Abstract
Background and purpose. The body in stroke physiotherapy is everywhere in practice but neglected as a concept in clinical theory. This study explored the embodied experience for people with stroke at the time of transition from rehabilitation to community living. The purpose of this study was to gain an in-depth understanding of embodiment to inform the delivery of physiotherapy after stroke.
Subjects and methods. Seven people with stroke, aged 66 to 89 years, were interviewed one month after discharge from a stroke rehabilitation unit. Interviews were analyzed using grounded theory methodology.
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 oneself; 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 the ‘cohesive body-self included subthemes of ‘freedom’, ‘control’, and ‘identity’, reflecting experiences of bodily movement and personal independence. Participants fluxed between these perspectives, within moments and over time, with these perspectives influenced by ‘anchors’ that included their environment, knowledge and attitudes.
Discussion and conclusion. The bodily experience of stroke is dynamic and intimately connected with a person’s sense of self. The social and physical environment as well as individual attributes can serve to ‘anchor’ people within their embodied experience of stroke. Physiotherapists play a pivotal role in how stroke survivors view themselves and their body following stroke. Physiotherapy practice could be enhanced by theory that acknowledges the integral connection between body and self. This study supports the need to widen the scope of rehabilitation for stroke health care professionals, including physiotherapists.