This interview with Gloria Zapata was compiled and translated by CPN Exec member Viviana Silva
You were the director of the research area called “kinesiology of human development” at the National University of Colombia. Could you please tell us how this interest was born and how your experience or education influenced your research?
My interest in the research area of “kinesiology of human development” arose in relation to my experience as a teacher in the National University of Colombia between the years of 1986-2006. This time was marked by the need to reform the curricular program of the profession to favour training of physiotherapists to become more committed to improving quality-of-life for people and communities to whom they provide their services. This new paradigm emerged by overcoming the tendency to practice reactionary “repairman” only techniques, with predominately commercial aims.
Perhaps the most important advance in this period was the conceptualization of the object of study of physiotherapy in terms of human body movement, as it led us to think about the human being as comprehensive, dynamic and with development potential. It was then, that I increased my interest in these three themes: development, human development, and body movement. This became clear as we reflected on the role of body movement in the development of physical and social capabilities of people. Therefore, three areas of widening knowledge related to physiotherapy were differentiated: the kinesiology of development, physiological morphological kinesiology, and kinesiotherapy. Two levels of study were established: that of concrete specificities related to each individual and that of universal constants related to the human being.
I think there were several reasons why I was interested in participating in the area of “kinesiology of development”. I list them below:
- a) I was a teacher in the pediatric area, where we studied the processes of biopsychosocial development from birth to adolescence;
- b) I was interested in studying the development of normal components and abnormalities of movement and the factors that affect it;
- c) In that period, groups of students were supported in their practices by vulnerable communities characterized by the presence of important risk factors for health, mainly related to poverty and social marginality; and
- d) It promoted the approach of developmental projects with strategies to help identify needs and alternatives with opportunities for the community to respond to them.
For me, permanent and continuous training was very important. I needed resources to understand the realities I was observing and the most appropriate ways to approach them. I believed this to be with humility and respect for their nature and characteristics and how to identify these. Professionally, I found that it was possible to participate as a support agent in this development, manifesting in the way that the communities wanted, felt and needed. The research questions were emerging on a day-to-day basis. We developed an approach to answering some of these questions through student thesis projects, completed as the final requirement of their degrees to qualify for the title of physiotherapist (then Physical Therapist).
What influenced your interest in the management and care of people with dementia?
The experience accumulated in this area and the complementary training were very important when it comes to working with and for people with some type of dementia. Also here, questions were arising on a day-to-day basis through direct contact and observation. In Spain economic and social conditions are better, people have access to complete and higher quality health services. And although some of my questions still had a lot to do with the role of body movement in the development of physical abilities of people, now I also wondered about their role to prevent or slow down cognitive impairment.
How has your research developed since you decided to enter the area of “kinesiology of human development”?
As a researcher, I was part of the group of teachers who made the first attempts to conduct research. I drew a lot of the work that was done from this widening area of research and also from the beginning of the Institute for Human Development and Dis-Capacity. It was a slow, difficult task, limited by inexperience in management issues as well as the scarce technical and financial human resources available then. It was a lonely process, often frustrating and inconclusive. The best resource you can count on when starting to develop this area was the students. As a teacher, the accompaniment and advice offered in the elaboration of the degree thesis (identify subjects, revise them, define and apply methodologies to obtain and analyse the data, draw conclusions, write reports), not only served to stimulate their concerns and abilities for research, but also allowed me to have “researchers in training” that explored topics of interest to this widening area. In order for the investigation to advance, it is not only necessary for our physiotherapists to acquire and develop research skills by training in masters or doctorates, participating in research groups, in local or national projects, but also that University and research groups have the appropriate funding. In Colombia at that time, there was no Government assistance or private funding available for research such as this.
How has your research developed since you decided to work for people with dementia?
In Spain, I was worked as a physiotherapist at a reference centre for people with different types of dementia between 2008 and 2016. Working with and for these people, I could observe and identify -in almost all – one or more characteristics related to the capacity of movement which increased risk factors for disease. With the intention of helping them to maintain functional capacities and control these potential risk factors, I created and launched a daily program of simple activities that involve physical exercise and the practice of movements similar to those that they would perform frequently in their daily lives. This is how the Postural Correction Program came about, to increase the prevention of immobility and promotion of physical activity in people with dementia.
As these activities complemented and increased the benefits obtained by people applying physiotherapy treatments, we simply called it “the reinforcement program”. This helped individualise and adapt activities specifically for the characteristics of each user, and control potential risk factors and contraindication to participation. This information was collected and analysed by observation and direct interaction with the person in their environment (Day Centre or Coexistence Unit), their clinical history and the results of the valuations made by the Centre’s interdisciplinary team.
Therefore, we were able to introduce the practice of regulated physical activity as a resource to help slow down the deterioration of physical, locomotor and cognitive abilities, improve cardiovascular competence and maintain a good level of physical condition. Working with these programs allowed us to combine procedures and interventions with structured and flexible contents, enabling responses to specific capabilities and preferences from each person. This defines “the reinforcement program” within the framework of person-centred care and planning.
Who has influenced you most in this area (s)?
I must recognize a few different influences. I think that the core subjects of my physiotherapy training were fundamental (Biology, childhood development and culture, human development and social development, disability, methodology of research in health sciences). Another was to have the opportunity to venture into the performance of the profession as part of multidisciplinary teams. I have been able to share with psychology professionals, neuropsychology, psychiatry, pedagogy, music therapy, medicine, pharmacy, nutrition, nursing, physical education, sociology, social work, anthropology, history, speech therapy, occupational therapy. And of course, a major influence was the literature review. Some of the authors that have been important to me are: Lev Vygotsky, Jean Piaget, Abraham Maslow, Jerome Bruner, Albert Bandura, Howard Gardner, Paul Ausubel, Margareth Rood, Herman Kabat, Vojta, Berta and Carl Bobath, Carr and Sheperd, Feldenkrais, Carlo Perfetti, Rodolfo Llinás, Urie Bronfenbrenner, Hannah Arendt, Robert Schalock, Rocío Ballesteros, Maria Teresa Anguera, Antonio Marina, and Horak Fay.
In summary, I would only add that it is very important to highlight the work of physiotherapists across many different areas of engagement. As this information becomes available to other professionals, it can be a favourable factor for inter-disciplinary relations and the formation of collaborative teams.
What are your current challenges and what areas you would like to see grow in the physiotherapists of today?
I am currently interested in the field of mental health which is a great challenge for me. Hopefully, we will see continued growth in interventions supported by evidence and quality research in any field of professional practice of physiotherapists.
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