A century-long struggle towards professionalism. Key factors in the growth of the physiotherapists' role in the United States, from subordinated practitioners to autonomous professionals

This article, adopting a historical point of view, aims to shed light and provide some insights into the long-lasting, tortuous process that led to a full recognition of the legitimacy of physiotherapists' professional role in the United States as we presently know it. To achieve this purpose, the paper singles out which were the most relevant components that contributed to shape physiotherapists' identity, who, during the twentieth century, shifted from the role of mere practitioners to that one of autonomous professionals. If it is uncontested that a clear distinction was soon traced between physiotherapists and osteopaths, and a second one, although more contrasted, with chiropractors, the essay advocates that physiotherapy evolved from a various, heterogeneous set of body manipulators (namely, from 'bonesetters', fitness trainers, masseurs/masseuses, and general nurses), and that it would be simplistic to reduce the profession forerunners to the over-cited WWI 'reconstruction aides'. The article furthermore argues that physiotherapists had to struggle with the solid medical dominance to achieve recognition as autonomous practitioners, and that two fundamental positive factors toward this goal were the foundation and growth of a nationwide professional organization, and the implementation of a standardized, accredited college education.