Physical therapy / physiotherapy
Military physical therapists working with patients on balance problems, orthopedic, amputee, Examining patient's strength, flexibility, joint range of motion balance and gait.
ICD-9-CM	93.0-93.3
MeSH	D026761
[edit on Wikidata]

Physical therapy (PT), also known as physiotherapy, is a healthcare profession, as well as the care provided by physical therapists who promote, maintain, or restore health through patient education, physical intervention, disease prevention, and health promotion. Physical therapist is the term used for such professionals in the United States, and physiotherapist is the term used in many other countries.

The career has many specialties including musculoskeletal, orthopedics, cardiopulmonary, neurology, endocrinology, sports medicine, geriatrics, pediatrics, women's health, wound care and electromyography. PTs practice in many settings, both public and private.^[1]

In addition to clinical practice, other aspects of physical therapy practice include research, education, consultation, and health administration. Physical therapy is provided as a primary care treatment or alongside, or in conjunction with, other medical services. In some jurisdictions, such as the United Kingdom, physical therapists may have the authority to prescribe medication.^[2]

Physical therapy addresses the illnesses or injuries that limit a person's abilities to move and perform functional activities in their daily lives.^[3] PTs use an individual's history and physical examination to arrive at a diagnosis and establish a management plan and, when necessary, incorporate the results of laboratory and imaging studies like X-rays, CT-scan, or MRI findings. Physical therapists can use sonography to diagnose and manage common musculoskeletal, nerve, and pulmonary conditions.^[4][5][6] Electrodiagnostic testing (e.g., electromyograms and nerve conduction velocity testing) may also be used.^[7]

PT management commonly includes prescription of or assistance with specific exercises, manual therapy, and manipulation, mechanical devices such as traction, education, electrophysical modalities which include heat, cold, electricity, sound waves, radiation, assistive devices, prostheses, orthoses, and other interventions. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness and wellness-oriented programs for healthier and more active lifestyles, providing services to individuals and populations to develop, maintain, and restore maximum movement and functional ability throughout the lifespan. This includes providing treatment in circumstances where movement and function are threatened by aging, injury, disease, or environmental factors. Functional movement is central to what it means to be healthy.^{[citation needed]}

Physical therapy is a professional career that has many specialties including musculoskeletal, orthopedics, cardiopulmonary, neurology, endocrinology, sports medicine, geriatrics, pediatrics, women's health, wound care and electromyography. Neurological rehabilitation is, in particular, a rapidly emerging field. PTs practice in many settings, such as privately-owned physical therapy clinics, outpatient clinics or offices, health and wellness clinics, rehabilitation hospital facilities, skilled nursing facilities, extended care facilities, private homes, education and research centers, schools, hospices, industrial and these workplaces or other occupational environments, fitness centers and sports training facilities.^[1]

Physical therapists also practice in non-patient care roles such as health policy,^[8][9] health insurance, health care administration and as health care executives. Physical therapists are involved in the medical-legal field serving as experts, performing peer review and independent medical examinations.^[10]

Education varies greatly by country. The span of education ranges from some countries having little formal education to others having doctoral degrees and post-doctoral residencies and fellowships.^[11]

Regarding its relationship to other healthcare professions, physiotherapy is one of the allied health professions.^{[12][13][14][15]} World Physiotherapy has signed a "memorandum of understanding" with the four other members of the World Health Professions Alliance "to enhance their joint collaboration on protecting and investing in the health workforce to provide safe, quality and equitable care in all settings".^[16]

Physicians like Hippocrates and later Galen are believed to have been the first practitioners of physical therapy, advocating massage, manual therapy techniques and hydrotherapy to treat people in 460 BC.^[17] After the development of orthopedics in the eighteenth century, machines like the Gymnasticon were developed to treat gout and similar diseases by systematic exercise of the joints, similar to later developments in physical therapy.^[18]

The earliest documented origins of actual physical therapy as a professional group date back to Per Henrik Ling, "Father of Swedish Gymnastics," who founded the Royal Central Institute of Gymnastics (RCIG) in 1813 for manipulation, and exercise. Up until 2014, the Swedish word for a physical therapist was sjukgymnast = someone involved in gymnastics for those who are ill, but the title was then changed to fysioterapeut (physiotherapist), the word used in the other Scandinavian countries.^[19] In 1887, PTs were given official registration by Sweden's National Board of Health and Welfare. Other countries soon followed. In 1894, four nurses in Great Britain formed the Chartered Society of Physiotherapy.^[20] The School of Physiotherapy at the University of Otago in New Zealand in 1913,^[21] and the United States 1914 Reed College in Portland, Oregon, which graduated "reconstruction aides."^[22] Since the profession's inception, spinal manipulative therapy has been a component of the physical therapist practice.^[23]

Modern physical therapy was established towards the end of the 19th century due to events that affected on a global scale, which called for rapid advances in physical therapy. Following this, American orthopedic surgeons began treating children with disabilities and employed women trained in physical education, and remedial exercise. These treatments were further applied and promoted during the Polio outbreak of 1916.^{[citation needed]}

During the First World War, women were recruited to work with and restore physical function to injured soldiers, and the field of physical therapy was institutionalized. In 1918 the term "Reconstruction Aide" was used to refer to individuals practicing physical therapy. The first school of physical therapy was established at Walter Reed Army Hospital in Washington, D.C., following the outbreak of World War I.^[24] Research catalyzed the physical therapy movement. The first physical therapy research was published in the United States in March 1921 in "The PT Review." In the same year, Mary McMillan organized the American Women's Physical Therapeutic Association (now called the American Physical Therapy Association (APTA). In 1924, the Georgia Warm Springs Foundation promoted the field by touting physical therapy as a treatment for polio.^[25] Treatment through the 1940s primarily consisted of exercise, massage, and traction. Manipulative procedures to the spine and extremity joints began to be practiced, especially in the British Commonwealth countries, in the early 1950s.^[26][27]

Around the time polio vaccines were developed, physical therapists became a normal occurrence in hospitals throughout North America and Europe.^[28] In the late 1950s, physical therapists started to move beyond hospital-based practice to outpatient orthopedic clinics, public schools, colleges/universities health-centres, geriatric settings (skilled nursing facilities), rehabilitation centers and medical centers. Specialization in physical therapy in the U.S. occurred in 1974, with the Orthopaedic Section of the APTA being formed for those physical therapists specializing in orthopedics. In the same year, the International Federation of Orthopaedic Manipulative Physical Therapists was formed,^[29] which has ever since played an important role in advancing manual therapy worldwide.

An international organization for the profession is the World Confederation for Physical Therapy (WCPT). It was founded in 1951 and has operated under the brand name World Physiotherapy since 2020.^[30][31]

Educational criteria for physical therapy providers vary from state to state, country to country, and among various levels of professional responsibility. Most U.S. states have physical therapy practice acts that recognize both physical therapists (PT) and physical therapist assistants (PTA) and some jurisdictions also recognize physical therapy technicians (PT Techs) or aides. Most countries have licensing bodies that require physical therapists to be member of before they can start practicing as independent professionals.^{[citation needed]}

This section needs additional citations for verification. Please help improve this article by adding citations to reliable sources in this section. Unsourced material may be challenged and removed. Find sources: "Physical therapy" – news · newspapers · books · scholar · JSTOR (July 2018) (Learn how and when to remove this message)

The Canadian Alliance of Physiotherapy Regulators (CAPR)^[32] offers eligible program graduates to apply for the national Physiotherapy Competency Examination (PCE). Passing the PCE is one of the requirements in most provinces and territories to work as a licensed physiotherapist in Canada.^[33] CAPR has members which are physiotherapy regulatory organizations recognized in their respective provinces and territories:

• Government of Yukon, Consumer Services^[34]
• College of Physical Therapists of British Columbia^[35]
• College of Physiotherapists of Alberta^[36]
• Saskatchewan College of Physical Therapists^[37]
• College of Physiotherapists of Manitoba^[38]
• College of Physiotherapists of Ontario^[39]
• Ordre professionnel de la physiothérapie du Québec^[40]
• College of Physiotherapists of New Brunswick/Collège des physiothérapeutes du Nouveau-Brunswick^[41]
• Nova Scotia College of Physiotherapists^[42]
• Prince Edward Island College of Physiotherapists^[43]
• Newfoundland & Labrador College of Physiotherapists^[44]

Physiotherapy programs are offered at fifteen universities, often through the university's respective college of medicine. Each of Canada's physical therapy schools has transitioned from three-year Bachelor of Science in Physical Therapy (BScPT) programs that required two years of prerequisite university courses (five-year bachelor's degree) to two-year Master's of Physical Therapy (MPT) programs that require prerequisite bachelor's degrees. The last Canadian university to follow suit was the University of Manitoba, which transitioned to the MPT program in 2012, making the MPT credential the new entry to practice standard across Canada. Existing practitioners with BScPT credentials are not required to upgrade their qualifications.

