Group treatment targeting core stability and balance for persons with Multiple Sclerosis. An observational study
ForfatterDybesland, Andreas Rosenberger
The purpose of the thesis was to gain insight into group physiotherapy practice for Persons with Multiple Sclerosis targeting core stability and balance exercises. Research regarding the interaction between the physiotherapist and patients, and how the physiotherapist solves challenges related to individualized treatment in the group, and changes in movement quality over time, is limited. The study is anchored in a phenomenological and hermeneutical philosophy of science, and based on three non-participatory observations during a 5-week group intervention in private physiotherapy practice. Content analysis using integrated perspectives from phenomenology, natural- and social sciences was performed. The analysis resulted in two main-themes; “Common structure and individual adaptations” and “Changes, motivation and progression”. The main-themes are supplemented by two sub-themes, “Core activation: Variations on a Theme” and “Individual hands-on: a two edged sword?” for the first, then “Taking part in ups and downs” and “Building movement as a layer of bricks”. The results indicate that individualized interaction between the physiotherapist and group participants are important for achieving core activation and movement quality in tasks given within a common structure. Targeted hands seem important for improving movement performance during training, understanding and learning related to activities of daily living. However, it is vital to reflect on the use of targeted hands related to self-initiated active movement, as the group setting lays some restrictions to individualization. The participants’ relations, awakening of changes in movement quality and success in tasks can promote motivation. The physiotherapists’ knowledge in movement analysis seems vital for achieving this. Gait analysis shows that tasks at the body functions and structure level improve movement quality in gait over time, thus indicating a learning effect. The findings underpin the importance of individual adaptations in group therapy, and that changes in core activation and postural control affect motivation, group dynamics and qualitative aspects of gait.
ForlagUiT Norges arktiske universitet
UiT The Arctic University of Norway
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