Physiotherapy Practice

ISSN: 0266-6154 (Print) (Online) Journal homepage: http://www.tandfonline.com/loi/iptp19

To identify the physiotherapy paradigm: A

challenge for the future

Raija Tyni-Lenné

To cite this article: Raija Tyni-Lenné (1989) To identify the physiotherapy paradigm: A challenge
for the future, Physiotherapy Practice, 5:4, 169-170, DOI: 10.3109/09593988909037769

To link to this article: http://dx.doi.org/10.3109/09593988909037769

Published online: 10 Jul 2009.

Submit your article to this journal

Article views: 181

View related articles

Citing articles: 9 View citing articles

Full Terms & Conditions of access and use can be found at

http://www.tandfonline.com/action/journalInformation?journalCode=iptp19

Download by: [186.116.79.247] Date: 10 October 2016, At: 09:35

&si&w Rachk (1989) 5, 169-170
6Lawrence Erlbaum Agocintcs Limited 1989
EDIT0 R IAL
To identify the physiotherapy paradigm: A
challenge for the future
Every one of us has at some time during his or
her physiotherapy career inquired: ‘What is phy-
siotherapy, actually?’ When a person becomes a
physiotherapist, his or her professional paradigm
includes: what he or she wants to do as a phy-
siotherapist, the skills to perform activities per-
taining to physiotherapy practice, a picture of
that part of the world with which physiotherapy
activities are concerned, and a view on physioth-
erapy.
Since there is no general knowledge base in
physiotherapy, each of us, when describing what
physiotherapy is, expresses different aspects of
the physiotherapy paradigm depending on what
we value and are conscious of in physiotherapy.
We often discuss the interests and competences of
physiotherapists, but we more seldom reflect the
pictures of the world and views on profession and
science, including ideals, in physiotherapy. The
only internationally published article I am aware
of that deals with a view of the world and a view
of science in physiotherapy was written by Helen
Hislop (1975). However, these are very import-
ant issues for the development of our profession
and discipline. Therefore, it is necessary that
members of our profession turn their attention to
physiotherapy paradigms.
The American Physical Therapy Association
(APTA) has encouraged physiotherapists to par-
ticipate in the advancement of theory in phy-
siotherapy (APTA, 1986). The concept of theory
in physiotherapy is then used at different levels-
from a certain type of patient treatment to the
level of general physiotherapy theory. As
recently as May 1988, Krebs and Harris pointed
out that they cannot provide any examples of
general physiotherapy theory because they are
not aware of any such general theory having
been published (Krebs and Harris, 1988).
According to APTA’s committee on research,
history teaches that a profession cannot hope to
gain scientific credibility by clinging to data
without theory (APTA, 1986). Could one way to
start to develop the general theory of physiother-
apy be to describe and explain the paradigm of
physiotherapy?
The concept of paradigm was first used by
Thomas Kuhn (Kuhn, 1970).HHkan Tornebom,
a Swedish professor of theory of science, has
elaborated the concept and appIied it to other
practices than research. Physiotherapy can be
described as a complex of practices in which
physiotherapists are involved. A practice has at
least one main function, and it may contain parts
which have other functions. Every practice that
functions for changes in the sociocultural world
has its paradigm. Actors are equipped with speci-
fic paradigms in relation to these practices (Tor-
nebom, 1986).
All professions are characterised by their spe-
cific paradigms. Actors’ professional paradigms
are acquired during education and further de-
veloped in practice. Tornebom’s concept of par-
adigm includes four components: interest, com-
petence, picture of world, and view on science,
including ideals of science (Tornebom, 1985;
1986; 1987).
Three main practices are contained in the
field of physiotherapy: clinical practice/patient
care practice, educational practice and research
practice, each of them including several subprac-
tices. I consider administration as a part of each
of these practices.
Clinical practice and educational practice
have a long tradition in physiotherapy and their
paradigms have undergone a long international
development. However, the concept of paradigm
has the characteristics of an iceberg; we are only
conscious of a small part of it. Research practice
is very young in physiotherapy, and in many
169
170 PHYSIOTHERAPY PRACTICE
countries it has not yet started. In certain coun-
tries, like Sweden, possibilities for research have
lately been opened for physiotherapists.
Paradigm discussions are necessary when pre-
paring the genesis of a new field of research, and
have as their goal to work out the paradigm
specific to this new field of science. Paradigm
discussions are always important and are a means
of development, both for individuals and for the
discipline at large. Paradigms deserve to be sub-
mitted to systematic study (Tornebom, 1986).
The practice-oriented aspects of research can-
not be established unless the paradigms of the
practitioners are subject to articulation and criti-
cal assessment, to be followed by necessary modi-
fication ('Tornebom, 1985). Physiotherapy re-
search belongs to the practice-oriented sphere
within research. It is our responsibility to identify
our paradigm and to establish physiotherapy
research to the benefit of our patientslclients,
and to the care complex at large. It is my view
that in our established practices, in the field of
patient care and education, a physiotherapy par-
adigm can be identified. The full establishment
of physiotherapy science will then be possible
and there will be a path towards the general
theory of physiotherapy.
I strongly encourage physiotherapists to re-
flect upon, discuss, and study the paradigms of
physiotherapy in its different practices and sub-
practices.
Raija Tyni-LennC
Stockholm, Sweden
References
APTA 1986 Committee on research: Theory in physical
therapy. Physical Therapy 66: 661462
Hislop H 1975 The not-so-impossible dream. Physical
Therapy 55: 1064-1080
Krebs D E, Harris S R 1988 Elements of theory
presentation in physical therapy. Physical Therapy 6 8
690-693
Kuhn T S 1970 The structure of scientific revolutions, 2nd
edn. University of Chicago Press, Chicago, pp 66-79
Tornebom H 1985 Reflections on practice-oriented
research. Report from the Department of Theory of
Science, University of Gothenburg
Tornebom H 1986 Caring, knowing and paradigms.
Report from the Department of Theory of Science,
University of Gothenburg
Tornebom H 1987 Program for studies of paradigm.
Report from the Department of Theory of Science,
University of Gothenburg