Monica Mattsson

Body awareness therapy with sexually abused women. Part 2: Evaluation of body awareness in a group setting

Abstract This study examines the results of a new treatment modality described in part 1 ( JBMT , 1(5), 280–288). Seven women were studied for 20 months. Symptoms (VAS-rating), self-image (SASB) and body image were assessed at the start and 1 year after the therapy. An interview was carried out for an evaluation of the outcome of the therapy as well as to achieve extended knowledge about the consequences of CSA. The tests showed that the symptoms diminished by half. The self-image and body image improved in the majority; patients with most symptom reduction and positive changes in self-love also showed a positive personal relationship with their body. The open interpretation of the interviews generated four categories (the room, the control, the choice, and the gift) which are discussed in a closer analysis of the social dimensions of the CSA phenomena. The authors suggest how the approach with body awareness group therapy can be refined and developed in working with CSA.

Motor function in adults with Asperger's disorder: A comparative study

In the original description of Aspergers disorder (AD), clumsiness was an associated feature. Several studies of children have shown deficits in motor control, whereas research regarding adults is scarce. The aim of the present study was to compare motor function in adults with AD, with a normal comparison group. Gross and fine motor skills were examined by a standardized, norm referenced test developed for children, but also used in young adults, the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP). In addition, a questionnaire regarding the participants’ physical activity during leisure time was administered. We found that adults (age 21–35) with AD (N=15) performed significantly worse than the normal comparison group (N=29) in six of eight subtests in the BOTMP. Males with AD were less physically active than males in the comparison group. Among females, physical activity did not differ between the groups. There was a positive association between physical activity and gross motor function in the AD group. Participants with AD were encouraged by the assessments. Physical coaching may be an important future field for improving quality of life in adults with AD.

Body awareness therapy with sexually abused women:Part 1: Description of a treatment modality

Abstract Child sexual abuse (CSA) and its consequences have become highlighted and the aftermath of the trauma creates severe physical and psychological impairment. The aim of this study was to improve understanding about CSA and to describe and consider a new physiotherapeutic treatment modality led by a physiotherapist and a gynaecologist, where psychological, medical and pedagogical frameworks interweave.

Rating body awareness in persons suffering from eating disorders A cross-sectional study

Abstract In patients with eating disorders (ED) body awareness is of interest and the connection between body awareness and self-esteem has been discussed. The aim was to study the concordance of physiotherapists (PT) observation and patients own report of bodily expression in patients with ED. Characteristics of ED patients’ specific bodily expression and implications of the findings for clinical practice were also of interest. Two assessment scales were used, the Body Awareness Scale – Health (BAS-H), based on observations and the Interview Scale Body Ego (ISBE). Total scales and subscales were compared. Altogether 87 ED patients (Total Group, TG) were assessed. Twenty-six patients had anorexia nervosa (AN), 20 bulimia nervosa (BN) and 41 patients ED not otherwise specified (EDNOS). Significant correlations between total BAS-H and total ISBE (r = 0.48–0.57) were found for AN, EDNOS and TG groups. In the subscale centring, correlations were found for all groups (r = 0.42–0.60). In the subscale relations , correlations were found for AN, EDNOS and TG groups (r = 0.43–0.60). The ED patients were characterized by withheld breathing and restrictive expressions of body movements and emotions. Body awareness and self-awareness seemed to be reduced. Body Awareness Therapy might well be offered as a therapeutic tool in establishing a realistic body image.

Long-term effects of physiotherapeutic treatment in outpatient psychiatric care

Two consecutively selected groups of patients at an outpatient psychiatric clinic were studied (experimental (E) and control (C) groups). Both groups received conventional treatment, and in the E group psychiatric psysiotherapeutic treatment (PPT) was added. The effects of PPT were assessed immediately after termination of PPT and after a further 3.5 months. The instrument used for assessments were the SASB, measuring self-image; the SCL-90, measuring symptoms; and a semistructured interview focusing on satisfaction with treatment and treatment outcome. The patients were diagnosed on the basis of DSM-III-R, and a judgement of the level of psychologic development was made. Immediately after the E groups termination of PPT, patients in both groups had a less consistent self-image with more self-attack and lower self-control than a sample of “normals”, and the patients receiving PPT had an even less normal self-image, with more self-attack, lower self-control, and a more conflictive self-image than the C gr...

