Physiotherapy treatment of children with cerebral palsy: The complexity of communication within sessions and over time

Abstract

Physiotherapy involves complex communication and interaction. The purpose of the present study was to conduct in-depth analyses of communication during treatment for children with cerebral palsy within sessions and over time. Treatment took place at the children's educational settings. Subjects were participants in three long-term therapy courses. A multiple case synthesis of the cases was carried out on the basis of in-depth interviews with physiotherapists and teachers and repeated video-recordings. In order to compare processes of communication within and over sessions, a three-step procedure was applied: identification of main communicative patterns, identification of variability and stability of patterns, and detailed analysis of selected part-processes. Four main communicative patterns were identified: two divergent patterns labelled “Different and competing perspectives” and “Insecurity and confusion” and two convergent, labelled “Actively searching for common ground” and “Shared and effortless dialogue”. The variability of communication was considerable, within and over sessions, and also within the selected part-processes. The findings can be described and understood within a dynamic systems framework, capturing the complex dynamics of communication within and over sessions, as well as during specific moments.

• Communication
• dynamic systems theory
• interaction
• paediatric physiotherapy practice