Physiotherapy for patients with rheumatic inflammatory diseases - towards a theoretical platform for clinical practice

Abstract

Objective: To clarify theoretical understanding underpinning physiotherapy practice for patients with rheumatic inflammatory diseases. Methods: Physiotherapists at Lillehammer Rheumatism Hospital in Norway, and a researcher collaborated to clarify what physiotherapy practice implies. Scientific papers related to physiotherapy for rheumatic diseases were read and facilitated reflections about own clinical practice. The conversations were tape recorded and analysed after each meeting. Preliminary analyses inspired questions for further elaboration and selection of new articles to be read. Results: Physiotherapists focused earlier mainly on relieving symptoms, preventing and reducing disease-induced functional limitations. During the last 20 years, an increasing emphasis is on enabling patients to continue to work and perform regular exercise to prevent physical inactivity, loss of physical capacity, and comorbid lifestyle diseases. The physiotherapists also underlined the importance of using their “hands as instrument" in their examination and treatment. Two different ways of interpreting body, movement and function can justify physiotherapy practice; one related to disease and function capacity and the other to patients' bodily illness experiences disturbing connectivity to own body and life. Conclusion: Both objective and subjective theoretical understandings of body and functioning underpin what physiotherapy for rheumatic diseases may entangle.

Keywords

• physiotherapy
• rheumatology
• rheumatic diseases
• rehabilitation
• theoretical perspective