Sivertsen Marianne, Normann Britt
Department of Physiotherapy, Nordland Hospital Trust , Bodø , Norway and.
Physiother Theory Pract. 2015 Mar;31(3):153-9. doi: 10.3109/09593985.2014.986350. Epub 2014 Nov 28.
People with severe traumatic brain injury (sTBI) are often young and need long-term follow-up as many suffer complex motor, sensory, perceptual and cognitive impairments. This paper aims to introduce phenomenological notions of embodiment and self as a framework to help understand how people with sTBI experience reorientation to everyday life, and to inform clinical practice in neurological physiotherapy. The impairments caused by the sTBI may lead to a sense of alienation of one's own body and changes in operative intentionality and in turn disrupt the reorganization of self, identity, everyday life and integration/co-construction of meaning with others. Applying a first-person conception of the body may extend insights into the importance of an adapted and individualized approach to strengthen the sensory, perceptual and motor body functions, which underpin the pre-reflective and reflective aspects of the self. It seems important to integrate these aspects, while also paying attention to optimizing co-construction of meaning for the person with sTBI in the treatment context. This requires understanding the patient as an experiencing and expressive body, a lived body (body-as-subject) and not just the body-as-object as is favored in more traditional frameworks of physiotherapy.
重度创伤性脑损伤(sTBI)患者通常较为年轻,由于许多人存在复杂的运动、感觉、感知和认知障碍,因此需要长期随访。本文旨在引入体现和自我的现象学概念,作为一个框架,以帮助理解sTBI患者如何体验重新融入日常生活,并为神经物理治疗的临床实践提供参考。sTBI造成的损伤可能导致身体的异化感,以及操作意向性的变化,进而扰乱自我、身份认同、日常生活以及与他人意义整合/共同建构的重组。应用身体的第一人称概念可能会拓展对采用适应性和个性化方法来强化感觉、感知和运动身体功能重要性的理解,这些功能支撑着自我的前反思和反思方面。在治疗背景下,整合这些方面似乎很重要,同时也要注意为sTBI患者优化意义的共同建构。这需要将患者理解为一个体验和表达的身体,一个活生生的身体(主体身体),而不仅仅是传统物理治疗框架中所青睐的客体身体。