Little did Sandra Thornhill imagine, when she attended her first general meeting in Yokohama, Japan in 1999, that less than ten years later she would be elected as an executive member of the North American Caribbean region of the World Confederation of Physical Therapists (WCPT), a non-profit organisation with 101 member organisations representing over 250,000 physical therapists worldwide.

But then, her long career as a physiotherapist has always been one of advancement, and Mrs. Thornhill's new appointment is the latest milestone following years of study and dedication to her profession.

In addition to her role as co-ordinator of the physio- and occupational therapy community health programme at the Ministry of Health, she also chairs the Bermuda Physiotherapy Association and the Allied Health Professions Council – the latter being the registration body for health professionals, including physiotherapists, occupational therapists, and dietitians.

"My exposure in the world arena has helped to raise the standards at that level as well," she notes.

The WCPT divides the world into five regions – Africa, Asia West Pacific, Europe, South America, and North American Caribbean, which includes Bermuda.

Mrs. Thornhill was elected to the regional executive in June during the WCPT's general meeting and international congress in Vancouver, Canada, which was attended by more than 3,500 physical therapists, researchers, educators, policy makers and leaders in the profession.

The international organisation works to improve global health by encouraging high standards of physical therapy research, education and practice, as well as fostering communication and the exchange of information between regions. It also collaborates with governments, non-governmental and international organisations, such as the World Health Organisation, in promoting best practices of physical therapy rehabilitation within the profession, emphasising sound clinical reasoning and scientific evidence.

Mrs. Thornhill's appointment is for four years, and she is looking forward to serving with such an important international body. Her duties will include working on mandates and motions to put forward at World general meetings, and bringing regional concerns to the executive.

"It will be a busy time for me," she says. "I have to attend a meeting in London in October, and probably another one in the Spring, but a lot of our communication will be by e-mails and Skype. It is going to be an interesting experience."

Prior to her new appointment, Mrs. Thornhill had attended regional and world general meetings in Jamaica and Barcelona, and in 2001 Bermuda hosted a regional meeting.

The Bermuda Physical Therapy Association (BPTA) has been a member of WCPT since 1995, and Mrs. Thornhill says the Island has benefitted greatly from the affilitation.

"It has helped to move our standards of practice and ethical codes of conduct forward, and also as a member of the North American Caribbean region, to enjoy an international membership with the American Physiotherapists Association, which provides our members with access to all of their literature and 'Hooked on Evidence' website. That is where we find all of our research data on physiotherapy-related treatments."

Bermuda has between 35 and 40 practising physiotherapists, of which 26 are members of the Association, and their chairman says she is "very happy for our little association to have this recognition".

"I think it bodes well that we have hung together for this long. We can only go forward."

Noting that the BPTA's numbers tend to fluctuate because of its guest workers, Mrs. Thornhill says the Association's goal is to attract more Bermudians into the profession, although she is pleased to note that some, including males, are already doing so, and are looking forward to returning home once they have completed training and gained experience abroad.

Meanwhile, the physiotherapist is proud to note that her daughter Kim is following in her footsteps, and expects to graduate next year.

In terms of her own choice of career, Mrs. Thornhill says that, right from childhood her wish was always to work in the helping professions, inspired in part by a developmentally challenged relative. So, at age 19 she left for England, where she completed a four-year combined course in physiotherapy and orthopaedic nursing at the Robert Jones and Agnes Hunt Orthopaedic Hospital in Shropshire, which also had a spinal unit.

On her return home, she worked at Friendship Vale school for a year, before going to Canada to work in general hospitals in Toronto and Ontario, including the Ontario Crippled Children's Centre, where she gained a great deal of experience working wth children with developmental problems, including cerebral palsy.

On returning home, Mrs. Thornhill rejoined Friendship Vale School, where she remained for 13 years before moving on to treat a special baby, and from that developing a private base of young patients.

Next, the physiotherapist joined the Ministry of Health, initially working with seniors in the community health programme, and then also seeing children in the school system who needed therapy, while retaining her private patients.

Along the way, Mrs. Thornhill completed her paediatric certification in neurodevelopmental treatment, as well as "lots of courses related to sensory processing and orthopaedic issues".

"I just have a thirst for gaining as much hands-on experience and knowledge as I can to improve my treatment for children with these issues," she says.

When members of her profession were transferred to the Department of Health umbrella in 2000, Mrs. Thornhill became the co-ordinator for the physio- and occupational therapy community health programme, which covers early intervention services for children, the school health programme, and home-based therapy for seniors, which gives them access to other facilities and services.

"The programme is growing, so now I think there is a need for more physio and occupational therapists within the community," she says.

Naturally, over the course of her career, Mrs. Thornhill has seen many changes for the better as medical science and technology have advanced.

"Whereas in the old days people were hospitalised for much longer, now in some knee surgeries they are operated on and up and walking the same day. Through scientific research, physiotherapy has really moved forward in terms of modalities and treatment. Now the buzz-word is 'evidence based'," she says. "In some countries, such as the UK, the US, and some Canadian provinces, patients don't have to see a physician before seeing a physiotherapist, and that is where the profession needs to go."

One of the goals of Bermuda's physiotherapists is to raise community awareness of the services they provide, and what treatments should achieve.

"You should not have treatment indefinitely," Mrs. Thornhill says. "If, after five or six treatments, there has been no progress, we will refer you to the physician or another therapist. This is particularly true of orthopaedic conditions, such as muscle sprains and ligament injuries. Neurological conditions are a longer process, but patients must be active participants in their treatment in order to gain function.

"If you educate patients as to the nature of their condition, and what is wrong, that helps them to understand the problem, so they are more willing to follow through. I work mainly with families and children, and the same approach applies."

So how does a busy professional, wife and mother of two, including son Khari, manage to juggle all of the demands on her time?

"Maintaining a healthy balance, and having a very supportive family, including my mother, brothers and sisters-in-law, as well as a very supportive employer," she says.

"(Chief Medical Officer) Dr. Cann has been very supportive of the Association's involvement in international affairs. I love what I do, and I do it for the love of the profession."

Looking ahead to retirement, Mrs. Thornhill says that phase of her life will allow her to devote more time to what she likes doing best: working with infants and families.