Physiotherapy as a profession has been around for a very long time. It is well known and well established. On the other hand, Kinesiology is quite young as a regulated profession. Kinesiology in Ontario was regulation in 2013. So, it makes sense that not everyone is as familiar with kinesiology. From the outside looking in, physiotherapy and kinesiology can look pretty similar. Let’s look at some aspects of each profession; explore the differences and also the similarities!
Keep in mind that this information is about kinesiology and physiotherapy in Ontario and may not be completely accurate when applied to other countries or even to other provinces and territories in Canada. I am also taking in my own experience working in this space with clients who typically use OHIP funded services first.
It’s the law!
Get in! We’re going back in time! Right to the beginning; legislation. Every regulated health care professional has a scope of practice that has been made into law and must work within. A scope of practice describes the procedures, actions and processes that the healthcare professional can do in keeping with the terms of their license. You could say that it is sort of like a job description.
Kin scope of practice
The practice of kinesiology is the assessment of human movement and performance and its rehabilitation and management to maintain, rehabilitate or enhance movement and performance. – Kinesiology Act 2007
PT scope of practice
The practice of physiotherapy is the assessment of neuromuscular, musculoskeletal and cardio respiratory systems, the diagnosis of diseases or disorders associated with physical dysfunction, injury or pain and the treatment, rehabilitation and prevention or relief of physical dysfunction, injury or pain to develop, maintain, rehabilitate or augment function and promote mobility. – Physiotherapy act 1991
Alright! So let’s break this down a little bit. The scope of practice is only one part of the puzzle. We’ll get to some other pieces later. The Ontario Kinesiology Association has described Kinesiology as Prevention, Management and Performance. The scope of practice for Kinesiologists sounds fairly broad; and it is! This means that Kinesiologists work with a wide range of clients and also wide range of settings. From gyms to sports teams to health and safety to ergonomics to clinical settings to corporate wellness and so on.
The Scope of practice for physiotherapists is similar but leans more towards disease and illness. This is not to say that Kinesiologists only work with ‘healthy’ population and Physiotherapists only work with ‘unhealthy’ population. The Ontario Physiotherapy Association describes as ‘…the assessment, diagnosis, treatment and management of acute and chronic conditions, the prevention of injury and disability, and in promoting health and wellbeing.’
What are controlled acts?
The Regulated Health Professions Act, 1991, defines a controlled act as an activity that can cause harm if it is performed by an unqualified person
There are 14 controlled acts in Ontario – you can read them all on the Ontario website here Regulated Health Professionals Act
Some healthcare professionals are authorized to do many, a few, one or none of the controlled acts. You may think that medical doctors would be authorized to perform them all - but there is no profession that is authorized to do all the controlled acts. The authorizations are laid out in each profession’s act (ex Kinesiology Act 2007, Physiotherapy Act, 1991 etc)
Kinesiologists are not authorized to perform any controlled acts
Kinesiologists are not the only healthcare profession that are not authorized to perform any of the controlled acts. The other healthcare professions that are not authorized to do any controlled act are; acupuncturists, homeopaths, and speech language pathologists.
Physiotherapists are authorized to perform 7 of the 14 of the controlled acts;
- Communicating a diagnosis
- Moving joints of the spine beyond a person’s usual physiological range of motion using a fast, low amplitude thrust
- Tracheal suctioning
- Treating a wound below the dermis
- Putting an instrument, hand, finger into natural or artificial body opening
- Ordering the application of prescribed form of energy
- Administering substance by inhalation
So far, the largest difference between kinesiologists and physiotherapists is the controlled acts. Kinesiologists – zero, physiotherapists – seven.
We aren’t too cool for school!
Let’s zoom out just a bit and look at education differences and similarities:
To qualify to take the entrance to practice exam to the College of Kinesiologists of Ontario, the candidate must have a 4 year bachelor degree in kinesiology or similar degree (such as human kinetics or physical education). Some kinesiology graduates will choose to continue on to a masters of professional kinesiology degree but it is not required.
Physiotherapists will have an undergraduate degree (often times a degree in kinesiology) and go on to complete 2 years of a masters of physiotherapy program before applying to the College of Physiotherapists of Ontario.
Both Kinesiologists and Physiotherapists will take continuing education courses throughout their career. These courses help to increase their skills and knowledge in a particular area of their profession. And so, Kinesiologists and Physiotherapists tend to have a focus within their profession. For example; a kinesiologist that specializes in gait analysis of a marathoner is likely more knowledgeable in this area than a physiotherapist who specializes in rehabilitation for those who suffered injuries from a car accident and vice versa. This can also be true from one kinesiologist to another and from one physiotherapist to another.
