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Chinese Version
History of physical therapy services in Taiwan Authors: Shwu-Fen Wang, Huei-Ming Chai, Hua-Fang Liao, Gi-Ying Shi
Translator: @Young-Kuang Su
 

The development of physical therapy in Taiwan began in the 1950's, continued through the later part of the 20th century, and can be divided into three periods: 1) initiation period, 2) foundation-building period, and 3) expansion period.

INITIATION PERIOD (1950-1966)

After the poliomyelitis epidemic breaking out in Taiwan in the 1950's, the great demand for physical therapy, brought about by the children with physical handicaps deriving from poliomyelitis attacks, spurred the introduction of physical therapy in Taiwan. The children, though they survived the epidemic, were left with a permanent imprint on both their physical appearances and mental status.

Simultaneously, as physical therapists, many of the spouses of the United States Military Advisory members volunteered their expertise to render physical therapy to these children and subsequently contributed tremendously to this stage of the physical therapy profession in Taiwan.

In 1958, the staff of the Department of Surgery, National Taiwan University Hospital (NTUH), initiated the very first Physical Therapy Room in the 1st west Orthopedic ward. To help patients suffering from the aftermath of the attack of the poliomyelitis epidemic, a few voluntary physical therapists from the United States--Mrs. Gray, Mrs. Saembough, Mrs. Taber, Mrs. Franklin, Mrs. Godston and Mrs. Eaton--trained the nursing staff to carry out the practice of physical therapy, such as weight training, application of assisting devices, functional training, etc.

In 1959, Dr. Chi-der Lu, president of Taipei Veteran General Hospital, requested support from Dr. Jing-ming Huang of National Defense Medical College to help him establish a physical therapy department. Afterwards, the hospital managed to offer such services in January 1960.

In 1964, in view of the various problems with which the poliomyelitis affected children were plagued, Madame Chiang, First Lady of the Republic of China, set up Cheng Hsin Orphanage Arrangements Committee for the purpose of founding a multi-function institution which could provide these children with medical treatment, rehabilitation devices, and education opportunities; which could also help them acquire vocational skills and even facilitate their job hunting processes. Therefore, years after, these children could make an adequate living on their own.

In 1965, the Rehabilitation Building of National Taiwan University Hospital, the first rehabilitation institution built with its own specialized ward, was completed. On the first floor, there were offices of the out-patient clinic and the physical therapy rooms, and on the second floor, there were a rehabilitation ward consisting of 22 beds and an electromyography room. In 1966, Mackay Memorial Hospital instituted the Poliomyelitis Rehabilitation Center.

While all the major hospitals in northern Taiwan were busy preparing to establish their physical therapy departments, with the aid of some western religious persons, the first institution which, meant only for children affected by poliomyelitis, combined the function of disease treatment and medical personnel training was founded in Ping Dong.

In 1959, for offering adequate medical assistance, Foodlan and Picasher, Norwegian medical staff of Ping Dong Christian Clinic (now Ping Dong Christian Hospital) searched around central and southern Taiwan for deserted children plagued with poliomyelitis. Furthermore, they invited Dr. Burgess, an American orthopedist, and some American physical therapists to perform orthopedic surgery and physical therapy for these children.

In 1960, with the land donated by 基督教行道會美國差會, Children Rehabilitation Center was founded with an exclusive purpose--offering free treatment for children with poliomyelitis. In 1963, Ping Dong Christian Clinic was renamed Ping Dong Christian Hospital. And later on Home For Poliomyelitis Affected Children (now 勝利之家) was founded with the goal of offering not only medical treatment but formal education as well.

In 1964, Ping Dong Christian Hospital formally founded its physical therapy department, which applied its services to both poliomyelitis affected children and general patients who needed physical therapy. At the same time, Chang Hua Christian Hospital offered physical therapy training courses for two terms and thereafter started providing patients with physical therapy services.

Throughout this period, the physical therapy profession was first started with the assistance of western medical staff and then domestic medical personnel were sent abroad to receive physical therapy training. Thereafter, physical therapy in Taiwan entered into its second stage of development.

FOUNDATION-BUIDING PERIOD (1967-1984)

In the beginning, the physical therapy profession in Taiwan was targeted at treatment for patients with poliomyelitis. However, college level education in physical therapy becoming increasingly accessible in Taiwan, physical therapy began to be involved in the treatment of other specialized medical fields.

In 1971, World Health Organization (WHO) sent a Filipino consultant, Mr. Leano, to help Mr. Dong-chu Chen, who had been to Japan to learn Prosthetics and Orthotics, set up prosthetic and orthotic services at NTUH. Simultaneously, Mr. Shi-cheng Liang, a PT teaching assistant, came back from Australia and started a professional training course for cerebral palsy treatment.