In the province of Quebec, prospective physiotherapists are required to have completed a college diploma in either health sciences, which lasts on average two years, or physical rehabilitation technology, which lasts at least three years, to apply to a physiotherapy program or program in university. Following admission, physical therapy students work on a bachelor of science with a major in physical therapy and rehabilitation. The B.Sc. usually requires three years to complete. Students must then enter graduate school to complete a master's degree in physical therapy, which normally requires one and a half to two years of study. Graduates who obtain their M.Sc. must successfully pass the membership examination to become members of the Ordre Professionnel de la physiothérapie du Québec (PPQ). Physiotherapists can pursue their education in such fields as rehabilitation sciences, sports medicine, kinesiology, and physiology.

In the province of Quebec, physical rehabilitation therapists are health care professionals who are required to complete a four-year college diploma program in physical rehabilitation therapy and be members of the Ordre Professionnel de la physiothérapie du Québec (OPPQ)^[45] to practice legally in the country according to specialist De Van Gerard.

Most physical rehabilitation therapists complete their college diploma at Collège Montmorency, Dawson College, or Cégep Marie-Victorin, all situated in and around the Montreal area.

After completing their technical college diploma, graduates have the opportunity to pursue their studies at the university level to perhaps obtain a bachelor's degree in physiotherapy, kinesiology, exercise science, or occupational therapy. The Université de Montréal, the Université Laval and the Université de Sherbrooke are among the Québécois universities that admit physical rehabilitation therapists in their programs of study related to health sciences and rehabilitation to credit courses that were completed in college.

To date, there are no bridging programs available to facilitate upgrading from the BScPT to the MPT credential. However, research Master's of Science (MSc) and Doctor of Philosophy (Ph.D.) programs are available at every university. Aside from academic research, practitioners can upgrade their skills and qualifications through continuing education courses and curriculums. Continuing education is a requirement of the provincial regulatory bodies.

The Canadian Physiotherapy Association offers a curriculum of continuing education courses in orthopedics and manual therapy. The program consists of 5 levels (7 courses) of training with ongoing mentorship and evaluation at each level. The orthopedic curriculum and examinations take a minimum of 4 years to complete. However, upon completion of level 2, physiotherapists can apply to a unique 1-year course-based Master's program in advanced orthopedics and manipulation at the University of Western Ontario to complete their training. This program accepts only 16 physiotherapists annually since 2007. Successful completion of either of these education streams and their respective examinations allows physiotherapists the opportunity to apply to the Canadian Academy of Manipulative Physiotherapy (CAMPT) for fellowship. Fellows of the Canadian Academy of manipulative Physiotherapists (FCAMPT) are considered leaders in the field, having extensive post-graduate education in orthopedics and manual therapy. FCAMPT is an internationally recognized credential, as CAMPT is a member of the International Federation of Manipulative Physiotherapists (IFOMPT), a branch of World Physiotherapy (formerly World Confederation of Physical Therapy (WCPT)) and the World Health Organization (WHO).

Physiotherapy degrees are offered at four universities: Edinburgh Napier University in Edinburgh, Robert Gordon University in Aberdeen, Glasgow Caledonian University in Glasgow, and Queen Margaret University in Edinburgh. Students can qualify as physiotherapists by completing a four-year Bachelor of Science degree or a two-year master's degree (if they already have an undergraduate degree in a related field).

To use the title 'Physiotherapist', a student must register with the Health and Care Professions Council, a UK-wide regulatory body, on qualifying. Many physiotherapists are also members of the Chartered Society of Physiotherapy (CSP),^[46] which provides insurance and professional support.

The primary physical therapy practitioner is the Physical Therapist (PT) who is trained and licensed to examine, evaluate, diagnose and treat impairment, functional limitations, and disabilities in patients or clients. Physical therapist education curricula in the United States culminate in a Doctor of Physical Therapy (DPT) degree,^[47] with some practicing PTs holding a Master of Physical Therapy degree, and some with a Bachelor's degree. The Master of Physical Therapy and Master of Science in Physical Therapy degrees are no longer offered, and the entry-level degree is the Doctor of Physical Therapy degree, which typically takes 3 years after completing a bachelor's degree.^[48] PTs who hold a Masters or bachelors in PT are encouraged to get their DPT because APTA's goal is for all PT's to be on a doctoral level.^[49] WCPT recommends physical therapist entry-level educational programs be based on university or university-level studies, of a minimum of four years, independently validated and accredited.^[50] Curricula in the United States are accredited by the Commission on Accreditation in Physical Therapy Education (CAPTE). According to CAPTE, as of 2022^[update] there are 37,306 students currently enrolled in 294 accredited PT programs in the United States while 10,096 PTA students are currently enrolled in 396 PTA programs in the United States.^[51]

The physical therapist professional curriculum includes content in the clinical sciences (e.g., content about the cardiovascular, pulmonary, endocrine, metabolic, gastrointestinal, genitourinary, integumentary, musculoskeletal, and neuromuscular systems and the medical and surgical conditions frequently seen by physical therapists). Current training is specifically aimed to enable physical therapists to appropriately recognize and refer non-musculoskeletal diagnoses that may present similarly to those caused by systems not appropriate for physical therapy intervention, which has resulted in direct access to physical therapists in many states.^[52]

Post-doctoral residency and fellowship education prevalence is increasing steadily with 219 residency, and 42 fellowship programs accredited in 2016. Residencies are aimed to train physical therapists in a specialty such as acute care, cardiovascular & pulmonary, clinical electrophysiology, faculty, geriatrics, neurology, orthopaedics, pediatrics, sports, women's health, and wound care, whereas fellowships train specialists in a subspecialty (e.g. critical care, hand therapy, and division 1 sports), similar to the medical model. Residency programs offer eligibility to sit for the specialist certification in their respective area of practice. For example, completion of an orthopedic physical therapy residency, allows its graduates to apply and sit for the clinical specialist examination in orthopedics, achieving the OCS designation upon passing the examination.^[53] Board certification of physical therapy specialists is aimed to recognize individuals with advanced clinical knowledge and skill training in their respective area of practice, and exemplifies the trend toward greater education to optimally treat individuals with movement dysfunction.^[54]

Physical therapist assistants may deliver treatment and physical interventions for patients and clients under a care plan established by and under the supervision of a physical therapist. Physical therapist assistants in the United States are currently trained under associate of applied sciences curricula specific to the profession, as outlined and accredited by CAPTE. As of December 2022, there were 396 accredited two-year (Associate degree) programs for physical therapist assistants In the United States of America.^[55]

Curricula for the physical therapist assistant associate degree include:^[56]

• Anatomy & physiology
• Exercise physiology
• Human biology
• Physics
• Biomechanics
• Kinesiology
• Neuroscience
• Clinical pathology
• Behavioral sciences
• Communication
• Ethics
• Research
• Other coursework as required by individual programs

Job duties and education requirements for Physical Therapy Technicians or Aides may vary depending on the employer, but education requirements range from a high school diploma or equivalent to completion of a 2-year degree program.^[57] O-Net reports that 64% of PT Aides/Techs have a high school diploma or equivalent, 21% have completed some college but do not hold a degree, and 10% hold an associate degree.^[58]

Some jurisdictions allow physical therapists to employ technicians or aides or therapy assistants to perform designated routine tasks related to physical therapy under the direct supervision of a physical therapist. Some jurisdictions require physical therapy technicians or aides to be certified, and education and certification requirements vary among jurisdictions.^{[citation needed]}

Physical therapy-related jobs in North America have shown rapid growth in recent years, but employment rates and average wages may vary significantly between different countries, states, provinces, or regions. A study from 2013 states that 56.4% of physical therapists were globally satisfied with their jobs.^[59] Salary, interest in work, and fulfillment in a job are important predictors of job satisfaction.^[59] In a Polish study, job burnout among the physical therapists was manifested by increased emotional exhaustion and decreased sense of personal achievement.^[60] Emotional exhaustion is significantly higher among physical therapists working with adults and employed in hospitals. Other factors that increased burnout include working in a hospital setting and having seniority from 15 to 19 years.^[60]

