PHYSIOTHERAPY: From Medical Gymnast to Physiotherapist
The academic discipline of physiotherapy can be traced back to the early 19th century. In 1813, gymnastics instructor Per Henrik Ling took the initiative to establish the Royal Gymnastics Institute in Stockholm. Here, students graduated as medical gymnasts. Over time, the title evolved to physiotherapist, and in 2014, the current professional title of physiotherapist was officially introduced.
These name changes reflect the development of the field. The programme’s focus has shifted from treating medical diagnoses to strengthening the body's movement and functions, ultimately resting on evidence-based knowledge of how to best treat patients in various contexts. Today, physiotherapists work with patients not only in healthcare and home settings but also in workplaces and gyms.
”The programme has been designed to give physiotherapists a more independent professional role, enabling them to plan, examine, assess, and implement preventive, therapeutic, and rehabilitative measures.”
From Institute to Medical Faculty
In the 1940s, the programme was transferred from the Royal Gymnastics Central Institute to Karolinska Institutet (KI). In 1959, this transition laid the foundation for Sjukgymnastinstitutet, which became part of KI’s Faculty of Medicine.
During the following decade, the programme was given its own curriculum, emphasizing movement therapy through both theoretical studies and practical training, primarily in hospitals. However, treatment was still largely guided by medical diagnoses. Until the 1950s, most students were male, but by the following decades, the student body had shifted to being almost exclusively female.
A significant shift away from a strong focus on medical diagnoses took place in the 1970s. This broadening perspective on patient care aligned with international trends, which also saw the rapid development of new treatment methods and techniques. During this period, the curriculum expanded to include subjects such as pedagogy and social medicine.
University Status and Postgraduate Education
In 1977, KI assumed full responsibility for the physiotherapy education at Sjukgymnastinstitutet. The programme was granted university status, allowing students to pursue doctoral studies. It also became a national standard that new physiotherapy programmes should be linked to a medical faculty.
The Vård 77 government inquiry led to further reforms in the 1980s. One of its aims was to give greater prominence to theory and research methodology in education. Among the changes was the integration of physiotherapy and occupational therapy into a single rehabilitation programme. However, this merger was difficult to implement in Stockholm due to administrative differences between the programmes.
Around the same time, KI established the Department of Physiotherapy.
The next major reform came in 1993 when the physiotherapy programme became a three-year course, granting both a professional qualification and a bachelor's degree. The curriculum was structured into three parts: a preclinical phase, a clinical phase with elective courses, and a degree project.
During the 1990s, efforts intensified to further strengthen the programme’s research focus. Government funding supported the upskilling of teachers, many of whom pursued master's degrees and later defended doctoral theses. In 1998, Karin Harms-Ringdahl became Sweden’s first professor of physiotherapy.
Integration into NVS
In 2002, the Department of Physiotherapy merged with the Department of Neurobiology, Care Sciences and Society (NVS, previously called Neurotec). One of the goals of this merger was to foster collaboration with other healthcare professions, including occupational therapy. The aim was to increase students' understanding of each other's expertise. Joint lectures and coordinated clinical training further strengthened these interdisciplinary connections.
”We saw significant benefits in strengthening interprofessional cooperation. It became clear that working across professional boundaries not only enhanced the status of both professions but, more importantly, improved their competence. However, integrating training elements in practice remains a challenge.”
Interprofessional education has remained a priority, as seen in the master’s programme in dementia care at Silviahemmet, launched in 2012 for occupational therapists and physiotherapists.
The merger of NVS and the Department of Physiotherapy further advanced the academisation of education. A concrete example of this was the introduction of clinical lectureships, which provided better supervision for students in clinical training and strengthened evidence-based learning.
”The pedagogical approach has evolved significantly over the years—from something resembling a master-apprentice model to a student-centred learning approach.”
Strong International Collaborations
Since the late 1970s, international partnerships have played a crucial role in shaping the programme. The introduction of the three-year structure in 1993 further strengthened internationalisation, with exchange programmes for both students and faculty. The decision to change the professional title to physiotherapist was also influenced by international standards.
Today, physiotherapists' expertise is built on a combination of theoretical and practical knowledge, as well as a professional approach that incorporates studies in physiotherapy, preclinical subjects (such as anatomy and physiology), and medical and behavioural sciences. The programme prepares students for independent roles in healthcare, occupational health, and private practice. Additionally, digital platforms for healthcare consultations are becoming increasingly prominent.
The programme’s structure is designed to promote lifelong learning, allowing graduates to return and update their knowledge throughout their careers.
”We emphasised lifelong learning early on, encouraging students to see the programme as a foundation to build upon while continuously acquiring new knowledge throughout their professional careers.”
TEXT: Magnus Trogen Pahlén.