From Therapeutic Approaches Towards An Integrated Theory of Body-Related Learning In Rehabilitation of Children And Adults With Neurological Disorders

Main Article Content

Heidrun Karin Becker

Keywords

Occupational therapy, Physiotherapy, Neurorehabilitation, Body-related learning, Learning strategies, Lived body, Motor learning, Skill acquisition

Abstract

Background: Occupational therapists and physiotherapists seek to enable clients with neurological diseases to improve their occupational performance. In German-speaking countries, several different therapeutic approaches are used. These approaches all promote body-related learning and are based on practical experiences and/or different theoretical frameworks. For most of these approaches, clinical evidence to support a decision for one over the other is lacking. To date, there is no coherent theory, which covers, describes and explains all aspects of body-related learning.


Objectives: The purpose of this paper is to introduce an integrated theory of body-related learning which describes a variety of strategies to promote learning processes in occupational therapy and physiotherapy.


Method: In order to determine the major features of body-related learning, six therapeutic approaches for occupational and physiotherapy are analysed based on a content analysis. They cover a broad range of therapies for children and adults, from mild coordination disorders to severe cerebral movement disorders. Based on the literature, interviews, deepening discussions in seminars and congresses, the therapeutic approaches are scrutinized about how they (intend to) support learning processes and how they describe and theoretically explain their own methodology. A comparison reveals differences in the learning processes of the various approaches. Theoretical reflections based on theories of phenomenology, anthropology, sociology and cognitive science lead to the conception of a theory of body-related learning.


Findings: In the various therapeutic approaches, different strategies are used which first and foremost differ from each other with regard to the learner’s attitude towards his own body. The learner either adopts a distanced und reflecting attitude towards his body or he learns through immediate experience. For that reason, a distinction is made between body-related learning and lived-body-related learning. In the German language, there are two words for “body”: “Körper” (the physical body) represents a distanced view of the body; “Leib” (the lived-body) represents the immediate experience. But even the most distanced view does not take a person out of his/her lived-body. Lived-body-related learning is based on imprinting through feeling, perception and experience, on incorporation, imitation, trial-and-error learning, situative learning and procedural learning. Body-related learning processes contain verbalization, reflection and imagination, which are used with motor and problem-solving learning. Cognition theories explain how patterns and symbols emerge, which are essential for learning and living in the environment. Thus, body-related learning occurs through actions, which are experienced as meaningful and relevant and are embedded into the environment. It is these actions, which constitute body, lived-body and environment.


Conclusions: For successful and sustainable learning both body and lived-body must be considered. What is learned through reflection and control must be felt and internalized in the lived-body; what needs to be changed must for the greater part be taken out of the lived-body and into reflection. The theory of body-related learning can support planning, implementation and reflection of the therapeutic practice. It describes the strategies, procedures and theoretical basics of body-related learning, which can be used to provide therapy with a sound theoretical foundation. Further it supports clinical research by focussing on learning strategies instead of approaches.

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