According to the United States Department of Labor's Bureau of Labor Statistics, there were approximately 210,900 physical therapists employed in the United States in 2014, earning an average of $84,020 annually in 2015, or $40.40 per hour, with 34% growth in employment projected by 2024.^[61] The Bureau of Labor Statistics also reports that there were approximately 128,700 Physical Therapist Assistants and Aides employed in the United States in 2014, earning an average $42,980 annually, or $20.66 per hour, with 40% growth in employment projected by 2024. To meet their needs, many healthcare and physical therapy facilities hire "travel physical therapists", who work temporary assignments between 8 and 26 weeks for much higher wages; about $113,500 a year.^[62] Bureau of Labor Statistics data on PTAs and Techs can be difficult to decipher, due to their tendency to report data on these job fields collectively rather than separately. O-Net reports that in 2015, PTAs in the United States earned a median wage of $55,170 annually or $26.52 hourly and that Aides/Techs earned a median wage of $25,120 annually or $12.08 hourly in 2015.^[58][63] The American Physical Therapy Association reports vacancy rates for physical therapists as 11.2% in outpatient private practice, 10% in acute care settings, and 12.1% in skilled nursing facilities. The APTA also reports turnover rates for physical therapists as 10.7% in outpatient private practice, 11.9% in acute care settings, 27.6% in skilled nursing facilities.^[64][65][66]

Definitions and licensing requirements in the United States vary among jurisdictions, as each state has enacted its own physical therapy practice act defining the profession within its jurisdiction, but the Federation of State Boards of Physical Therapy ^[67] has also drafted a model definition to limit this variation. The Commission on Accreditation in Physical Therapy Education ^[68] (CAPTE) is responsible for accrediting physical therapy education curricula throughout the United States of America.^{[citation needed]}

The title of Physiotherapist is a protected professional title in the United Kingdom. Anyone using this title must be registered with the Health & Care Professions Council^[69] (HCPC). Physiotherapists must complete the necessary qualifications, usually an undergraduate physiotherapy degree (at university or as an intern), a master rehabilitation degree, or a doctoral degree in physiotherapy.^[70] This is typically followed by supervised professional experience lasting two to three years. All professionals on the HCPC register must comply with continuing professional development (CPD) and can be audited for this evidence at intervals.^[71]

The body of knowledge of physical therapy is large, and therefore physical therapists may specialize in a specific clinical area. While there are many different types of physical therapy, the American Board of Physical Therapy Specialties lists ten current specialist certifications. Most Physical Therapists practicing in a specialty will have undergone further training, such as an accredited residency program, although individuals are currently able to sit for their specialist examination after 2,000 hours of focused practice in their respective specialty population, in addition to requirements set by each respective specialty board.^{[citation needed]}

Cardiovascular and pulmonary rehabilitation respiratory practitioners and physical therapists offer therapy for a wide variety of cardiopulmonary disorders or pre and post cardiac or pulmonary surgery. An example of cardiac surgery is coronary bypass surgery. The primary goals of this specialty include increasing endurance and functional independence. Manual therapy is used in this field to assist in clearing lung secretions experienced with cystic fibrosis. Pulmonary disorders, heart attacks, post coronary bypass surgery, chronic obstructive pulmonary disease, and pulmonary fibrosis, treatments can benefit^[72] from cardiovascular and pulmonary specialized physical therapists.^{[73][verification needed]}

This specialty area includes electrotherapy/physical agents, electrophysiological evaluation (EMG/NCV), physical agents, and wound management.

Geriatric physical therapy covers a wide area of issues concerning people as they go through normal adult aging but is usually focused on the older adult. There are many conditions that affect many people as they grow older and include but are not limited to the following: arthritis, osteoporosis, cancer, Alzheimer's disease, hip and joint replacement, balance disorders, incontinence, etc. Geriatric physical therapists specialize in providing therapy for such conditions in older adults.

Physical rehabilitation can prevent deterioration in health and activities of daily living among care home residents. The current evidence suggests benefits to physical health from participating in different types of physical rehabilitation to improve daily living, strength, flexibility, balance, mood, memory, exercise tolerance, fear of falling, injuries, and death.^[74] It may be both safe and effective in improving physical and possibly mental state, while reducing disability with few adverse events.^[74]

The current body of evidence suggests that physical rehabilitation may be effective for long-term care residents in reducing disability with few adverse events.^[74] However, there is insufficient to conclude whether the beneficial effects are sustainable and cost-effective.^[74] The findings are based on moderate quality evidence.

Wound management physical therapy includes the treatment of conditions involving the skin and all its related organs. Common conditions managed include wounds and burns. Physical therapists may utilize surgical instruments, wound irrigations, dressings, and topical agents to remove the damaged or contaminated tissue and promote tissue healing.^[75] Other commonly used interventions include exercise, edema control, splinting, and compression garments. The work done by physical therapists in the integumentary specialty does work similar to what would be done by medical doctors or nurses in the emergency room or triage.^{[citation needed]}

Neurological physical therapy is a field focused on working with individuals who have a neurological disorder or disease. These can include stroke, chronic back pain, Alzheimer's disease, Charcot-Marie-Tooth disease (CMT), ALS, brain injury, cerebral palsy, multiple sclerosis, Parkinson's disease, facial palsy and spinal cord injury. Common impairments associated with neurologic conditions include impairments of vision, balance, ambulation, activities of daily living, movement, muscle strength and loss of functional independence.^[73] The techniques involve in neurological physical therapy are wide-ranging and often require specialized training.^{[citation needed]}

Neurological physiotherapy is also called neurophysiotherapy or neurological rehabilitation. It is recommended for neurophysiotherapists to collaborate with psychologists when providing physical treatment of movement disorders.^[76] This is especially important because combining physical therapy and psychotherapy can improve neurological status of the patients.^{[citation needed]}

Orthopedic physical therapists diagnose, manage, and treat disorders and injuries of the musculoskeletal system including rehabilitation after orthopedic surgery, acute trauma such as sprains, strains, injuries of insidious onset such as tendinopathy, bursitis, and deformities like scoliosis. This specialty of physical therapy is most often found in the outpatient clinical setting. Orthopedic therapists are trained in the treatment of post-operative orthopedic procedures, fractures, acute sports injuries, arthritis, sprains, strains, back and neck pain, spinal conditions, and amputations.^{[citation needed]}

Joint and spine mobilization/manipulation, dry needling (similar to acupuncture), therapeutic exercise, neuromuscular techniques, muscle reeducation, hot/cold packs, and electrical muscle stimulation (e.g., cryotherapy, iontophoresis, electrotherapy) are modalities employed to expedite recovery in the orthopedic setting.^{[77][verification needed]} Additionally, an emerging adjunct to diagnosis and treatment is the use of sonography for diagnosis and to guide treatments such as muscle retraining.^[78][79][80] Those with injury or disease affecting the muscles, bones, ligaments, or tendons will benefit from assessment by a physical therapist specialized in orthopedics.^{[citation needed]}

Pediatric physical therapy assists in the early detection of health problems and uses a variety of modalities to provide physical therapy for disorders in the pediatric population. These therapists are specialized in the diagnosis, treatment, and management of infants, children, and adolescents with a variety of congenital, developmental, neuromuscular, skeletal, or acquired disorders/diseases. Treatments focus mainly on improving gross and fine motor skills, balance and coordination, strength and endurance as well as cognitive and sensory processing/integration.^{[citation needed]}

Physical therapists are closely involved in the care and wellbeing of athletes including recreational, semi-professional (paid), and professional (full-time employment) participants. This area of practice encompasses athletic injury management under 5 main categories:

1. acute care – assessment and diagnosis of an initial injury;
2. treatment – application of specialist advice and techniques to encourage healing;
3. rehabilitation – progressive management for full return to sport;
4. prevention – identification and address of deficiencies known to directly result in, or act as precursors to injury, such as movement assessment
5. education – sharing of specialist knowledge to individual athletes, teams, or clubs to assist in prevention or management of injury

Physical therapists who work for professional sports teams often have a specialized sports certification issued through their national registering organization. Most Physical therapists who practice in a sporting environment are also active in collaborative sports medicine programs too (See also: athletic trainers).

