Natvik Eli, Groven Karen Synne, Råheim Målfrid, Gjengedal Eva, Gallagher Shaun
a Faculty of Health Studies, Department of Health and Caring Sciences , Western Norway University of Applied Sciences , Førde , Norway.
b Faculty of Health, Institute of Physiotherapy , Oslo Metropolitan University, Oslo, Norway.
Physiother Theory Pract. 2019 Feb;35(2):101-108. doi: 10.1080/09593985.2018.1441934. Epub 2018 Feb 27.
Physiotherapists are well placed to help people adjust and engage meaningfully with the world following major weight loss. Recent research indicates that the body size a patient has lived with for years can continue to affect movement and perception even after largescale weight loss. This article explores this discrepancy in depth from the perspective of phenomenology and space perception and through the concepts of body image, body schema, and affordances. It draws on an empirical example in which a nautical engineer described his lived experience of returning to work following bariatric surgery and the discrepancies he experienced while adjusting to his new situation, particularly when moving his smaller body around the ship's engine room, previously inaccessible to him. Analysis of this empirical example suggests that transitions in weight and size following bariatric surgery are both highly explicit in awareness (i.e., body image) and outside awareness (i.e., body schema). Major weight loss can open up new affordances and possibilities of being in the world, but only after adjustments in body image and body schema. The article suggests ways in which such insights can contribute to physiotherapists' clinical development and practice when working with patients undergoing major weight loss.
对于帮助人们在大幅减重后适应并积极融入这个世界，物理治疗师有着得天独厚的优势。最近的研究表明，即使在大幅减重之后，患者多年来所适应的身体尺寸仍可能继续影响其运动和感知。本文从现象学和空间感知的角度，通过身体意象、身体图式和可供性等概念，深入探讨了这种差异。文中引用了一个实证案例，一名航海工程师描述了他在接受减肥手术后重返工作岗位的生活经历，以及他在适应新情况时所经历的差异，尤其是当他较小的身体在以前无法进入的船舶机舱内移动时。对这个实证案例的分析表明，减肥手术后体重和体型的变化在意识层面（即身体意象）和意识之外的层面（即身体图式）都非常明显。大幅减重可以带来新的可供性和在世界上生存的可能性，但这只有在身体意象和身体图式得到调整之后才会实现。本文提出了一些方法，说明这些见解如何能在物理治疗师与大幅减重患者合作时，促进他们的临床发展和实践。
