Physiotherapists' use of touch in inpatient settings

BACKGROUND AND PURPOSE: Although touch is a basic element in the practice of physiotherapy, no research has been done to establish the type and purpose of practitioner touch in clinical settings. The purpose of the present study was to determine how physiotherapists use touch in inpatient acute and rehabilitation settings. METHOD: Fifteen physiotherapists with three or more years' experience were videotaped treating two to three patients. The participant physiotherapists reviewed a videotape of themselves and described the types of touch used and their intent behind each touch. Cross-case analysis was used to determine common themes in the descriptions. Mutually exclusive categories of touch were then refined, based on the cases. RESULTS: The most common types of touch used by physiotherapists included assistive touch, touch used to prepare the patient, touch to provide information, caring touch, touch to provide a therapeutic intervention, and touch used to perceive information. The physiotherapists also used 33 different combinations of touch, that is, a single touch used for more than one purpose. CONCLUSIONS: Inpatient physiotherapists clearly perform in a 'high touch' arena. Clinical experience was reported as the strongest factor in developing the physiotherapists' sensitivity to patient needs and their skill in using specific types of touch. Further research is needed concerning the way patients perceive and respond to the presence or absence of these various forms of practitioner touch.