Women's health or pelvic floor physical therapy mostly addresses women's issues related to the female reproductive system, child birth, and post-partum. These conditions include lymphedema, osteoporosis, pelvic pain, prenatal and post-partum periods, and urinary incontinence. It also addresses incontinence, pelvic pain, pelvic organ prolapse and other disorders associated with pelvic floor dysfunction. Manual physical therapy has been demonstrated in multiple studies to increase rates of conception in women with infertility.^{[81][82][83][84]}

Physical therapy in the field of oncology and palliative care is a continuously evolving and developing specialty, both in malignant and non-malignant diseases. Physical therapy for both groups of patients is now recognized as an essential part of the clinical pathway, as early diagnoses and new treatments are enabling patients to live longer. it is generally accepted that patients should have access to an appropriate level of rehabilitation, so that they can function at a minimum level of dependency and optimize their quality of life, regardless of their life expectancy. ^[85]

People with brain injury, musculoskeletal conditions, cardiac conditions, or multiple pathologies benefit from a positive alliance between patient and therapist. Outcomes include the ability to perform activities of daily living, manage pain, complete specific physical function tasks, depression, global assessment of physical health, treatment adherence, and treatment satisfaction.^[86]

Studies have explored four themes that may influence patient-therapist interactions: interpersonal and communication skills, practical skills, individualized patient-centered care, and organizational and environmental factors.^[87] Physical therapists need to be able to effectively communicate with their patients on a variety of levels. Patients have varying levels of health literacy so physical therapists need to take that into account when discussing the patient's ailments as well as planned treatment. Research has shown that using communication tools tailored to the patient's health literacy leads to improved engagement with their practitioner and their clinical care. In addition, patients reported that shared decision-making will yield a positive relationship.^[88] Practical skills such as the ability to educate patients about their conditions, and professional expertise are perceived as valuable factors inpatient care. Patients value the ability of a clinician to provide clear and simple explanations about their problems. Furthermore, patients value when physical therapists possess excellent technical skills that improve the patient effectively.^[87]

Environmental factors such as the location, equipment used, and parking are less important to the patient than the physical therapy clinical encounter itself.^[89]

Based on the current understanding, the most important factors that contribute to the patient-therapist interactions include that the physical therapist: spends an adequate amount of time with the patient, possesses strong listening and communication skills, treats the patient with respect, provides clear explanations of the treatment, and allows the patient to be involved in the treatment decisions.^[89]

Physical therapy has been found to be effective for improving outcomes, both in terms of pain and function, in multiple musculoskeletal conditions. Spinal manipulation by physical therapists is a safe option to improve outcomes for lower back pain.^[90] Several studies have suggested that physical therapy, particularly manual therapy techniques focused on the neck and the median nerve, combined with stretching exercises, may be equivalent or even preferable to surgery for carpal tunnel syndrome.^[91][92] While spine manipulation and therapeutic massage are effective interventions for neck pain, electroacupuncture, strain-counterstrain, relaxation massage, heat therapy, and ultrasound therapy are not as effective, and thus not recommended.^[93]

Studies also show physical therapy is effective for patients with other conditions. Physiotherapy treatment may improve quality of life, promote cardiopulmonary fitness and inspiratory pressure, as well as reduce symptoms and medication use by people with asthma.^[94] Physical therapy is sometimes provided to patients in the ICU, as early mobilization can help reduce ICU and hospital length of stay and improve long-term functional ability.^[95] Early progressive mobilization for adult, intubated ICU patients on mechanical ventilation is safe and effective.^[96]

Psychologically informed physical therapy (PIPT), in which a physical therapist treats patients while other members of a multidisciplinary care team help in preoperative planning for patient management of pain and quality of life, helps improve patient outcomes, especially before and after spine, hip, or knee surgery.^[97]

Telehealth (or telerehabilitation) is a developing form of physical therapy in response to the increasing demand for physical therapy treatment.^[98] Telehealth is online communication between the clinician and patient, either live or in pre-recorded sessions with mixed reviews when compared to usual, in-person care.^[99] The benefits of telehealth include improved accessibility in remote areas, cost efficiency, and improved convenience for people who are bedridden and home-restricted, or physically disabled.^[99] Some considerations for telehealth include: limited evidence to prove effectiveness and compliance more than in-person therapy, licensing and payment policy issues, and compromised privacy.^[100] Studies are controversial as to the effectiveness of telehealth in patients with more serious conditions, such as stroke, multiple sclerosis, and lower back pain.^[101] The interstate compact, enacted in March 2018, allows patients to participate in Telehealth appointments with medical practices located in different states. ^[102]

During the COVID-19 pandemic, the need for telehealth came to the fore as patients were less able to safely attend in-person, particularly if they were elderly or had chronic diseases. Telehealth was considered to be a proactive step to prevent decline in individuals that could not attend classes. Physical decline in at risk groups is difficult to address or undo later. The platform licensing or development are found to be the most substantial cost in telehealth. Telehealth does not remove the need for the physical therapist as they still need to oversee the program.^{[103][104][105]}

• Europe: Regulated professions database – Physiotherapist, European Commission

This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. Find sources: "Injury prevention" – news · newspapers · books · scholar · JSTOR (September 2016) (Learn how and when to remove this message)

Injury prevention is an effort to prevent or reduce the severity of bodily injuries caused by external mechanisms, such as accidents, before they occur. Injury prevention is a component of safety and public health, and its goal is to improve the health of the population by preventing injuries and hence improving quality of life. Among laypersons, the term "accidental injury" is often used. However, "accidental" implies the causes of injuries are random in nature.^[1] Researchers prefer the term "unintentional injury" to refer to injuries that are nonvolitional but often preventable. Data from the U.S. Centers for Disease Control show that unintentional injuries are a significant public health concern: they are by far the leading cause of death from ages 1 through 44.^[2] During these years, unintentional injuries account for more deaths than the next three leading causes of death combined.^[2] Unintentional injuries also account for the top ten sources of nonfatal emergency room visits for persons up to age 9 and nine of the top ten sources of nonfatal emergency room visits for persons over the age of 9.^[3]

Injury prevention strategies cover a variety of approaches, many of which are classified as falling under the "3 Es" of injury prevention: education, engineering modifications, and enforcement/enactment of policies.^[4] Some organizations and researchers have variously proposed the addition of equity, empowerment, emotion, empathy, evaluation, and economic incentives to this list.^[5][6][7]

Injury prevention research can be challenging because the usual outcome of interest is deaths or injuries prevented and it is difficult to measure how many people did not get hurt who otherwise would have. Education efforts can be measured by changes in knowledge, attitudes, and beliefs and behaviors before and after an intervention; however, tying these changes back into reductions in morbidity and mortality is often problematic. Effectiveness of injury prevention interventions is typically evaluated by examining trends in morbidity and mortality in a population may provide some indication of the effectiveness of injury prevention interventions.^{[citation needed]} Online databases, such as the Web-based Injury Statistics Query and Reporting System (WISQARS) allow both researchers and members of the public to measure shifts in mortality over time.^[8]

Traffic safety and automobile safety are a major component of injury prevention because it is the leading cause of death for children and young adults into their mid 30s.^{[citation needed]} Injury prevention efforts began in the early 1960s when activist Ralph Nader exposed automobiles as being more dangerous than necessary in his book Unsafe at Any Speed. This led to engineering changes in the way cars are designed to allow for more crush space between the vehicle and the occupant.^{[citation needed]} The Centers for Disease Control and Prevention (CDC) also contributes significantly to automobile safety. CDC Injury Prevention Champion David Sleet illustrated the importance of lowering the legal blood alcohol content limit to 0.08 percent for drivers, requiring disposable lighters to be child resistant; and using evidence to demonstrate the dangers of airbags to young children riding in the front seat of vehicles.^[9]

Engineering: vehicle crash worthiness, seat belts, airbags, locking seat belts for child seats.

Education: promote seat belt use, discourage impaired driving, promote child safety seats.

Enforcement and enactment: passage and enforcement of primary seat belt laws, speed limits, impaired driving enforcement.

