International survey of the utilisation of physiotherapy in treatment centers for survivors of torture

Introduction: Literature about treatment of survivors of torture tends to focus on counseling and primary medical care. There are fewer published articles about the utilization of physiotherapy at treatment centers for survivors of torture and other forms of trauma. Methods: Lists were compiled of about 169 treatment centers receiving funding from the United National Voluntary Fund, 150 from the International Rehabilitation Council for Torture Victims, and another 40 treatment centers in the United States through the National Capacity Building Project. A survey about utilization of physiotherapy at treatment centers for survivors was created which included questions about the utilization of physiotherapy, treatment modalities provided by physiotherapists, other professionals working at the centers, perceived barriers to providing physiotherapy and interest in collaboration as a global physiotherapy community.  Surveys were emailed to centers in French, Spanish and/or English. Results: 87 responses were received, for a response rate of 43% (87 of 200 emails sent). Approximately 30% of centers report that their clients have no access to physiotherapy, with one third of the centers having physiotherapy on staff (in contrast with 85% of survey respondents having psychotherapy/counseling on staff, 73% having social work on staff and 55% primary medicine). About one third of responding torture treatment programs reported being able to refer to physiotherapists outside of their centers. Therapeutic exercise, manual therapy, massage, and group activities and exercises were the most commonly reported treatment modalities provided by physiotherapists. Lack of funds or resources and shortage of physiotherapy personnel were perceived as being the biggest challenges limiting clients’ access to physiotherapy. Twenty-nine of the respondents (33%) were physiotherapists, and of these, 90% reported being interested in collaborative activities with other physiotherapists working with survivor of torture