The phenomena movement quality and movement awarenesstheory construct and communication within mental health physiotherapy

Abstract

Background: Within physiotherapy of mental health and psychiatry there is a need to clarify the phenomena of movement quality and movement awareness because of a growing interest in how to promote movement quality through movement awareness learning. The thesis is rooted in physiotherapy, and draws on inspiration from the physiotherapy approach Basic Body Awareness Therapy (BBAT), well-known for its teaching of movement quality and its specific movement pedagogy. Two basic assumptions are implemented in the thesis, a phenomenological approach to investigate lived movement experiences and a salutogenic approach to focus on assets for health. Purpose: The overall purpose of this thesis is directed towards the two phenomena of movement quality and movement awareness through studying core phenomena in the context of clinical physiotherapy, a movement vocabulary of movement quality for professional communication and, and synthesising previous research on movement quality and movement awareness, and mapping a construct of a movement awareness domain to communicate this construct within the field of mental health physiotherapy. Material and Methods: In Study I, Part 1 and Part 2, the nominal group technique (NGT) was chosen for a consensus-building process to identify core phenomena and statements describing BBAT. This was conducted in the form of a weekend-workshop, with a cohort of 21 physiotherapy experts, recruited as teachers in BBAT, from 10 European countries. The participants prioritised data through a six-step strategy. For data-analysis in Part 1, content analysis was used. In Part 2, data were calculated and organised according to the three levels 100%, 66% and 33% agreement. In Study II, a phenomenological design was chosen to identify clinical, movement-related phenomena, with a cohort of 15 national and local physiotherapy experts, recruited according to criteria from the field of neurology, primary health care and psychiatry. Data were collected through qualitative interviews. Data analysis followed recommendation from Giorgi, modified by Malterud. In Study III, a meta-synthesis of three previous qualitative publications on the phenomena of movement quality and movement awareness, was conducted to review text-material and models. Content analysis was used for data analysis. Ethical recommendations were followed. Results: In Study I, Part 1, a total of 138 phenomena were identified and clustered in three categories, clinical core phenomena, historical roots phenomena, and research and evaluation phenomena. The clinical core phenomena, were 106 phenomena organized into three clusters: movement quality phenomena, movement awareness practice phenomena, and movement awareness therapy and pedagogy phenomena. In Part 2, the participants reached 100% consensus on 16 of 30 statements describing BBAT. The statements represent descriptions ranked as important for communication with patients, health professionals and society. In Study II, a multi-perspective movement vocabulary of 122 health characteristic terms were identified for professional communication. A movement vocabulary is considered to be valuable within mental health rehabilitation as shared vocabulary for communication. In Study III, a construct of a movement awareness domain for physiotherapy in mental health was identified and visualised through a small- and a large-scale map of three learning pillars. The domain provides personcentred and involving coping strategies for rehabilitation purposes in mental health physiotherapy. Conclusion: The results from the three studies are: first, clarification of the phenomena of movement quality and movement awareness, with related phenomena and statements describing BBAT; second, a multi-perspective movement vocabulary of health-terms of movement quality for professional communication; and third, a construct of a movement awareness domain in mental health physiotherapy, visualised through a small-scale and large-scale map, including three learning pillars, Movement quality components, Choice of movement components and Movement awareness strategy components. On the background of the studies, the thesis provides a framework of future vision, mission and enabling pillars of a movement awareness domain in mental health physiotherapy.