Pedestrian safety is the focus of both epidemiological and psychological injury prevention research. Epidemiological studies typically focus on causes external to the individual such as traffic density, access to safe walking areas, socioeconomic status, injury rates, legislation for safety (e.g., traffic fines), or even the shape of vehicles, which can affect the severity of injuries resulting from a collision.^[10] Epidemiological data show children aged 1–4 are at greatest risk for injury in driveway and sidewalks.^{[citation needed]} Children aged 5–14 are at greatest risk while attempting to cross streets.^{[citation needed]}

Psychological pedestrian safety studies extend as far back as the mid-1980s, when researchers began examining behavioral variables in children.^{[citation needed]} Behavioral variables of interest include selection of crossing gaps in traffic, attention to traffic, the number of near hits or actual hits, or the routes children chose when crossing multiple streets such as while walking to school. The most common technique used in behavioral pedestrian research is the pretend road, in which a child stands some distance from the curb and watches traffic on the real road, then walks to the edge of the street when a crossing opportunity is chosen.^{[citation needed]} Research is gradually shifting to more ecologically valid virtual reality techniques.^{[citation needed]}

Coquitlam
City
City of Coquitlam
Coquitlam Town Centre
Flag Coat of arms Logo
Motto:  The Spirit of the Rivers is the Strength of the People[1]
Location of Coquitlam in Metro Vancouver
Coordinates: 49°17′02″N 122°47′31″W / 49.28389°N 122.79194°W / 49.28389; -122.79194
Country	Canada
Province	British Columbia
Regional district	Metro Vancouver
First settled	7000 BCE
Incorporated as a district municipality	July 25, 1891[2]
Amalgamated	October 7, 1971[2]
Incorporated as a city	June 18, 1992[2]
Seat	Coquitlam City Hall
Government [3]
• Type	Mayor-council government
• Body	Coquitlam City Council
• Mayor	Richard Stewart
• City Council	List of councillors Craig Hodge Matt Djonlic Teri Towner Brent Asmundson Dennis Marsden Trish Mandewo Steve Kim Robert Mazzarolo
• MPs (fed.)	List of MPs Bonita Zarrillo (NDP) Port Moody—Coquitlam Ron McKinnon (Liberal) Coquitlam—Port Coquitlam
• MLAs (prov.)	List of MLAs Rick Glumac (NDP) Port Moody-Coquitlam Selina Robinson (NDP) Coquitlam-Maillardville Fin Donnelly (NDP) Coquitlam-Burke Mountain
Area [4][5]
• Total	152.5 km2 (58.9 sq mi)
• Land	122.15 km2 (47.16 sq mi)
Elevation	24 m (79 ft)
Population  (2021)[4]
• Total	148,625
• Estimate  (2023)[6]	168,250
• Rank	34th in Canada 6th in British Columbia 5th in Metro Vancouver
• Density	1,216.7/km2 (3,151/sq mi)
Time zone	UTC−08:00 (PST)
• Summer (DST)	UTC−07:00 (PDT)
Forward sortation area	V3E, V3J – V3K
Area codes	604, 778, 236, 672
Website	www.coquitlam.ca

Coquitlam (/koʊˈkwɪtləm/ ^ⓘ koh-KWIT-ləm)^[7] is a city in the Lower Mainland of British Columbia, Canada. Mainly suburban, Coquitlam is the sixth-largest city in the province, with a population of 148,625 in 2021,^[4] and one of the 21 municipalities comprising Metro Vancouver. The mayor is Richard Stewart.^[3]

Simon Fraser explored the region in 1808, encountering the Indigenous Coast Salish peoples. Europeans started settling in the 1860s. Fraser Mills, a lumber mill on the north bank of the Fraser River was constructed in 1889, and by 1908 there were 20 houses, a store, post office, hospital, office block, barber shop, pool hall, and a Sikh temple.

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The Coast Salish people were the first to live in this area, and archaeology confirms continuous occupation of the territory for at least 9,000 years. The name Kwikwetlem is said to be derived from a Coast Salish term "kʷikʷəƛ̓əm" meaning "red fish up the river".^[8]

Explorer Simon Fraser came through the region in 1808, and in the 1860s Europeans gradually started settling the area. Coquitlam began as a "place-in-between" with the construction of North Road in the mid-19th century to provide Royal Engineers in New Westminster access to the year-round port facilities in Port Moody.^[9]

The young municipality got its first boost in 1889 when Frank Ross and James McLaren opened what would become Fraser Mills, a $350,000, then state-of-the-art lumber mill on the north bank of the Fraser River. The Corporation of the District of Coquitlam was incorporated in 1891. By 1908, a mill town of 20 houses, a store, post office, hospital, office block, barber shop, pool hall and Sikh temple^[10] had grown around the mill. A mill manager's residence was built that would later become Place des Arts.^{[11][failed verification]}

Over the next two years, several contingents of French Canadian mill workers arrived from Quebec, and Maillardville was born. Named for Father Edmond Maillard, a young Oblate from France, it became the largest Francophone centre west of Manitoba. Maillardville's past is recognized today in street names, the Francophone education system and French immersion programs, French-language Girl Guides and scouts, and celebrations such as Festival du Bois.^[9][12]

Following World War II, Coquitlam and the rest of the Lower Mainland experienced substantial population growth that continues today. The opening of Lougheed Highway in 1953 made the city more accessible and set the stage for residential growth. In 1971, Coquitlam and Fraser Mills were amalgamated, which gave the city a larger industrial base. The mill closed in 2001, and is now currently the subject of a proposed waterfront community.^[11][13][14]

Coquitlam is situated some 10 to 15 km (6.2 to 9.3 mi) east of Vancouver, where the Coquitlam River connects with the Fraser River and extends northeast along the Pitt River toward the Coquitlam and Pitt lakes. Coquitlam borders Burnaby and Port Moody to the west, New Westminster to the southwest, and Port Coquitlam to the southeast. Burke Mountain, Eagle Ridge, and 1,583 m (5,194 ft) tall Coquitlam Mountain form the northern boundary of the city.^[15][16][17] Coquitlam's area, 152.5 square kilometres (58.9 sq mi), is about six times larger than either Port Moody or Port Coquitlam.^[5]

Coquitlam is in the Pacific Time Zone (winter UTC−8, summer UTC−7), and the Pacific Maritime Ecozone.^[18][19]

Coquitlam's geographic shape can be thought of as a tilted hourglass, with two larger parcels of land with a smaller central section connecting them.

Southwest Coquitlam comprises the original core of the city, with Maillardville and Fraser River industrial sector giving way to the large, elevated, flat-plateaued residential areas of Austin Heights. These older residences, with larger property dimensions, are increasingly being torn down and replaced with newer and larger homes. The Poirier Street area was the city's original recreational centre with the Coquitlam Sports Centre, Chimo Aquatic and Fitness Centre, and sports fields located there, while City Hall was previously located further south in Maillardville.^[20]

The Austin Heights area contains Como Lake, a renowned urban fishing and recreation area, and headwaters for the Como watershed. The watershed represents one of the last urban watersheds in the Tri-Cities that supports wild stocks of coho salmon as well as other species at risk such as coastal cutthroat trout (both sea-run and resident) and bird species such as the great blue heron and green heron.^[21] It also contains Mundy Park, one of the largest urban parks in the Metro Vancouver area.

In 1984, the provincial government sold 57 hectares (141 acres) formerly attached to Riverview Hospital to Molnar Developments. Shortly afterward, this land was subdivided and became Riverview Heights, with about 250 single-family homes. The remaining 240 acres (0.97 km²) of this still-active mental health facility has been the subject of much controversy amongst developers, environmentalists, and conservationists. In 2005, the city's task force on the hospital lands rejected the idea of further housing on the lands and declared that the lands and buildings should be protected and remain as a mental health facility.^[22] In May 2021, the Government of British Columbia announced that the Riverview lands had been renamed səmiq̓wəʔelə (pronounced suh-MEE-kwuh-EL-uh), meaning "The Place of the Great Blue Heron". The kʷikʷəƛ̓əm Nation and BC Housing are working on a long-term master plan for development of the site.^[23]

Coquitlam Town Centre, was designated as a "Regional Town Centre" under the Metro Vancouver's Livable Region Strategic Plan. The concept of a town centre for the area dates back to 1975, and is intended to have a high concentration of high-density housing, offices, cultural, entertainment and education facilities to serve major growth areas of the region, served by rapid transit service.^[20] It is in the town centre that many public buildings can be found, including City Hall, a branch of the Coquitlam Public Library, an R.C.M.P. station, Coquitlam's main fire hall, the David Lam Campus of Douglas College, the Evergreen Cultural Centre, City Centre Aquatic Complex, Town Centre Park and Percy Perry Stadium.

In 1989, the provincial government sold 570 hectares (1,409 acres) of second-growth forested land on the south slope of Eagle Mountain, known locally as Eagle Ridge, to developer Wesbild. This resulted in the closure of Westwood Motorsport Park in 1990, and the creation of Westwood Plateau, which was developed into 4,525 upscale homes, as well as two golf courses.^[24][25]

With development on Westwood Plateau completed and the opening of the David Avenue Connector in 2006, Coquitlam's primary urban development has now shifted to Burke Mountain in the northeastern portion of the city.^[26][27]

With new development of the Evergreen Extension of the Millennium Line of the SkyTrain rapid transit system which began operation in December 2016, Coquitlam's urban development area has again shifted to Burquitlam and secondly Burke Mountain. The Burke Mountain area plan is now divided into 4 new neighbourhood plans: Lower Hyde Creek Neighbourhood, Upper Hyde Creek Neighbourhood, Partington Creek, and Smiling Creek.^[28]

Like much of Metro Vancouver, Coquitlam has an oceanic climate (Köppen climate type Cfb), experiencing mild temperatures and high precipitation; warm, dry summers and cool, wet winters. However, compared to most other cities in the area, precipitation is especially heavy in Coquitlam due to its proximity to the mountain slopes. With westward air moving off the Pacific Ocean, the air is forced to flow up the Coast Mountains causing it to cool and condense and fall as precipitation, this process is known as orographic precipitation. The orographic effect is mainly responsible for the massive 1,969 mm (77.5 in) annual average precipitation that Coquitlam receives each year, with most falling as rainfall in the fall and winter months, with 316 mm (12.4 in) in November; the summer is usually sunny with minimal precipitation with 60.7 mm (2.39 in) in July. Although the mild temperatures allow for mostly rain to fall during the winter months, occasionally snow will fall. With a slightly higher elevation compared to the rest of Metro Vancouver, Coquitlam receives an average of 64.4 cm (25.4 in) of snow each year, with it rarely staying on the ground for a few days, adding to a very intermittent snow cover during the winter season.

