characteristics of training in masso-kinesitherapy is a very good knowledge of the human anatomy and its biomechanics.
The most known care is the respiratory kinesitherapy of the infants reached of Bronchiolite, to help with the expulsion of the mucosities, and the realization of an elastic application ( strapping ), flexible (support of the arm, binding bends with the body) or rigid (corset for immobilization of the Rachis).
In a more complete way, the activities of the masseur-kinesitherapist include/understand:
- massages,
- the manual lymphatic drainage;
- postures and acts of articular mobilization
- manual mobilization of all articulations, other than the operations of force, in particular of vertebral handling and the reductions of osseous displacement;
- muscular reinforcement (sporting or post-traumatic);
- musculo-tendineux stretchings;
- realization and application of flexible, adhesive applications or not, of temporary apparatuses of rehabilitation and apparatuses of postures;
- sensorimotor rehabilitation (addresses itself more particularly to the central nervous system disorders);
- rehabilitation of the disorders of balance (neuro-vestibular rehabilitation);
- relieving neuromusculaire;
- different techniques physiotherapeutic:
- electrotherapy:
- applications of electric currents: D.C. current (or galvanic), medicamentous galvanization, diélectrolyse, the choice of the medicamentous product being exclusive competence of the doctor prescriber, and antalgic current of electrostimulation and excito-engine;
- use of the mechanical waves (let us infrasons, sound vibrations, ultrasounds);
- use of the electromagnetic waves (short waves, centrimetric waves, Infra-red S, Ultraviolet S);
- Other techniques of physiotherapy:
- thermotherapy and cryothérapie, other than very proceeded being able to lead to a lesion of the teguments;
- kinébalnéothérapie and hydrotherapy;
- pressothérapie;
- provided that a doctor can intervene constantly, it can:
- to practice vertebral elongations by motor tractions (implementation manual or electric);
- to make practice cardiovascular rehabilitation of subjects reached of recent myocardial infarction and to carry out the recording of electrocardiograms during the meetings of cardiovascular rehabilitation, interpretation while being reserved to the doctor;
- to make practice respiratory rehabilitation and/or make aspirations trachéales at a tracheotomized or intubé patient.
The MK. always carry out assessments to establish a diagnosis kinesitherapic and to adapt its techniques to the needs for the patient.
Rehabilitation
Direct rehabilitation
- orthopedic rehabilitation ;
- neurological rehabilitation ;
- rehabilitation in neurology pediatry
- rehabilitation of the traumatic affections or not of the locomotor apparatus;
- respiratory rehabilitation;
- geriatric rehabilitation (gériokinésithérapie);
- cardiovascular rehabilitation;
- rehabilitation of the vascular and lymphatic trophic disorders;
- postural rehabilitation;
- rehabilitation of the rheumatic affections;
- rehabilitation of the flarings;
- rehabilitation in reanimation.
Rehabilitation of after-effects
-
rehabilitation of the amputee, installed or not;
- abdominal rehabilitation, including Postpartum as from the postnatal examination;
- rehabilitation périnéo-sphinctérienne in the fields urologic, gynaecological and proctologic, including postpartum as from the sixtieth day after the childbirth;
- cutaneous rehabilitation and of the flarings;
Rehabilitation of a particular function
-
rehabilitation of facial mobility and the Chewing;
- rehabilitation of the Swallowing;
- rehabilitation of the disorders of the balance;
For more information on the modes of massages, they are clarified in the medical encyclopedia Vulgaris .
The profession
Legal context of professional exercise
In France, the professional acts and the occupation of kinesitherapist are defined by October 8th 1996 (Ministry of Labor and affairs social, NOR: TASP9623057D):
- “Article 1 - masso-kinesitherapy consists of acts carried out in a manual or instrumental way, in particular at ends of rehabilitation, the purpose of which are to prevent the deterioration of the functional capacities, to contribute to their maintenance and, when they are deteriorated, to restore them or to compensate for it. They are adapted to the technological developments of sciences and. ”
- “Article 2. - In the exercise of his activity, the masseur-kinesitherapist takes account of the characteristics psychological, social, economic and cultural of the personality of each patient, at all the ages of the life. Within the framework of the medical regulation, it establishes a diagnosis kinesitherapic and chooses the acts and the techniques which appear to him most suitable. ”
This article is to be supplemented by:
-
the decree of February 22nd, 2000:
-
the Decree of June 27th, 2000
Article 1st. Article 2 of the decree of October 8th, 1996 referred to above is modified as follows: 1 - He is added at the end of the first subparagraph the following sentence: " The masseur-kinesitherapist communicates to the doctor any information in his likely possession of him to be useful for the establishment of the medical diagnosis or the adaptation of the treatment according to the health condition of the person and of his evolution ". 2 - The second subparagraph is replaced by two subparagraphs thus written: " Within the framework of the medical regulation, it establishes an assessment which includes/understands the diagnosis kinesitherapic and the objectives of care, as well as the choice of the acts and of the techniques which appear to him most suitable. " This assessment is addressed to the doctor prescriber and, at the conclusion of the last meeting, is supplemented by a card recalling the kinesitherapic evolution of the treatment, also addressed to the doctor prescriber. "
The masseur-kinesitherapist carries out his acts according to a medical regulation; within the framework of this regulation, it establishes a Diagnostic kinesitherapic by which it chooses the acts and the techniques best adapted to the condition of the patient (age, psychological and social factors, capacities…). During care, it carries out an assessment kinesitherapic with an aim of adapting the techniques and the equipment.
