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Embodied-enactive clinical reasoning in physical therapy.

Gunn Kristin Øberg1, Britt Normann, Shaun Gallagher

  • 1Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway , Tromsø , Norway .

Physiotherapy Theory and Practice
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Summary

Clinical reasoning in physical therapy requires more than instrumental or narrative models. An enactive, embodied approach, focusing on therapist-patient interaction, offers a more complete understanding of patient impairments, especially in neurological conditions.

Keywords:
Clinical reasoningembodimentenactive intersubjectivityphysical therapy

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Area of Science:

  • Neuroscience
  • Cognitive Science
  • Physical Therapy

Background:

  • Clinical reasoning is crucial for physical therapists to assess patient movement and plan interventions.
  • Current instrumental and narrative models of clinical reasoning may be incomplete by focusing solely on physical disturbances.
  • A need exists for a more holistic understanding of clinical reasoning that incorporates the patient-therapist dynamic.

Purpose of the Study:

  • To introduce a phenomenologically informed enactive perspective on clinical reasoning.
  • To argue that embodied cognition and therapist-patient interaction are integral to clinical reasoning.
  • To apply this enactive perspective to physical therapy for patients with neurological diseases.

Main Methods:

  • Drawing on phenomenologically inspired enactivism (embodied cognition).
  • Analyzing the dynamics of lived bodily engagement between physical therapist and patient.
  • Applying the enactive perspective to clinical reasoning in neurological rehabilitation.

Main Results:

  • Instrumental and narrative models of clinical reasoning may inadequately represent patient impairments.
  • The embodied, interactive process between therapist and patient actively constitutes clinical reasoning.
  • An enactive approach offers a more complete framework for understanding and addressing patient impairments.

Conclusions:

  • The enactive perspective, emphasizing embodied cognition and interaction, provides a more comprehensive model for clinical reasoning in physical therapy.
  • This approach is particularly relevant for understanding and treating impairments resulting from neurological diseases.
  • Future clinical reasoning models should integrate the dynamic, lived experience of the therapist-patient relationship.