Coquitlam is also located in one of the warmest regions in Canada where average mean annual temperature is 10.2 °C (50.4 °F). Temperatures are warm during the summer months with an average high of 22.7 °C (72.9 °F), and an average low of 13.4 °C (56.1 °F) in August. During the winter months, the average high is 5.6 °C (42.1 °F), and the average low is 0.9 °C (33.6 °F) in December. This relatively mild climate, by Canadian standards, is caused by the warm Alaska Current offshore and the many mountain ranges preventing the cold arctic air from the rest of Canada from reaching the southwest corner of British Columbia.

On June 28, 2021, Coquitlam reached an all-time high temperature reading of 41 °C (106 °F), shattering the previous record of 37.0 °C (98.6 °F).^[29][30]

In the 2021 Census of Population conducted by Statistics Canada, Coquitlam had a population of 148,625 living in 55,949 of its 58,683 total private dwellings, a change of 6.7% from its 2016 population of 139,284. With a land area of 122.15 km² (47.16 sq mi), it had a population density of 1,216.7/km² (3,151.3/sq mi) in 2021.^[4]

According to the 2016 Census, 47% of households contained a married couple with children, 30% contained a married couple without children, and 22% were one-person households. Of the 40,085 reported families: 76% were married couples with an average of 3.0 persons per family, 15% were lone-parents with an average of 2.5 persons per family, and 9% were common-law couples with an average of 2.6 persons per family. The median age of Coquitlam's population was 41.1 years, slightly younger than the British Columbia median of 43.0 years. Coquitlam had 85.6% of its residents 15 years of age or older, less than the provincial average of 87.5%.^[40]

According to the 2016 census, about 44% of Coquitlam residents were foreign-born, much higher than the 28% foreign-born for the whole of British Columbia. The same census documented the median income in 2015 for all families was $65,020, compared to the provincial average of $61,280. 58.2% of respondents 15 years of age and older claim to have a post-secondary certificate, diploma or degree, compared to 55% province-wide.^[40] Lastly, also as of the 2016 census, only 23.4% of Coquitlam residents who work outside the home work within the city of Coquitlam itself, just less than half the provincial average of 48.9% of residents who work within their own municipality, yet 22.2% of Coquitlam residents take public transit, bicycle or walk to work, close to the provincial average of 22.4%.^[41]

The 2016 census found that English was spoken as the mother tongue of 50.47% of the population. The next most common mother tongue language was Mandarin, spoken by 9.66% of the population, followed by Cantonese at 6.43%.^[40] The south slope of Coquitlam, which includes Maillardville, has a pocket of French speakers.

According to the 2021 census, religious groups in Coquitlam included:^[4]

• Irreligion (73,945 persons or 50.1%)
• Christianity (55,150 persons or 37.4%)
• Islam (9,315 persons or 6.3%)
• Buddhism (3,110 persons or 2.1%)
• Hinduism (1,955 persons or 1.3%)
• Sikhism (1,855 persons or 1.3%)
• Judaism (405 persons or 0.3%)
• Indigenous Spirituality (45 persons or <0.1%)

As a bedroom community, the majority of Coquitlam residents commute to work in Vancouver, Burnaby, and other Metro Vancouver suburbs. Coquitlam's main industrial area lies in the southern Maillardville/Fraser Mills area near the Fraser River. Among the largest employers within Coquitlam are the City of Coquitlam with approximately 850 employees, Art in Motion with approximately 750 employees, and Hard Rock Casino with approximately 600 employees.^[47][48] Other major employers include Coca-Cola, Sony, and the Marine Propulsion division of Rolls-Royce.^[49][50]

In 2007, there were 610 retail businesses in Coquitlam, and these provided 8,765 jobs (27% of all jobs) within the city. Most retail businesses are concentrated around Coquitlam Centre in the Town Centre area, and big-box retailers such as IKEA and The Home Depot in the Pacific Reach areas, with the remainder of the city's retail outlets centered around the Austin Heights and North Road sectors.^[51]

The Tri-Cities Chamber of Commerce has over 900 members including businesses, professionals, residents and other community groups, governed by a 14-person volunteer Board of Directors.^[52]

Being in close proximity to Vancouver and surrounded by the rest of the Lower Mainland, Coquitlam residents have access to virtually unlimited choice in cultural and leisure activities. Within the city itself are numerous venues that bring these choices closer to home.

Coquitlam was designated as a Cultural Capital of Canada in 2009 by the Department of Canadian Heritage.^[53]

The Molson Canadian Theatre, a 1,074-seat multi-purpose venue, opened as part of a $30 million expansion to Coquitlam's Hard Rock Casino in 2006, while Cineplex Entertainment operates the 4,475-seat SilverCity Coquitlam movie complex with 20 screens.^[54][55][56]

A partnership of the city, the arts community, private business and senior governments, the Evergreen Cultural Centre in the Town Centre area is a venue for arts and culture, a civic facility designed to host a wide variety of community events. It features a 264-seat black box theatre, rehearsal hall, art studios and art gallery. Evergreen serves as the home venue for the Pacific Symphonic Wind Ensemble, the Coastal Sound Music Academy, the Coquitlam Youth Orchestra, and the Stage 43 Theatrical Society. Nearby proscenium theatres include the 336-seat Terry Fox Theatre in Port Coquitlam, and the 206-seat Inlet Theatre in Port Moody.^[57]

Numerous yearly festivals are staged at various locations throughout Coquitlam,^[58] including Festival du Bois (first full weekend in March),^[12] the Water's Edge Festival (third full weekend in March),^[59] Como Lake Fishing Derby (last Sunday in May),^[60] BC Highland Games (last Saturday in June),^[61] a Canada Day Celebration at Town Centre Park,^[62] the BC Dumpling Festival (mid-August),^[63][64] and the Blue Mountain Music Festival (mid-July).^[65]

Coquitlam has a considerable number of open green spaces, with the total area of over 890 hectares (2,200 acres). There are over 80 municipal parks and natural areas, with Mundy Park located roughly in the centre of the city being the biggest, and Ridge Park located in the highlands near the city's northern edge. Pinecone Burke Provincial Park, Minnekhada Regional Park, and Pitt Addington Marsh are on the northern and eastern border of the city, while the restricted area of the Metro Vancouver's Coquitlam watershed border Coquitlam to the north. Colony Farm is a 404-hectare park that straddles the Coquitlam and Port Coquitlam boundaries, offering walking trails rich with wildlife and gardens. Town Centre Park is a large city park located in the central area of the city, it provides city residents with many recreational activities.^[66][67] Como Lake Park and Glen Park are also popular with local residents.