Both kinesiologists and physiotherapists must take an entrance to practice exam to belong to their respective colleges and therefore to practice in Ontario. These colleges are not educational institutions, rather, they are regulatory bodies that develop rules to regulate the profession. These rules must protect the public’s right to competent, safe and ethical care. You can learn more about regulation on the College of Kinesiologists ‘Understanding Regulation’ page.
If a healthcare professional break any of the rules set out by their respective college, the college has pathways to hold the professional accountable. This protects the clients/patients of healthcare professionals.
In summary; the pathways to each profession are quite similar. Both professions have great knowledge and understanding of human anatomy and human movement. Both are regulated healthcare professionals. Physiotherapists continue on to a masters program but both undergo continuing education throughout their careers and tend to focus on particular areas in the profession.
It’s called style hunny – treatment style that is…
The treatment style or treatment method and treatment timing are two things that can really separate kinesiology and physiotherapy.
When we talk about these aspects of the professions, we are speaking broadly. Not every single kinesiologist or every single physiotherapist will treat in this manner.
Most kinesiologists (myself included) will have longer sessions and see clients for a longer period of time than physiotherapists. For myself, I typically will see my clients for 45min to 60min each session and 1-3 times per week. Typically, a client will be discharged when they no longer want my services. Kinesiologists do not tend to delegate treatments to others. Kinesiologists primarily use active treatments. Patients/clients are actively participating in the sessions. Therapeutic exercise is the primary modality of kinesiologists
Physiotherapy treatment times tend to be shorter and discharge happens when the patient/client has met all the goals of the treatment plan. Sometimes, physiotherapy treatments are delegated to another person. Meaning; treatment plans are developed by a physiotherapist and then delivered by physiotherapy assistants. Physiotherapy assistants have been trained to carry out treatment plans as prescribed by the supervising physiotherapists. Physiotherapists will incorporate more passive techniques such as ultrasound, TENs, acupuncture, and manual techniques with active programming.
Typically my clients will have seen a physiotherapist through provincially funded programs and then once discharged, they are referred to me. For example; a client has had a stroke. They began with in-patient rehab at Freeport hospital with the physiotherapy team there. They transitioned to outpatient care once they were able to meet goals ‘x’, ‘y’ and ‘z’. As an ‘outpatient’ that they were living at home and travelling to Freeport for physiotherapy treatments. They achieved goals ‘a’, ‘b’ and ‘c’ and so they are discharged from physiotherapy care. The physiotherapist believes the client would benefit from ongoing exercise/rehab support at home and so they refer the client to me. I would do an assessment and work with the client to develop goals that are meaningful to them.
From this example, the client/patient sees a physiotherapist during the acute (the time right after the injury) phase and a kinesiologist during the chronic phase.
Show me the money!
That brings us to funding. This is also a glaring difference between Kinesiology and Physiotherapy. Most insurance companies will provide coverage for Physiotherapy services while few cover Kinesiology services. More and more companies are including Kinesiology in their coverage packages and most that have a ‘health spending account’ will put Kinesiology under that. If you want Kinesiology services covered in your benefits package, be sure to talk to your human resources person.
Physiotherapy is provincially funded (OHIP) in hospitals, long term care homes and through the Local Health Integrated Network (LHIN) – previously known as CCAC (community care access centre). Through these centres patients/clients can receive limited physiotherapy support in hospital or in their home. Kinesiology is not provincially funded.
Some of this is explained by the age of each profession. In Ontario, physiotherapy was first regulated in 1924 while kinesiology was first regulated in 2013. Physiotherapy as a regulated profession has 89 years of exposure on kinesiology.
So, is one profession better than the other? No. Each has their time and place. Kinesiology and Physiotherapy work very well together in tandem as well as in succession. The bottom line is to find the regulated health professional that listens to you, meets your needs, helps you to progress towards you goals and that you trust. Regulated health professionals are held accountable for their actions and treatments by their collages which means you as a client, have somewhere to go if your health professional is breaking the rules of the college.
References:
Regulated Health Professions Act, 1991, S.O. 1911, c.18 https://www.ontario.ca/laws/statute/91r18#BK12
Physiotherapy Act, 1991, S.O. 1991,c.37 https://www.ontario.ca/laws/statute/91p37
Kinesiology Act, 2007, S.O. c.10, Sched. O https://www.ontario.ca/laws/statute/07k10?search=kinesiology+act
College of Kinesiologists of Ontario – Understanding Regulation https://www.coko.ca/patients-and-clients/understanding-regulation/
Ontario Kinesiology Association - https://oka.on.ca/index.html
Ontario Physiotherapy Association - https://opa.on.ca/
Carrie Doll Kinesiology provides in-home Kinesiology services to Kitchener- Waterloo, St. Jacobs, Elmira and area