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Olsen A.L.1,2, Strand L.I.1, Magnussen L.H.1,3, Sundal M.-A.3, Skjærven L.H.3
1University of Bergen, Department of Global Public Health and Primary Care, Bergen, Norway, 2Haukeland University Hospital, Department of Physiotherapy, Bergen, Norway, 3Bergen University College, Department of Health and Social Sciences, Bergen, Norway
Background: A number of valid and reliable evaluation tools are developed and applied in physiotherapy to assess movement and function. It is recommended to integrate the patients' experiences into the evaluation. Body Awareness Rating Scale - Movement Quality and Experience (BARS-MQE) is a physiotherapeutic evaluation tool developed to assess how movement awareness is expressed in the movement quality. Additionally, BARS-MQE is designed to bring the patient's voice more to the front, complementing findings observed by the physiotherapist. BARS-MQE includes 12 simple daily-life movements lying, sitting, standing, walking and relational, repeated about 10 times and evaluated in two steps: 1) First, the physiotherapist guides the patient to contact, explore and develop the specific movement, while observing and scoring movement quality according to criteria. 2) Secondly, the patient is asked an open question after completing the movement: “How was this for you, just now, - can you describe your immediate movement experience?” Part 2 is not scored, and the information is handled qualitatively in the dialogue between physiotherapist and patient.
Purpose: To capture the patients' immediate descriptions of experienced movement quality when exploring 12 daily-life movements included in BARS-MQE.
Methods: The study included the first 25 participants in an RCT where BARS-MQE was conducted according to test protocol. They were 20 women and 5 men with primary hip osteoarthritis (aged 40-74). Collected data consisted of patient descriptions of movement experiences in the BARS-MQE evaluation, step 2. Data were audiotaped in the evaluation session, and transcribed verbatim. Data were analysed in accordance with qualitative content analysis.
Results: First analysis shows that the results cluster around four themes: 1) experiencing movement restrictions locally around the affected hip and generally in the upper body, 2) awareness of compensational movement habits and their consequences for muscular tension and breathing patterns, 3) experiencing increased trust in the body when moving slowly and controlled, and 4) experiencing insight and interest when becoming aware of concrete strategies that affect movement quality and well-being.
Conclusion(s): In this project, patients with hip osteoarthritis have described immediate experiences from exploring simple, daily-life movements included in the BARS-MQE. The findings indicate that patients can become aware of and gain insight in how they use their body and their breathing, and how this affects their well-being. BARS-MQE is designed to shift between giving the patient time to explore movement and describe their immediate experience from it, which shows to open for personal learning as well as promote communication with the physiotherapist. From the findings, patients` descriptions of own movement awareness can offer complementary clinical information to the physiotherapeutic assessment of movement quality.
Implications: When applying BARS-MQE as an evaluation tool, physiotherapists gain direct descriptions from the patient`s description of their functional problems. The results reveal that patient descriptions derived from open questions connected to movement experiences in the here and now situation can complement the physiotherapists understanding when evaluating the patients movement pattern, and in addition facilitate a shift of focus from pathology to health.
Funding acknowledgements: Bergen University, The Norwegian Fund for Post-graduate Training in Physiotherapy.
Topic: Musculoskeletal: lower limb
Ethics approval: The Norwegian Regional Committee of Ethics approved the study.
All authors, affiliations and abstracts have been published as submitted.
