Diagnostics in Physiotherapy Á Processes, Patterns and Perspectives. Part II

The aim of this two-part article is to present some of the major findings of and conclusions in the author's doctoral dissertation on physiotherapeutic practice. The study represents an attempt at increasing our knowledge about the diagnostic process in physiotherapy and to make explicit the basic assumptions, classificatory schemes and explanatory models underlying it. First encounters between patients and physiotherapists in natural settings were observed and video-recorded supplemented by interviews of the participants. Three categories of physiotherapists participated - manual, psychomotor and visiting therapists - and randomly selected patients. Part I (in this issue pp. 140-50) contains a critical discussion of dominant assumptions in Western conceptions of the body and disease, and presents alternative ways of thinking which have profound implications for clinical work. The analyses show that the variety in the practice was considerable, and the patterns between and within the three categories of practice were consistent and salient: the three categories used different approaches and operated within different interpretative frames throughout. They directed their attention towards different aspects of the patient's body, function and life situation, they interpreted information differently, they concluded their examinations in different ways and suggested different treatments. The findings are discussed and contextualized in light of the theoretical perspectives outlined in Part I. This study demonstrates how practice and the way of thinking can differ among physiotherapists. The author calls for renewed reflection on actual practice, and for approaching the diagnostic process as an active interpretative enterprise.