In the event of urgency and in the absence of a doctor, the masseur-kinesitherapist is entitled to achieve the gestures of helps necessary until the intervention of a doctor. He can also take part in the establishment of sporting assessments of aptitude, with ergonomic research (gestures and postures of the work) like with the prevention of health (councils, gymnastic hygienic, of maintenance or preventive).
For the implementation of treatments prescribed by the doctor, the masseur-kinesitherapist is entitled to use techniques for example of massage. " Article 3. - One understands by massage any external operation, carried out on fabrics, with a therapeutic aim or not, in a manual way or via apparatuses other than the apparatuses of electrotherapy, with or without the assistance of products, which comprise a mobilization or a methodical stimulation, mechanical or reflex of these tissus."
The exercise of kinesitherapy in France
In France, the majority of the masseur-kinesitherapists (nearly 80%) exert on a purely liberal basis, exerting only or in association in cabinets. The profession, mainly male, of an average age of forty year, is feminized, especially in the paid sector. Professionals exert in centers of functional rehabilitation or public or private hospital sector. Several liberal trade unions and company doctors SNMKR, FFMKR, Objective Kiné, paid CNKS, ANKS represent the professionals attached to the organizations of supervision: Ministry for health, Direction regional of the sanitary affairs and social (DRASS), Social security, ministry for the public office…
These organizations support the constitution of a National council about the masseur-kinesitherapists which is very disputed within the professionals exeçants. For unit of liberals and employees in activity (this excluded those which are terrent in the various authorities to profit from privileges under cover to work for the profession), the order is only one useless and expensive intermediary for the particular, and lucrative professional for the elected official. The missions of professional regulation will be assumed by physiotherapists far away from the practice of ground; technocrats of kinesitherapy to some extent.
Initial training
The initial training of the masseur-kinesitherapist currently proceeds over 3 years (in the school) in addition to the year of contest. A very selective contest (approximately 2 to 3% of allowed) authorizes the entry in training institute in masso-kinesitherapy. This contest and the studies of kinesitherapy is governed by ministerial decree. The methods of this contest differ according to the modes from the institutes: - is three tests on the basis of program of biology, physics and chemistry of college - is after a first year of medical study associated with kiné courses in prépa, the average of the 2 tests determining the classification. Recently, it is also possible to enter a IFMK on file while passing by one year validated in faculty of STAPS (Sciences and Technology of the Physical-activities and Sportives). The students are accepted having received the best results in the matters like the anatomy, physiology, biomechanics. The ENKRE (National school of Kinesitherapy and Rehabilitation) with Saint-Maurice thus accommodates 20 students out of 3 faculties STAPS each year. She proposes also every year the entry with 10 high level Sportsmen, who can follow the formation by continuing their sporting practice. The 35 training institutes in masso kinesitherapy (IFMK), which trains each year 1500 young professionals, have different legal statuses: deprived with lucrative, associative or public goal. Initial training out of the public sector is relatively expensive. She is organized in each institute by a director or chief technical officer (tallies of health masseur-kinesitherapist) assisted executives of formative health MK.
The studies are on the mode of alternation, the students being for half of their time in practice near patients and for half in progress theoretical and practical works in training institute. At the conclusion of these three years of study, after validation of the continuous assessment (on 20 points), the candidate is introduced the diploma proof of State: two practice exams of setting in professional situation (each one on 40 points, in the presence of a patient) and the defense of a report (on 20 points). The handing-over of this diploma of State (at least 60/120 by adding up the tests) by the DRASS authorizes the professional exercise.
The articulation between the current devices of formation and the university European system causes debates, in particular on the question of the creation of a fourth year of study and its possible equivalence with the university degree of first year of master.
Professional continuing educations and prospects
The kinesitherapists can profit, to maintain their knowledge, of continuing education throughout their professional exercise, either within the university framework, or by the means of associative training companies or with lucrative goal.
In addition to the maintenance of knowledge or the acquisition of new competences, these formations give access levels of expertise in the legal fields, ergonomic, social… Thus, kinesitherapy currently extends its field in the fields of education, the prevention and the orientation beyond its traditional curative and palliative actions, as well in the sectors of health, social as sport and “wellbeing”.
After at least four years of full-time exercise, a masseur-kinesitherapist can claim to reach at an Training institute of framework of health, offering to him professional prospects for framing and/or formation. These frameworks of health kinesitherapists can also claim then with ranks of senior officers or directors of care, after contest, in the die rehabilitation from which they result.
In Belgium
- to see the kinesitherapists in Belgium on Wikinations.be
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