Movement, touch and talk in Norwegian psychomotor physiotherapy.

People suffering from musculoskeletal disorders are frequently treated by physiotherapists using a wide variety of therapeutic approaches. In debates over the relative merits of hands-on and hands-off therapies, proponents of hands-off methods have argued that hands-on clinical work turn patients into «passive¼ recipients. But this is a simplistic proposition. Psychomotor physiotherapy is a Norwegian therapeutic approach characterized by a more or less continuous bodily dialogue combined with talk in examination and treatment sessions alike. Touch is thus a significant part of the ongoing interaction between patient and therapist. Through concrete examples, the article shows how the physiotherapists-using hands-on methods extensively-induce active responses in the patients, aid them to trust their bodies, change dysfunctional habits and become aware of their capacity for handling their health problems. The therapists do this by exploring and molding patients' movements, handling their muscle tensions and encouraging ways of breathing in combination with talk. The examples demonstrate that the body is just as «communicative¼ as talk itself and how new insights-to patients and therapists alike-can be obtained by juxtaposing verbal and bodily messages systematically. The examples also suggest that the meaning of "touch" varies. Consequently, what touch entails will necessarily inform clinical practice. Combining the theoretical framework of psychomotor therapy with phenomenology, perspectives from neuroscience and insights from the social sciences, the article casts new light on potentials and challenges triggered by the intertwining of talk and bodily handling typical of psychomotor therapy clinical work. A case is made for a view of the body as intrinsically communicative and for a more profound understanding of what not only psychomotor therapy but physiotherapy generally can offer.

Physical education classes - a double-edged sword: a qualitative study of Norwegian high-school students' experiences.

Aim: The aim of this study was to explore students' experiences of physical education (PE) and to gain insight into what contributes to engaging them in PE.Methods: A total of 316 second-year high-school students from five schools participated by completing a school assignment. The data were analyzed according to content analysis. Findings: Two main themes were developed. The first was One-sided emphasis on performance, bodily skills, and assessment with the corresponding sub-themes: Skills and performance; and Assessment, tests, and grading. The second was Wish for play, respite, co-determination, and togetherness with the sub-themes: Play and spontaneity; Respite, Togetherness and cooperation; and Co-determination and engagement. Our findings reveal a wide range of student experiences with PE classes, from a welcome respite in an otherwise sedentary and theoretically dominated day at school and enjoying being physically active with classmates, to frustration about extensive use of tests, lack of mastery, and feelings of exclusion.Conclusion: To be consistent with the values of the Ministry of Education in Norway, we conclude that the content and mode of delivery of PE in schools would benefit from being rethought if the intent is to facilitate children to stay physically active. Norwegian physiotherapists are promoters of health and physical activity across the lifespan. As part of health services in schools, they are in a prime position to optimize the PE experience for students.

The quantified self: closing the gap between general knowledge and particular case?

RATIONALE, AIMS AND OBJECTIVES: This paper addresses the movements 'evidence-based' (EBM) and 'personalized' (PM) medicine. The former is being criticized for failing to do justice to clinical complexity and human individuality. The latter aims at tailoring medical knowledge for every patient in a personalized fashion. Instrumental to this effort is the technological development engendering unlimited amounts of data about bodily fragments. The aim of this article is to stimulate a debate about the notion of the body and knowledge in medicine. METHODS: An authentic sickness history is used as a vantage point for a more comprehensive account of biomedicine. RESULTS: The analysis of the sickness history demonstrates how biomedical logic guided all approaches in the care for this particular patient. Each problem was identified and treated separately, whereby neglecting the interaction between body parts and systems, and between the woman's bodily condition and her experiences. The specialists involved seemed to look for phenomena that fit categories of disorders 'belonging' to their field. These approaches engendered unintended effects: chronification, poly-pharmacy and multi-morbidity, leading to an unsustainable increase in medical costs. CONCLUSIONS: The article elucidates how the status that professionals ascribe to the body has vital implications for what they regard as relevant and how they interpret the information they have collected. On this ground, we challenge both the prevailing and tacitly accepted separation between the physical body and human experience and the view of knowledge underpinning EBM and PM. The growing molecularization of the body veils decisive sources of human illness.

The association between timed up and go test and history of falls: the Tromsø study.

BACKGROUND: Fall-related injuries in older adults are a major health problem. Although the aetiology of falls is multifactorial, physical factors are assumed to contribute significantly. The "Timed up and go test" (TUG) is designed to measure basic mobility function. This report evaluates the association between TUG times and history of falls. METHODS: A retrospective, observational, population-based study was conducted on 414 men and 560 women with mean age 77.5 (SD 2.3). TUG time and falls during the previous 12 months were recorded. Covariates were age, sex, medical history and health-related mobility problems. Means, confidence intervals and test characteristics for TUG were calculated. Odds ratios and influence of covariates were examined by logistic regression. RESULTS: The mean TUG time was 11.1s (SD 2.5) among male non-fallers and 13.0s (SD 7.8) among fallers. The difference was 1.9s (95%CI 0.9-3.0). The odds ratio for fallers being in the upper quartile was 2.1 (95%CI 1.4-3.3). Adjusted for covariates, the odds ratio was (OR = 1.8, 95%CI 1.1-2.9). The corresponding mean was 13.0s (SD 5.74) among female non-fallers and 13.9s (SD 8.5) among fallers. The difference was 0.9 (95%CI -0.3-2.1). The odds ratio for fallers being in upper quartile was 1.0 (95%CI 0.7-1.4). The area under the ROC curve was 0.50 (95%CI 0.45-0.55) in women and 0.56 (95%CI 0.50-0.62) in men. CONCLUSION: TUG is statistically associated with a history of falls in men but not in women. The ability to classify fallers is poor, and the clinical value of the association is therefore limited.

Face-to-face and hands-on: assumptions and assessments in the physiotherapy clinic.

Drawing on findings from physiotherapy practice, this article discusses several interrelated concerns that are highly relevant for health care research: How do professionals constitute their very object--"the body"--and what are the connections between professionals' views of the body, their approaches to it, and patient participation? By providing a comparative analysis of two first encounters in physiotherapy, where patients' musculoskeletal disorders are assessed, I show how variously physiotherapists can practice and reason. One therapist is guided by assumptions deriving from the biomedical sciences, the other by an understanding of the body as the center of experience and field of expression. I show that the status clinicians ascribe to the body has important implications for what kind of information they regard as relevant, and I argue that the diversities accounted for provide unequal possibilities for collaboration and patient participation. I sum up by calling for more comprehensive studies of clinical practice in natural settings.