Which knowledge? An examination of the knowledge at play in physiotherapy with children

ABSTRACT

This article explores how knowledge is expressed and enacted in the practice of physiotherapy with children. The empirical material was generated through close observation of seven physiotherapy treatment sessions involving 7 children between 6 and 11 years old and 5 physiotherapists. Observations were undertaken by the first author, whose post-session written notes, along with comments and questions, constitute the database of this article. Through processing and analysis of data, we have written and present three experiential anecdotes as basis for further analysis and discussion. The article shows how children take initiative during therapy and display playful knowledge both of their body, moving capacity and of the equipment and tasks introduced. The physiotherapists seem to tend to emphasize physiological knowledge relating to the body, its functions and the “dangers” of pathological movement patterns. As a result, physiotherapists and child clients appear caught in a kind of stagnant co-existence where their connection and contact are at a standstill and there is little exchange of knowledge between them. We argue that, for therapy with children to develop along qualitative and creative lines, physiotherapists need to explicitly recognize children as humans of knowledge and embrace their playful contributions as significant to therapy.

KEYWORDS:

• Children
• knowledge exchange
• physiotherapy practice
• phenomenology

Acknowledgments

We would like to thank Gro Rugseth for constructive feedback on an earlier draft of this article.

Declaration of interest

The authors report no declarations of interest.

Notes

¹ The participants diagnosed having cerebral palsy was, according to Gross Motor Function Classification System (GMFCS), functioning between levels I-IV.

² The participants diagnosed having spina bifida had lessons at about level L5 and S1.

³ Among the participants who had undergone heart surgery during their first year of life, children with simple or moderate defects, such as single arterial septal defect, ventricular septal defect, co-arctation of aorta, aortic valve stenosis, and pulmonic stenosis were excluded.

⁴ The observer (and first author) is a physiotherapist specializing in physiotherapy for children. The second author is a physiotherapist specializing in manual therapy. The third author has a background in the philosophy of science. All three have broad experience in research with different methodology.

Additional information

Funding

Financial support was from The Norwegian Fund for Post-Graduate training in Physiotherapy through the FYSIOPRIM project.