Touch, while ubiquitous and ever present in the practice of physiotherapy, is conspicuously absent from physiotherapy-related research. Based on a theoretical perspective inspired by phenomenology, this article explores and elaborates on the meaning and significance of touch in the practice of physiotherapy. The research data were generated through 16 close observations conducted in primary care clinics, and through interviews with 9 physiotherapists and with 9 patients suffering from chronic neck problems. The findings revealed how the use of touch in the practice of physiotherapy brings people into proximity in ways more complex than simple skin-to-skin contact. Through nontouch, touch, and movements, physiotherapists invite their patients to participate in the process of creating and performing therapy; dialogue through touch and movement is vital. Touch in physiotherapy depends on the physiotherapist's embodied skills; those they cultivate in order to respectfully listen to their patients and guide them to explore their own bodily capacity, limits and possibilities. The findings also suggest that observing therapy from outside and from participating in it offer significant different experiences, information, understanding, and meanings. The differences between physiotherapy as observed expression and as lived experience would seem to have important implications for understanding the practice of physiotherapy.

BackgroundPhysiotherapists (PTs) in primary health care manage patients with large variation in medical diagnosis, age, functional status, disability and prognosis. Lack of knowledge and systematically collected data from patients treated by PTs in primary health care has prompted this longitudinal observational physiotherapy project. This paper aims to describe a method for developing a database of patients managed by PTs in primary health care, with the main purpose to study patients’ characteristics, treatment courses and prognostic factors for favourable outcome.MethodsThis is a longitudinal observational project, following patients through their physiotherapy treatment periods in primary health care in Norway and until one year after inclusion. The project involves both private practitioners and municipally employed PTs working in primary health care in nine municipalities in Norway. The patients are recruited to three different cohorts depending on age and whether they are referred to a private practitioner or a municipally employed PT. All data are recorded electronically, transferred and stored securely. For all patients we have included extensive questionnaires to obtain information about demographics, disability and function, pain-related variables, psychosocial factors, treatments and evaluation of treatment as well as response to clinical tests. The PTs have access to use their own patients’ data. We have also prepared for linkage to national patient registers and data collected in population-based studies to be able to gather further important data.DiscussionThis project will have important implications for physiotherapy services in primary health care. The database contains more than 3000 patients, and data collection is ongoing. Data collected so far suggest that the patients included are representative of the larger population of patients treated by private practitioners or municipally employed PTs in Norway. This large scale prospective physiotherapy project will provide knowledge about the patient groups, applied treatments and short- and long-term outcome of the patients.Trial registrationClinicalTrials.gov Identifier: NCT03626389. Registered on August 13th 2018 (retrospectively registered).Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3729-y) contains supplementary material, which is available to authorized users.

Our analyses indicate that the ICF could serve as a conceptual framework to clarify the measurement construct of the PEDI scales, and as taxonomy to describe and clarify the item content of the Functional Skills scales. Both as framework and taxonomy the ICF showed limitations in covering functioning in early childhood.

Although there has been a focus on problematic issues related to health care services and complaints made by patients, individuals who suffer from medically unexplained syndromes continue to report being epistemically marginalized or excluded by health professionals. The aim of this article is to uncover a deeper understanding of the what‐ness of experiencing being naked in the eyes of the public while waiting to be recognized as ill. Therefore, a phenomenological approach was chosen to inductively and holistically understand the human experience in this context‐specific setting. Semi‐structured interviews were conducted with two men and six women between 25 and 65 years of age, who had been on sick leave for more than 52 weeks. Their symptoms were consistent with Exhaustion Disorder (ICD‐10, F43.8A). The meaning of the interviewees' lived experience was explored using a life‐world approach to phenomenological reflection and writing. The participants described their experience of encountering the general practitioner as taking part in a battle. Feeling distrusted by others seemed to result in disconnection from their habitual lifeworld, which in turn triggered a shame reaction. Additionally, the study showed a possible distrust related to several communication levels within the health care system, which influenced the recovery process negatively. Lack of experienced support can lead to exacerbated feelings of distress. Accordingly, the psychosocial experience of being ill might be as important as its unknown aetiology. Therefore, in the context of these interpersonal relations, both norms, values, and attitudes, and issues of power need to be considered and addressed properly.