In 1968, Dr. Yi-nan Lien, then a physiatrist and instructor, came back from the United States and subsequently committed himself strongly to developing local rehabilitation medical system for 32 years before he retired in the year 2000.

With the growing acknowledgement of the importance of physical therapy, all local major hospitals, in turn, began establishing a rehabilitation department or physical therapy department which mainly offered general rather than specialized physical therapy services. In 1980, the Department of Health (DOH) of the R.O.C. government demanded that all the provincial and municipal hospitals have to meet the basic requirement that each hospital must recruit at least two qualified physical therapists to its medical personnel.

Following the trend of the specialization of medical doctors, the clinical services of physical therapy also began specializing. All the major hospitals, one after another, founded acute neuropathy unit, burn unit, and cardiosurgery intensive care unit; furthermore, for out-patients, they established cerebral palsy clinic, respiration therapy clinic, and sports injury clinic, all of which offered related physical therapy.

In 1983, the physical therapy clinical internship courses of NTUH were first divided into four major areas: orthopedic physical therapy, neurological physical therapy, cardiopulmonary physical therapy, and pediatric physical therapy. This system later on was followed by other educational institutions in Taiwan.

During the whole foundation-building period, despite the external factors restricting the development of physical therapy, physical therapy services became more and more popular along with the gradual amelioration of the health-care environment in Taiwan. Consequently, the importance of physical therapy came to be increasingly recognized by the managers of the hospitals. And with the advancement of physical therapists' knowledge and skills, service items of the physical therapy profession increased accordingly.

EXPANSION PERIOD (1985-till now)

In addition to the increase in the number of physical therapists due to the growth of the educational institutions, the quality of physical therapy manpower has also improved.

The treatment style of physical therapy has also been transformed from institutional services into community or home-care services. Since 1995, helped by varieties of other specialists, the faculty of the School of Physical Therapy at NTU, together with the members of the Physical Therapy Association of the Republic of China have participated in the Specialized and Integrated Intervention Plan for Physical and Mental Handicapped Children coordinated by the Taipei County government in order to provide physically and mentally handicapped children with integrated evaluation and treatment.

Thereby, physical therapists could offer integrated services to schoolchildren; thus, physical therapists became part of the required personnel in the local education bureau, which extended the physical therapy services from the medical system to the educational system. In 1999, entrusted by Taipei City's Bureau of Health, the Physical Therapist Labor Union of Taipei City organized a home-care physical therapy team and offered free but high quality long-term services, which later on was followed by the government of Chiayi City, Nantou County, Taichung County, and Taipei County.

And all of this thus further confirmed the value of the community services provided by physical therapists. In July 2001, the restriction on instituting a physical therapy office in the community was lifted; therefore, instead of staying in a major hospital to wait for patients, a physical therapist could go straight into the community and render immediate assistance to them.

As for the community services dedicated to the society as a feedback, the members of the physical therapy profession have made every endeavor to achieve the best quality. In 1991, the Physical Therapy Association of the Republic of China established the Li-li Huang Award to memorize Professor Li-li Huang, who had contributed all her life to the development and education of physical therapy, to encourage members who can offer special contribution to the society, and to guide the members of this profession to help the people in need.

In 1999, after the 921 earthquake, the Service Team for the Victims of Kuo Shin Country, which consisted of faculty from different universities, served in Nantou County at their leisure time for some six months. Additionally, the Physical Therapy Association of the Republic of China also actively assisted the local Bureau of Health to carry out the Rehabilitation Plan for Victims of 921 Reconstruction Areas, which included hiring qualified physical therapists and providing fixed spot, touring, or home-care services.

This plan made a good example of the community services model and with the idea of Total Community Participation , it safeguarded the health of the people on this island.

To sum up, the physical therapy profession in Taiwan has been developing from the initial period whose physical therapy profession focused mainly on rehabilitation for the children plagued with the aftermath left by poliomyelitis.

The foundation-building period of which the physical therapy profession consisted of four major fields: orthopedic physical therapy, neurological physical therapy, cardiopulmonary physical therapy, and pediatric physical therapy; and further into the expansion period the physical therapy profession of which was composed of three different styles: the institutional physical therapy, the community physical therapy, and the homecare physical therapy.

Hence, physical therapy services appeared to be more and more diversified. In view of the growing demand for physical therapy, the physical therapy profession should make every effort to give appropriate responses to that.

 

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