MISSION

BUILDING NEW HORIZONS FOR THE ROLE OF THE RESPIRATORY PHYSIOTHERAPIST

Pulmonary Rehabilitation became known and applied in Italy in the 1970's following the example of The Brompton Hospital, with chest physiotherapy being introduced primarily in the surgical wards and in the treatment of Cystic Fibrosis. In 1989 a group of italian physiotherapists pointed out the need to set up an association with the aim to expand the practice of Respiratory Physiotherapy into other fields; for example in the treatment of chronic diseases and in intensive care and to further cultural growth and development of the Respiratory Physiotherapist as a health figure. This need originated from the lack of formal education provided and from the inadequate role attributed to the Physiotherapist by the National Health Care System. In fact, in Italy and in other European countries, physiotherapists working in the respiratory field present an incredibly varied description of their education and professional experience. Furthermore formal education of the Physiotherapist is unspecialized and principally oriented to the orthopeadic and neurological fields of Rehabilitation. Upon graduating, with a 3-year degree, the Physiotherapist is considered qualified to work in any field of rehabilitation, whether neurological or respiratory, and in the majority of cases the 'Training in Pulmonary Rehabilitation' Is acquired spontaneously by the Physiotherapist without any request from the entity for whom he or she works. Thus acquisition only comes after attending post-graduate courses and/or through significant work experience. Actually, the italian reality only reflects in part the European situation, where only 29% of Physiotherapists who work in intensive care have a post-graduate degree in Intensive Care, and while 43% have a generic specialization in Respiratory Therapy and in Italy, 28% do not have any specific training in the respiratory field at all (Norremberg V: 2000; 26:988-994). Despite the facts provided, the presence of a Physiotherapist is being required more and more in the Pneumology division, in the Semi-Intensive and Intensive Care Units and yet, very rarely is his/her specific competence requested in respiratory problems. Nevertheless the Physiotherapist's service is only guaranteed 6 out of 7 days and for no more than 7 hours a day. And in the majority of cases, Physiotherapists who work on Respiratory Physiotherapy and Rehabilitation must also deal with Orthopaedic and Neurological Rehabilitation. It goes without saying that such work measures do not favor nor facilitate the 'specialization' process in times when science and technology are instead evolving continuously and demanding specialization. Nevertheless one has to admit that the Rehabilitation scene has not only profoundly changed in the past two decades at the workplace but also at the legislative front have there been significant changes. Only in 1994 did the Ministry of Health ratify the regulations concerning the professional role and profile of the Physiotherapist. Furthermore, the Degree in Physiotherapy was established substituting all other previous education diplomas granting the possibility for post-graduate studies. Thus, today ARIR finds itself in a more favorable condition for its main objective to be achieved: to build the professional figure (model) of the respiratory physiotherapist. From the onset of its creation, ARIR has primarily covered scientific updating and publishing, yet in the last few years, it has established important collaborative relations with some Italians Universities, esteemed Associations and with Scientific Associations whether Italian or foreign; these relations have opened endless opportunities to increase collaboration, share and integrate skills of all Respiratory Physiotherapist from different realities.

At this moment, ARIR is active in:

-Editorial Activities: -with the Italian Journal of Respiratory Rehabilitation and Physiotherapy. (Rivista Italian di Fisioterapia e Riabilitazione) -with the elaboration of Scientific books for national editions. The journal, 'Selezione ARIR da Respiratory Care e AARC Times'

-Didactive Activities -several ARIR members are lecturers of Respiratory Rehabilitation at the University of Physiotherapy. -Vocational Training and Updating courses accredited by the Ministry of Health for the continual Medical Training (ECM).

-Activity on www.arirassociazione.org

-Collaboration with other Associations: Associazione Italiana Pneumologi Ospedalieri (AIPO), American Association for Respiratory Care (AARC) and with the European Respiratory Care Association (ERCA)

These are only some of the steps taken by ARIR to ensure the achievement of their goal common to all. ARIR is well aware of the reality and challenges it faces in Physiotherapy and Respiratory Rehabilitation in the Italian Health Service. We invite our colleagues to approach ARIR to share their experience to improve better working conditions for all.

THE ARIR BOARD OF DIRECTORS