One-year follow-up of body awareness and perceived health after participating in a multimodal pain rehabilitation programme – A pilot study

Abstract Purpose: To evaluate body awareness and perceived health in patients with chronic pain after participation in a multimodal rehabilitation (MMR) programme and at 1-year follow-up. Method: Thirty-nine patients participated in a 5-week outpatient MMR programme. They were evaluated with the main outcome measures: the Body Awareness Scale (BAS) using an interview (BAS-I) and a movement test (BAS-Obs), the Nottingham Health Profile (NHP) and the Sense of Coherence (SOC). A subgroup analysis was conducted based on the BAS-Obs scores at the start of the MMR programme with cut-off at the upper quartile ≥ 26 point, classified as low body awareness; the three lower quartiles were classified as moderate/high body awareness. Results: All patients improved on the BAS-Obs and the BAS-I from the start to the end of the MMRP (p < 0.001) and at 1-year follow-up on four of the BAS-Obs subscales (p < 0.005). The moderate/high body awareness group improved on BAS-I, NHP and SOC (p < 0.01) and on two BAS-I subscales (p < 0.005), while the low body awareness group improved on one subscale (p = 0.003). Conclusion: Our results suggest that the use of the BAS-Obs assessment to identify patients with high or low levels of body awareness could play an important part in understanding the individuals clinical needs and be useful for developing an effective rehabilitation programme for patients with chronic pain.

Supervision as an aid to professional development

Although supervision is a mandatory element in the vocational training programmes of many caring professions in Sweden and stressed as an important part of professionalisation, in physiotherapy it is less common. This paper describes the supervision physiotherapists undergo while monitoring a pain-school class. The physiotherapists’experiences of supervision are reported, and the structure and teaching methods of the supervised sessions are also identified in relation to the pain school. The impact of supervision on everyday clinical practice is elucidated. Physiotherapists strongly appreciated supervision led by an experienced colleague. One suggestion is that this kind of supervisory activity accelerates professional development. Finally, we summarise the personal qualities and competencies required by a supervisor in this kind of professional training.

“Many obstacles along the way” : follow-up of rehabilitation plans after multimodal pain rehabilitation

Abstract The aim of this study was to explore the content of rehabilitation plans after multimodal rehabilitation (MMR) for chronic pain patients, focusing on occupation-oriented measures. A secondary aim was to study how the individual rehabilitation plans had been carried out and implemented during 1 year after MMR. A multiple methods approach with quantitative and qualitative data was used. The quantitative part was descriptive and examined whether the rehabilitation plans were carried out, the number of recommendations in each plan and the type of measures suggested. The qualitative part constituted a content analysis of interviews. Vocational rehabilitation was the second most common recommendation for the whole group. The analysis of the interviews resulted in seven categories divided into two main categories: impeding factors and facilitating factors for rehabilitation. The compliance of professionals and external parties with the patients’ rehabilitation plans, and the patients’ positive experience of their change in behaviour, contributed to the completion of the rehabilitation plans. In conclusion, lack of follow-up from the professionals and negative bodily signals inhibited the completion of rehabilitation. Flexibility on the part of professionals and external actors regarding patients’ rehabilitation plans as well as their own positive experiences of striving for change facilitated rehabilitation.

To sing in a choir and be healthy — which are the mediating mechanisms?

It has been suggested in an article in the British associated to fear and anxiety and the release of a physically rigid belly is accompanied with a stress Medical Journal that attendance at cultural events and making music are determinants for survival (1). reduction (2). Choir-singing also implies optimising the fine balA headline in the publication was ‘‘Those who sing in choirs live longer’’. However, the ‘‘headlineance between self-assertion and collectivism. You need to keep to your own tune very strict. As a tenor makers’’ have been too quick off the mark and the statistical correlation between ‘‘making music’’ (the you must hold your notes and not be absorbed by the adjacent tunes. You must pay attention to your variable that includes ‘‘singing in a choir’’) and survival is not significant. The authors report a death specific task and not be involved in the melodies of the peole standing around you. A real test of vindicatrate reduction of 11% but the confidence interval is great. ing a personal task of one’s own. At the same time the over-all duty for the choir is Yet there are observations and personal testimonies regarding the stimulating and refreshing character of a collective assignment. Individual achievements are seldom counted—an advantageous joint outcome is singing (2,3). We wonder how a favourable influence of singing in a choir is mediated. How should it be what counts. Choir singing is an exercise in this profund and interpreted? Is it just the social community spirit during rehearsal evenings which creates solidarity difficult human activity. We think that a refinement of this ability is beneficial for healthy years to come. and comradeship so that a sense of general wellbeing is initiated and conveyed to produce more healthy years? REFERENCES We should like to suggest two other, more specific1. Bygren LO, Konlaan BB, Johansson SE. Attendance at ally related explanations of the association. cultural events, reading books or periodicals, and making It is well-known that among singers that deep music or singing in a choir is determinants for survival: breathing, deep down from the belly is necessary to Swedish interview survey of living conditions. BMJ 1996; be able to produce a strong, clear voice (3). The 313 (21 Dec): 1577–80. diaphragm muscle must be free and flexible. The 2. Buchholz I. Breathing, voice, and movemet therapy: warming-up before performing aims at relaxing the applications to breathing disorders. Biofeedback-Selfjaw and the throat and loosening the tight abdomen. Regul. 1994; 19: 141–53. To free the diaphragm implies at the same time an 3. Newham P. The singing cure: An introduction to voice opening and a link to a realm, related to emotions movement therapy. Shambhala Publications. Boston, USA. 1994. and tensions. A diaphragm that is held back is often