Place des Arts is a non-profit teaching arts centre in Maillardville founded in 1972, offering programs in visual arts, music, acting, and dance. It features specialized programs for school students and home learners, and presents concerts and exhibitions for the public. Studios are offered for pottery, fibre arts, yoga, ballet, drama, piano, drawing and painting. Place des Arts offers four faculty concerts throughout the year, as well as numerous recitals and presentations by students on an ongoing basis.^[68]

Place Maillardville is a community centre providing leisure activities for all age groups, with programs on French language, culture, as well as physical activities. Heritage Square offers visitors a wealth of historic sites, gardens, a bike path, and an outdoor amphitheatre; it is also home to the Mackin Heritage Home & Toy Museum.^[69]

The city is responsible for the maintenance of numerous sports and recreation fields, including 40 grass/sand/soil sports fields, five FieldTurf fields, 35 ball diamonds, several all-weather surfaces, a bowling green, a croquet/bocce court, and a cricket pitch.^[70] The city also operates Percy Perry Stadium and the Poirier Sport & Leisure Complex.^[71] Privately owned Planet Ice features 4 additional ice rinks, and more rinks are found throughout the Tri-Cities.^[72]

There exists many opportunities for a wide variety of activities in Coquitlam:

• Baseball – The Coquitlam Reds of the B.C. Premier Baseball League play their home games at Mundy Park;^[73] the Reds' most famous alumnus is former Major League All-Star and National League MVP Larry Walker.^[74][75] Coquitlam is also home to Coquitlam Little League, which has been part of Little League International since 1955; Coquitlam finished 3rd at the 1984 Little League World Series.^[76] In 2008, Coquitlam hosted the Junior League Canadian Championships.^[77]
• Basketball – Coquitlam is home to the Tri-City Youth Basketball Association; formed in 1999, it serves the Tri-Cities with over 1,400 players from grades 2 to 9.^[78] The program is part of the Steve Nash Youth Basketball program administered by Basketball BC. It is open to both boys and girls, and operates out of school gyms across the Tri-Cities area.^[79][80]
• CrossFit – The regional CanWest CrossFit games have been held in the Percy Perry Stadium since 2016.^[81][82]
• Cricket – Coquitlam is home to the Windies Cricket Club. The club consists of over 40 members with 3 adult teams playing in the Premier, Second & Fifth Divisions. The club is affiliated with the British Columbia Mainland Cricket League and games are played at Mackin Park. A youth Kanga Cricket Program was formed with the aim of promoting and growing the game of cricket in Coquitlam. The SuperStrikers cricket team is open to boys and girls aged 6 – 16.^[83][84]
• Football – Coquitlam is home to the Coquitlam Minor Football Association, which is a member of the Vancouver Mainland Football League. CMFA players range from 6 to 18 years of age, and play against teams from the Lower Mainland and Vancouver Island. Coquitlam was also the home of the Tri-City Bulldogs of the Canadian Junior Football League from 1991 to 2004.^[85]
• Golf – In addition to courses in neighbouring communities in the Tri-Cities, Coquitlam itself is home to several golf facilities. The Vancouver Golf Club, located in southwest Coquitlam, has hosted four major LPGA tour events as well as one Senior PGA Tour event. The Westwood Plateau Golf & Country Club is one of the highest rated golf courses in Canada. Both the Westwood Plateau Golf Academy and Eaglequest Golf Centre are designed as executive learning courses.^[86]
• Hockey – Founded in 2001, the Coquitlam Express of the British Columbia Hockey League play at the Poirier Sport & Leisure Complex.^[87][88][89] Coquitlam is also home to the Coquitlam Minor Hockey Association, a AAA club in the Greater Vancouver area in the Pacific Coast Division, with almost 1000 members from Initiation Hockey 1 to Juvenile.^[90]
• Lacrosse – Coquitlam is home to the Coquitlam Adanacs of the Western Lacrosse Association, who play at the Poirier Sport & Leisure Complex, and to the Coquitlam Minor Lacrosse Association.^[91] In July 2008, Percy Perry Stadium hosted the 2008 ILF Under-19 World Lacrosse Championships.
• Motorsports – Coquitlam was formerly home to Westwood Motorsport Park, Canada's first purpose-built permanent road course, located on what is now Westwood Plateau. The first race was held in 1959, and over the years hosted many different professional series including Formula Atlantic and Trans-Am. Notable drivers to have raced at Westwood include Formula One World Champion Keke Rosberg, Indianapolis 500 winners Bobby Rahal and Danny Sullivan, Gilles Villeneuve and Michael Andretti, and Greg Moore.^[92] The track finally closed in 1990 due to encroaching development,^[93] and racing moved to Mission Raceway Park.
• Softball – Coquitlam is home to the Coquitlam Minor Softball Association.^[94] This association consists of about 300 registered players, predominantly females between the ages of 5 – 19 years of age. Most of the games are held at Mundy Park, Riverview Park, and Hillcrest Park. The CMSA is home to the Coquitlam Classics competitive rep program.
• Rugby – The city is home to the United Rugby Club which claimed the BC Rugby Under 23 championship in 2018. The club has two senior men's team and one senior women's team, as well, the team has age grade programs from its mini's program for elementary school children to U-16 and U-19 teams.
• Soccer – The city is home to two major soccer associations, including the Coquitlam Metro-Ford Soccer Club which has over 2500 players that range from Under-5 to adult teams including the Women's Premier team which plays in the Pacific Coast Soccer League,^[95] and the North Coquitlam United Soccer Club.^[96]
• Swimming – City Centre Aquatic Complex is an indoor aquatic centre built in the Town Centre area at a cost of $8.2 million and opened in 1994. It features a 50m Olympic size swimming pool, wave pool, waterslide, 3,000-square-foot (280 m²) fitness centre, and physiotherapy clinic. The Chimo Aquatic and Fitness Centre (CAFC) opened in 2008 in the Austin Heights area at a cost of $19.5 million, replacing the older Chimo Pool nearby.^[97] It features a 25m swimming pool, a 20m lap pool, leisure pool, and fitness room. Coquitlam also operates three outdoor swimming pools (Eagle Ridge, Rochester, Spani), two outdoor wading pools (Blue Mountain, Mackin), and three outdoor splash pads (Blue Mountain, Panorama, Town Centre).^[98]
• Track and field – Coquitlam is home to the Coquitlam Cheetahs track and field club, who train at Percy Perry Stadium, which was named after their former coach who died in 2005.
• Water Polo – Coquitlam is home to a number of water polo clubs. In the summer the Coquitlam Sharks, members of the BCSSA, have a water polo component, and during the year, from October to April, the Coquitlam Lions, a recreational water polo club, have practices at the various pools from October to April:^[99] CCAC, Poirier and Eagle Ridge. In addition, Pacific Storm, a high performance water polo club, also holds some of its practices at CCAC.

Coquitlam is represented by two federal MPs in the Parliament of Canada. Bonita Zarillo (NDP) represents the Port Moody—Coquitlam riding, while Ron McKinnon (Liberal Party) represents Coquitlam—Port Coquitlam.^[100]

Coquitlam is represented by three provincial MLAs in the Legislative Assembly of British Columbia. Rick Glumac (British Columbia NDP) represents the Port Moody-Coquitlam riding, while Joan Isaacs (BC Liberals) represents Coquitlam-Burke Mountain, and Selina Robinson (BC NDP) represents Coquitlam-Maillardville.^[101]

In the 2018 civic election, Richard Stewart was reelected as mayor of Coquitlam, and Craig Hodge, Chris Wilson, Teri Towner, Bonita Zarillo, Brent Asmundson, Dennis Marsden, Trish Mandewo and Steve Kim were all elected to Coquitlam City Council.^[3] Coquitlam contracts out garbage and recycling services to International Paper Industries for city residents, but local businesses are responsible for their own garbage and recycling arrangements.^[102] Coquitlam Lake provides residents with a mountain-fed water source, while the city maintains its own sewage management system.^[103]

The nearest Supreme Court of British Columbia venue is the New Westminster Law Courts. Provincial Court of British Columbia cases were formerly handled through the Coquitlam Provincial Court, but this was closed in 1996 and moved to the new Port Coquitlam Provincial Court.^[104][105]

Coquitlam is served by TransLink, which is responsible for both public transit and major roads.

The city has four SkyTrain stations on the Millennium Line that are a part of the 10.9 km (6.8 mi) long Evergreen Extension.^[106] With a project cost of $1.4 billion, the line runs from the Coquitlam City Centre area, through Coquitlam Central Station and into Port Moody, re-entering Coquitlam on North Road and finally joining the existing Millennium Line at Lougheed Town Centre.

There is regular bus service on numerous lines running throughout the city and connecting it to other municipalities in Metro Vancouver, with a major exchange at Coquitlam Central Station.^[107]

The West Coast Express, with a stop at Coquitlam Central Station, provides commuter rail service west to downtown Vancouver and east as far as Mission.^[108] WCE operates Monday to Friday only (excluding holidays), with five trains per day running to Vancouver in the morning peak hours and returning through Coquitlam in the evening peak hours.

For motorists, the Trans-Canada Highway provides freeway access to Burnaby, Vancouver, Surrey, and other municipalities in the Lower Mainland. Lougheed Highway is an alternative route to the Trans-Canada, entering Coquitlam through Maillardville, past the Riverview Hospital area, up to Coquitlam Centre where it turns sharply east to Port Coquitlam. Barnet Highway begins at the Coquitlam Centre area and heads directly east through Port Moody and on to Burnaby and downtown Vancouver.^[109]

Coquitlam has 60 km of bike routes, including dedicated bike lanes on Guildford Way, David Avenue, United Boulevard, Mariner Way, Chilko Drive and others, plus additional routes through city parks.^[110]

Coquitlam is served by two international airports. Vancouver International Airport, located on Sea Island in the city of Richmond to the west, is the second busiest in Canada and provides most of the air access to the region. Abbotsford International Airport, located to the east, is the seventeenth busiest airport in Canada. Nearby Pitt Meadows Airport provides services for smaller aircraft^[111][112] and there are also Boundary Bay Airport and Langley Airport for small aircraft.

