PETALING JAYA: Patients are being stranded in a medical “grey area” due to growing confusion over rehabilitation care providers, according to the Private Physiotherapy Clinic Owners’ Association of Malaysia (PPCOA).
The association warns that this ambiguity often results in improper exercise advice and delayed referrals, both of which risk significantly worsening patient injuries.
Its president Datuk Dr BS Bains noted that this confusion arises because many individuals are often unable to distinguish between physiotherapists, occupational therapists, exercise therapists and fitness trainers.
Such confusion could result in some patients, especially stroke survivors, the elderly, and post-partum women, prolonging their injuries rather than seeking prompt treatment.
“The grey area is medically prescribed exercise. There are differences in muscle physiology between stroke patients, geriatric muscles, and post-delivery women. Only a physiotherapist knows this best.
“As Malaysia continues to strengthen its healthcare ecosystem, clarity within the rehabilitation sector is essential,” he said.
Dr Bains said many patients mistakenly assume generic gym-based exercises are suitable for all conditions, when in reality, rehabilitation programmes must be tailored to a person’s muscle strength, symmetry and underlying musculoskeletal issues.
He cited cases of stroke survivors and elderly patients who turned to gyms or personal trainers, only to suffer further injuries before eventually being referred to physiotherapists.
“For example, a 70-year-old may have unequal strength and mobility on both sides of the body. If they start doing lunges or weight-bearing exercises without proper assessment, they can end up with back injuries or worsen existing conditions,” he said.
According to PPCOA, physiotherapists are trained in movement science, clinical assessment, pain management and the diagnosis of physical dysfunction – a role distinct from occupational therapists, who focus on restoring daily living functions, and trainers, who concentrate on general fitness.
Public health medicine specialist Datuk Dr Zainal Ariffin Omar said the growing confusion between physiotherapy and other rehabilitation-related professions is serious and widespread, leading to fewer appropriate referrals and missed opportunities for patients to benefit from each profession’s unique expertise.
Dr Zainal pointed out that such confusion can lead to delayed or incorrect treatment.
“Patients receiving incomplete or inappropriate rehabilitation face suboptimal recovery, prolonged disability and a reduced quality of life.
Dr Zainal also proposed that authorities consider launching nationwide multilingual campaigns clearly explaining the distinct roles of physiotherapists, occupational therapists and other rehabilitation professions.
He also called for the implementation and enforcement of mandatory registration of the respective professions under the Allied Health Professions Act 2016 (Act 774), which provides a legal framework for regulating allied health professionals.
“Professional bodies like the Malaysian Physiotherapy Association and the Malaysian Occupational Therapy Association should work with the Health Ministry to establish clear, standardised referral protocols between medical doctors, physiotherapists and occupational therapists,” he said.
