Exploring the potential of a standardized test in physiotherapy: making emotion, embodiment, and therapeutic alliance count for women with chronic pelvic pain

Introduction: There has been an increased use of standardized measurements in health care meant to provide objective information to enhance the quality and effectivity of care. Patient performance tests are based on standardized predefined criteria with a limited focus. When facing multifaceted health conditions, information expanding the predefined criteria in a standardized test may be required to understand the patient’s complex symptoms. Relying on test information based on measurements according to functional biology, one risks missing information communicated by the sensitive and expressive body of the individual patient. The aim of this article is to investigate how body, self and illness perception is constituted as a co-construction between a physiotherapist and a patient with complex symptoms, expanding the use of a standard physiotherapy test. Methods: This qualitative study is based on video-recordings and in-depth interviews of seven women with the complex health condition chronic pelvic pain. The video recordings consist of the patients performing the Standard Mensendieck test pre- and post-treatment with Norwegian psychomotor physiotherapy. The interviews are based on the patients` and the physiotherapists` conversations while watching and elaborating on these video recordings. Empirical data is analyzed within the theoretical perspectives of phenomenology and enactive theory, especially focusing on the concepts of embodiment and intersubjectivity. Results: Taking an embodied approach, considering the body as expressive, communicative, and vulnerable to the environment and context, the results show that through bodily expressions the patients experienced the test situation as demanding, thus providing information beyond what the test was intended to measure. Additionally, when administering a standardized test, the interaction between the therapist and the patient had an impact on the results. Sensitive attention towards the patients bodily expressive emotions as a vital part of the interaction, reinforced therapeutic alliance by ensuring the integrity and autonomy of the patient. Discussion: Mutual communication, gave new insights regarding the patients’ complex symptoms and reinforced their belief in themselves and their recovery processes. Applying the patient’s expertise on herself and her life together with the professional expertise may make health care an interdependent practice where sensemaking is a co-construction of meaning between the patient and the health personnel

Chronic pelvic pain sufferers’ experiences of Norwegian psychomotor physiotherapy: a qualitative study on an embodied approach to pain.

Purpose - Chronic pelvic pain (CPP) is a multifaceted condition, and many women live with CPP without receiving any explanation for their complex symptoms. A multimodal approach including physiotherapy is the recommended treatment. To increase the limited knowledge of what is beneficial in physiotherapy, this article aims to explore women’s experiences of Norwegian psychomotor physiotherapy (NPMP) as treatment for CPP. Method - This qualitative study is based on in-depth interviews with eight women undergoing CPP. The concept of embodiment underpins the entire research project, and the analysis of the participants’ experiences builds on a phenomenological approach. Results and conclusion - Three final themes embrace the participants’ experiences of change after NPMP treatment: experiencing their body in new ways, letting go of tension, and understanding their symptoms. Through treatment, the participants moved from keeping bodily sensations at a distance towards increased bodily self-awareness. They realised that their state of tension was linked to their emotional life and stress was revealed as a trigger of bodily reactions they related to their symptoms. Positive bodily sensations were essential for the participants to let signals from their body guide their actions in a change process

How life events are perceived to link to bodily distress: A qualitative study of women with chronic pelvic pain.

Chronic pelvic pain (CPP) is highly prevalent among women and the condition is poorly understood. In addition to multiple symptoms from the pelvis, CPP patients frequently suffer bodily distress like musculoskeletal pain and negative emotional, behavioral, and sexual implications. This paper is based on a qualitative study including semi-structured interviews with eight women with CPP. Our project has been conducted within the framework of phenomenology, particularly shaped by the concept of embodiment. We discuss the link between the lived body and CPP and address the value of making the life experiences of the patient relevant to understand this complex condition