How do you judge if one movement is good and another bad? Many claim that movement is the core of physiotherapy 1, 2, 3. But how far is the profession prepared to go to justify its claim to be experts in movement? Presumably, no-one would dispute that the improved diffusion of oxygen through the pulmonary interstitial space of a COVID-19 sufferer is good. And we can celebrate those that made that possible. But what about the movement of air in a black man’s throat, or the movement of the knee of the police officer that killed him? What about the lack of movement of the people who stood around and watched him die? Is the movement of a thousand protesters good movement, even … [Read more...] about Is all movement ‘good’ movement?
There are two ways you can read the latest promotional campaign from the Canadian Physiotherapy Association, that states that physiotherapists’ work takes them ‘from treating patients to moving people’. The first is that physiotherapy spans hospital and home. The other is that the very nature of physiotherapy is changing. COVID-19 is undoubtedgly reshaping the contours of physiotherapy like other cataclysmic events before. But there are some important differences that we should be aware of. World War I and the polio epidemics that ran until the 1960s produced enormous numbers of casualties needing physical rehabilitation, but there had been wars and epidemics before. What was different … [Read more...] about Is COVID showing us the future for physiotherapy?
In the 2nd in this series of occasional posts looking back on the last six years of CPN blogposts we return to the thorny issue of the biopsychosocial model. Thorny because the BPS remains a touchstone for physiotherapists who claim to offer a more holistic therapy. All of these posts take a different view. Hopefully you'll still find returning to these arguments challenging and inspiring. The first post comes from October 2016 and asked whether the biopsychosocial model was all it was cracked up to be. The post focused on the claims of the BPS model to be holistic and pondered ' how the model has saturated people's thinking at the exclusion of other ways of being 'holistic'.This post … [Read more...] about Looking back on the biopsychosocial model
Earlier this week I wrote a post on the history of physiotherapy in times of pandemic for the history.physio site (link here). I've been thinking a lot about this recently and wanted to add a couple of more philosophical reflections that I hoped might be therapeutic for readers. The first thought ties in nicely with the history piece, and it is that we should remember that for almost the entire span of human history, humans have lived with the threat of illness and death, and it is only in the last half-century that some have enjoyed stable economies and secure employment, access to immediate, low-cost, advanced healthcare, good food and safe living conditions. I say 'some' because, … [Read more...] about Physiotherapy in a time of pandemic – an addendum
Part 8 - So how do you know if a piece of qualitative health research is good? In the seven blogposts that have preceded this, I’ve set out a personal critique of some of the problems I see all too often in qualitative research. I read and review dozens of qualitative health research articles each year, and my broader interest in the sociology and philosophy of health means I also get to read a lot of really good stuff too. So I’m claiming that as my mandate to offer some critical comments. So what makes for a good qualitative health research study, and how can you tell if you’ve found a diamond or just a bit of cheap plastic costume jewellery? Well I would say that the first thing … [Read more...] about Qualitative Health Research – A guide for the perplexed
Part 7 - Philosophy and the place of research methods Now we get to the heart of one of the most contentious issues in QHR. If you’ve followed the series so far, we’ve covered a lot of ground: sampling, generalisability, voice, and the ‘emic’ perspective, but we’re mining the motherlode now when we talk about the place of philosophy and methods in QHR. So let’s be clear from the outset, QHR places far too much emphasis on research methods and nowhere near enough on philosophy. Anchoring a qualitative study in philosophy is perhaps the most valuable thing you can do to a research study. Firstly, it guides every step of the process - every aim, and every question you pose of the … [Read more...] about Qualitative Health Research – A guide for the perplexed
Part 6 - Sampling and generalising The point of this series is not to cover what’s already in dozens of qualitative health research textbooks, but to offer some ‘back room’ insights into the possibilities and limitations of this underused resource. So far I’ve looked at where QHR came from, the concept of criticality, the ‘insider’ or emic perspective, power, and last week, your role as the researcher. Today I want to focus on one of the most common questions people pose about QHR, and that is “How can you possibly generalise from a study when you only have six participants?” This is a great question. Not only because it strikes at the heart of one of the important differences … [Read more...] about Qualitative health research – A guide for the perplexed