Peer Group 23 Jun 2016: Emily Timothy

ABSTRACT:Transitions in the embodied experience after stroke: A grounded theory study.
Timothy E (1), Graham F(2), Levack W(2)
(1)Canterbury District Health Board, Christchurch, New Zealand,
(2)Rehabilitation Teaching and Research Unit, University of Otago, New Zealand

Background and Purpose: The ‘body’ is central to the practice of physiotherapy, but clinical theory largely neglects the body as a concept. A better understanding of the embodied experience could enhance delivery of physiotherapy. The purpose of this study was to gain an in-depth understanding of embodiment for people after stroke while transitioning from hospital to home.
Subjects and Methods: We interviewed seven people with stroke, aged 66 to 89, one month after discharge from a stroke rehabilitation unit. Interviews were analyzed using grounded theory methods and a theoretical model was developed.
Results: Two main themes in the embodied experience of stroke were: (1) ‘A divergent body-self’ where participants referred to an objective physical body, separate to their sense of self; and (2) ‘A cohesive body-self’ reflecting a sense that ‘it’s all me’. ‘A divergent body-self’ included subthemes of a body that was ‘strange’, ‘unpredictable’ and ‘effortful’. In contrast ‘a cohesive body-self’ was comprised of the subthemes ‘freedom’, ‘control’, and ‘self-identity’, reflecting experiences of bodily movement, personal independence and self-identity. Participants fluxed between these perspectives, within moments and over time, with these perspectives influenced by ‘anchors’ including their environment, knowledge and attitude.
Discussion and Conclusion: The bodily experience of stroke is intimately connected with a person’s sense of self. A person’s social and physical environment, as well as their personal attributes can serve to ‘anchor’ them more comfortably within their embodied experience of stroke. Theory that acknowledges the integral connection between body and self could enhance physiotherapy practice. This study supports the need for physiotherapists to be adequately informed to integrate the embodied experience in their practice when working with people after stroke.