Varieties of functional assessment in physiotherapy

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Abstract
Objective — To increase our knowledge about the diagnostic process in physiotherapy and to identify possible differential frames of reference. Design — Video-recordings and semi-structured interviews of the participants. Setting — Natural working settings, i.e. private institutes and patients' homes. Participants — Manual, psychomotor, and district (visiting) therapists. Results — The three categories of therapists use different approaches and operate within different interpretative frames throughout. They direct their attention towards different aspects of the patient's body, function, and life situation, they interpret information differently, they conclude their examinations in different ways, and suggest different treatments. The observed dissimilarities are generally mirrored by the therapists' verbal statements. But certain discrepancies between actions and statements are also found. Conclusion — This study shows how practice and the way of thinking can differ among physiotherapists. Renewed reflection on actual practice is called for, and the diagnostic process should be approached as an active interpretive enterprise.

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