Description

The concept of the body which highlights the social and cultural aspects of life and an open concept of health, served as the theory for this study as well as the inspiration from two models of clinical practice. The data consist of observations of the practice of physiotherapy of seven hip arthroplasty patients, seven open semi structured interviews with the patients, followed by open semistructed interviews with the seven physiotherapists. The results showed that the physiotherapists only used their incidental knowledge of social/cultural aspects of the patients lives to motivate the patients to comply with the physiotherapy regimen. The physiotherapists gave a much higher priority to the physical capability of the patients than to social/cultural aspects. As experts, the physiotherapists legitimised the dialogue with the patients. The physiotherapists were not able to perform clinical practice according to the above mentioned concepts of body and health since they did not have enough information about cultural/social aspects. The patients had little or no direct influence upon the contents of the physiotherapy regimen. Finally, the author discusses this rather paternalistic clinical practice.

Culturally Incompatible

In physiotherapy, as with many other health-care practices, therapeutic interventions, based on scientific knowledge, may be at odds with patient experiences. Patients may understand what they need to do to improve their health condition, but feel that these requirements may be emotionally, socially, or culturally incompatible with their lifestyles, social behaviour, or personal choices. To work in the best interest of their patients, physiotherapists need to engage with the tensions that exist between scientific reason and social reality to offer a meaningful and relevant service for their patients. The challenge for physiotherapists is to arrive at decisions and interventions together with their patients that enhance, for example, mobility, social function, and well-being. To achieve this, physiotherapists need to rethink their professional role and translate their technical knowledge and goals into the patient lifeworld and patients for their part need to engage with physiotherapy professional knowledge. Often, the most commonly used strategy for facilitating this reciprocal engagement is open dialogue between patients and therapists. Habermas, a prominent contemporary philosopher and critical theorist, has developed a communicative theory that may support physiotherapists in their efforts to arrive at more sustainable and shared decisions with their patients. In this paper, I examine what constitutes physiotherapists practice knowledge and how Habermas theory of knowledge, interest, and communication strengthens shared decision-making and can be used as a vehicle toward emancipatory practice. Drawing on data generated in an action research project, I examine how Habermas ideas can be applied in emancipatory physiotherapy practice. The paper concludes that emancipatory practice is meaningful because it creates opportunities for reflection, evaluation, and choice for future physiotherapy practice.

Electrophysical

Physiotherapy students often struggle to translate anatomical knowledge from textbooks into a dynamic understanding of the mechanics of body movements in real life patients. We present the Augmented Studio, an augmented reality system that uses body tracking to project anatomical structures and annotations over moving bodies for physiotherapy education. Through a user and learner cantered design approach, we established an understanding that through augmentation and annotation, augmented reality technology can enhance physiotherapy education. Augmented Studio enables augmentation through projection mapping to display anatomical information such as muscles and skeleton in real time on the body as it moves. We created a technique for annotation to create projected hand-drawing on the moving body, to enable explicit communication of the teacher clinical reasoning strategies to the students. Findings from our pilot usability study demonstrate a more engaging learning and teaching experience and increased communication between teacher and students when using Augmented Studio. A detailed investigation of the anatomy of the lower cervical nerves and associated structures was undertaken, as these structures would most likely be affected by any stresses generated in the nerves of the brachial plexus during the upper limb tension test (ULTT). The investigation used dissection of three adult human spines and histological sections of three cervical spines. The results support the hypothesis that the lower cervical nerves have a specialised anatomical arrangement which may protect them from forces generated in the upper limb and cervical spine by the ULTT. The fifth, sixth and seventh cervical nerves are securely attached to many structures as they emerge from the spinal cord to form the brachial plexus. Furthermore, the posterior longitudinal ligament anchors the nerve roots to the vertebral bodies and intervertebral discs. The results suggest that innervated structures other than neuromeningeal tissue may also need to be considered when evaluating a patient positive ULTT response.