Residents and visitors wishing to travel to Vancouver Island, the Gulf Islands, and other destinations along the Inside Passage may use the BC Ferries car and passenger ferry service from two terminals in the communities of Tsawwassen and Horseshoe Bay, south and north of Vancouver respectively. BC Ferries operates the Queen of Coquitlam, a C-class ferry capable of carrying 362 cars and 1,466 passengers, which was launched in 1976. She received an $18 million rehabilitation in November 2002, and currently operates as a secondary vessel on the Departure Bay-Horseshoe Bay route.^[113]

Coquitlam is served by Fraser Health, which operates the 106-bed Eagle Ridge Hospital on the Port Moody/Coquitlam city boundary. ERH opened its doors in 1984 and operates a 24-hour emergency department, ambulatory, long-term care and acute care programs. It is a Centre of Excellence for elective surgery for urology, gynaecology, plastics and orthopedics. The hospital also offers public education clinics for asthma, diabetes, rehabilitation services and programs for cardiology, children's grief recovery, youth crisis response and early psychosis prevention.^[114]

Fraser Health also operates the 352-bed Royal Columbian Hospital just south of Coquitlam in New Westminster. Coquitlam residents are also served by many privately owned health care clinics, while Tri-Cities Health Services operates 653 residential care beds.^[115]

Coquitlam is also the home of Riverview Hospital, a large mental health facility, operating under the governance of BC Mental Health & Addiction Services. Riverview opened in 1913 and had 4,630 patients at its peak, but advances in treatment and cutbacks in funding have resulted in fewer people receiving mental health care, and much of the facility has closed over the last few decades.^[116]

Coquitlam contracts out its police service to the Royal Canadian Mounted Police, with the main police station adjacent to City Hall at Coquitlam Town Centre and community police stations in the Austin Heights and Burquitlam areas. The Coquitlam RCMP detachment also serves the municipalities of Anmore, Belcarra, and Port Coquitlam.^[117]

Coquitlam has its own fire service, known as Coquitlam Fire/Rescue, with four fire halls. Coquitlam uses names, not numbers for their halls. The fire halls are Town Centre, Austin Heights, Mariner Way, near Mundy Park and Burke Mountain.^[118]

Like all other municipalities in British Columbia, Coquitlam's ambulance service is run by the British Columbia Ambulance Service.^[119]

Coquitlam Search and Rescue is a volunteer search and rescue team operating under the Provincial Emergency Program. Coquitlam SAR is responsible for urban and wilderness search and rescue for the area between Indian Arm and Pitt Lake, and encompasses the local communities of Coquitlam, Burnaby, Port Coquitlam, Port Moody, New Westminster, Belcarra and Anmore. The SAR team is based at Town Centre Fire Hall.^[120]

The city manages four all-age community centres (Centennial, Pinetree, Poirier, Summit), and two senior community centres (Dogwood Pavilion, Glen Pine Pavilion).^[121]

Coquitlam is served by School District 43 Coquitlam, and offers four public secondary schools, seven middle schools, and dozens of elementary schools. Francophone education in the Tri-Cities is offered by Conseil Scolaire Francophone de la Colombie-Britannique.^[122][123]

Coquitlam Town Centre is home to the 4,000-student David Lam Campus of Douglas College, which offers university transfer, career-training and academic-upgrading programs. Therapeutic Recreation, Hotel and Restaurant Management, and Animal Health Technology programs are housed in the original main campus building. The $39 million Health Sciences Centre opened in 2008, with state-of-the-art facilities for Nursing, Psychiatric Nursing and other health-career programs.^[124]

There are two major universities, University of British Columbia and Simon Fraser University, located in the nearby municipalities. The British Columbia Institute of Technology (BCIT) in neighbouring Burnaby provides polytechnic education and grants degrees in several fields. Vancouver is also home to the Emily Carr University of Art and Design and the Vancouver Film School.^[125]

The Coquitlam Public Library has two branches: City Centre and Poirier. The library has a circulation of over 1.1 million items, and an annual budget of over $5 million.^[126]

In addition to the other Metro Vancouver media outlets, CKPM-FM was the first radio station dedicated to the Tri-Cities area when it took to the air in 2009.^[127]

Coquitlam is served by the bi-weekly Tri-City News newspaper.^[128]

A significant number of movie and television productions have been partly or completely filmed in Coquitlam in recent years, including a significant portion of 2018's Deadpool 2, 2014's Godzilla, both New Moon and Eclipse from the Twilight series, The X-Files, Juno, Smallville, Psych, The Sisterhood of the Traveling Pants, Dark Angel, The Day the Earth Stood Still, Romeo Must Die, Stargate SG1, Riverdale, and Watchmen.^[129] The city maintains the Coquitlam Film Office to coordinate permits, traffic and crowd control, and insurance for film and television productions.^[130]

Coquitlam currently has sister city relationships with the following:^[131]

• Foshan, People's Republic of China
• Paju, South Korea

In November 2017, the city stated that they had ended sister city relationships with Laizhou, Tochigi, Ormoc and San Juan.^[132]

Juno Award-winning rock musician Matthew Good is from Coquitlam. He graduated from Centennial Secondary in 1989, and became lead singer for the Matthew Good Band, one of Canada's most successful alternative rock bands in the 1990s. Centennial Secondary was featured in the "Alert Status Red" video, and its cheerleading squad recorded for "Giant".^[133] The Matthew Good Band was dissolved in 2002, and Good has since pursued a solo career and established himself as a political activist, blogger, and author.^[134]

Actor Taylor Kitsch graduated from Gleneagle Secondary in 1999,^[135] and went on to star in movies such as John Carter and Battleship and Lone Survivor as well as the television series Friday Night Lights'

Former FA Premier League goalkeeper Craig Forrest is from Coquitlam and attended Centennial Secondary. Forrest appeared in 263 games for Ipswich Town, 30 games for West Ham United, and three games for Chelsea. Forrest also earned 56 caps for the Canadian national soccer team, the most of any goalkeeper in team history, and earned the most clean sheets in the country's history. Forrest was elected to Canada's Soccer Hall of Fame in 2007.^[136][137] Former Canadian national soccer team midfielder Jeff Clarke and Canadian women's national soccer player Brittany Timko also both attended Centennial Secondary.^[138][139]

Former National Basketball Association player Lars Hansen was raised in Coquitlam and played his high school basketball at Centennial Secondary. He was a member of the Seattle SuperSonics 1979 NBA Championship team, and was elected to the Canadian Basketball Hall of Fame in 2008.^[140]

American political analyst and former Fox News co-host Rachel Marsden was raised in Northeast Coquitlam's Burke Mountain area.^[141]

Former BC Lions placekicker Lui Passaglia has resided in Coquitlam for over 20 years.^[142] Passaglia is a member of the Canadian Football Hall of Fame, and his #5 jersey is one of eight numbers retired by the Lions.^[143] Passaglia was voted #30 of the CFL's Top 50 players of the modern era by Canadian sports network TSN.^[144]

Playboy Playmate and actress Dorothy Stratten was raised in Coquitlam and attended Centennial Secondary School. Stratten was Playmate of the Year for 1980. She appeared in several movies, including Peter Bogdanovich's They All Laughed, then she was murdered by her estranged husband. Stratten was portrayed twice in biographies of her life, by Jamie Lee Curtis in Death of a Centerfold: The Dorothy Stratten Story and by Mariel Hemingway in Star 80.^[145]

Spoken word poet Chris Tse was raised in Coquitlam though he is based in Ottawa. He was captain of the Ottawa spoken word team that won the Canadian Festival of Spoken Word championships and placed second overall in the Poetry Slam World Cup in Paris, France.^[146]

Filipino pop and jazz singer, musician, lyricist, and songwriter Joey Albert is a Coquitlam resident.^[147]

Hockey players Mathew Barzal of the New York Islanders, Dante Fabbro of the Nashville Predators, and Vincent Iorio of the Washington Capitals were all born and raised in Coquitlam.^{[148][149][150]}

Science fiction novelist Dennis E. Taylor is a Coquitlam resident.^[151]

• Coat of arms of Coquitlam
• Tri-Cities
• Metro Vancouver
• Lower Mainland