Forty-seven-year-old, David Hunter, lives with Cerebral Palsy. He doesn’t think of his disability as a reason not to achieve his dreams though, but rather an opportunity to see what’s possible.

“David’s dream was to be able to climb the Harbour Bridge,” shares Rachel Brimblecombe, Founder of Better Rehab, where Mr Hunter has worked to increase his strength, balance, mobility and endurance.

“He worked hard so he could climb all the stairs necessary to get to the top of the bridge - and to do it in a manner that was safe, sustainable and ultimately felt achievable for him.

“This was achieved through a home exercise program that would focus on stair climbing and endurance so that he could achieve that task.”

Mr Hunter is one of a growing number of Australians with a disability reaping the benefits of physiotherapy, considered by many to be limited to musculoskeletal issues.

“There is a lack of awareness across the health care sector and within the physiotherapy profession itself, specifically about what working with people with a disability can do and the positive impacts that they can have in changing function and supporting them to live independent lives,” explains Ms Brimblecombe.

Physiotherapists working within the disability sector focus on the long term goals and outlook, she explains, allowing them to have a have a profound impact on the participant’s quality of life, their social and economic participation, as well as their ability to access the community and their homes.

“Physio in the context of disability includes an extremely wide scope of practice,” Ms Brimblecombe says.

“Physiotherapists working in the disability sector cover an array of different areas from building function, independence and capacity to prescribing assistive technology, assisting with respiratory health and management, as well as prescribing exercise and engaging in hydrotherapy, which are more traditionally thought of within the physio role,” she says.

“It is not just the treatment for an injury, Physiotherapists build participants function and their capacity so they can live more independent lives.

“There is a convoluted space between person environment and condition that physios have to consider rather than something like a sore shoulder in isolation.

“Therefore, participants with a disability need to be treated holistically as it is a much wider scope of practice due to the complex and broad nature of disability, which requires all skills acquired from a university degree and clinical practice.”

Physiotherapists within the disability sector work with participants that have intellectual disabilities, physical disabilities, mental health conditions, neurological disorders and psychosocial disabilities.

“They work with the full range of disability presentations because they are required to focus on improving function and participation so that can be applied to lots of people and lots of presentations.”

Physiotherapy is considered so critical to people with disabilities that it forms part of the NDIS program, allowing participants to access services.

“Typically, participants and their families don't think of physiotherapy as first line treatment, but in fact physios are able to assist in an array of critical areas, including prescribing mobility, assisting with transfers, prescribing recreational devices like bikes, as well as prescribe walking aids and wheelchairs.

Participants can also benefit from the prescription of respiratory devices, implementing respiratory management plans for people who have a history of chest infections or compromised airways.

“Furthermore, participants with psychosocial disabilities can benefit from physio, as shown in recent research. There is a lot of good, high-quality evidence about the importance of exercise and exercise routines in maintaining positive mental health, but also allowing people with psychosocial disabilities to access and participate in community activities, which increases their independence.”

Better Rehab has partnered with the Australian Physiotherapy Association to develop the level one disability course which will help train physiotherapists across Australia in upskilling within the NDIS, to help ensure there are adequate and competent physiotherapists working within the disability sectors.

“Disability is inherently complex, therefore It requires physios to have acute and high level critical thinking skills and be adaptable and flexible to participant needs,” Ms Brimblecombe says.

“It also requires physios to have knowledge across a broad scope of physiotherapy, practice from respiratory to neuro to mental health and psychosocial to exercise prescription as well as injury management.

“Not all physiotherapists have the skills to do that, and Better Rehab is working with the APA to increase awareness and resources for this.

“Furthermore, an understanding that a physiotherapist within the NDIS scope has a wide range of practice and can do many more things than just treat what you think of as pain.”

Ms Brimblecombe says the role that physiotherapy can play in helping participants achieve their goals should not be underestimated.

“And it may not be obvious at first, but working with dedicated physiotherapy professionals … can really allow participants to grow and to push themselves in their capacity further than they ever thought possible, just like David Hunter.”