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E-grāmata: End of Physiotherapy

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(AUT University, Auckland, New Zealand)
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Physiotherapy is arriving at a critical point in its history. Since World War I, physiotherapy has been one of the largest allied health professions and the established provider of orthodox physical rehabilitation. But ageing populations of increasingly chronically ill people, a growing scepticism towards biomedicine and the changing economy of healthcare threaten physiotherapys long-held status. Paradoxically, physiotherapys affinity for treating the body-as-machine has resulted in an almost complete inability to identify the roots of the professions present problems, or define possible ways forward. Physiotherapists need to engage in critically informed theoretical discussion about the professions past, present and future - to explore their practice from economic, philosophical, political and sociological perspectives.

The End of Physiotherapy aims to explain how physiotherapy has arrived at this critical point in its history, and to point to a new future for the profession. The book draws on critical analyses of the historical and social conditions that have made present-day physiotherapy possible. Nicholls examines some of the key discourses that have had a positive impact on the profession in the past, but now threaten to derail it. This book makes it possible for physiotherapists to think otherwise about their profession and their day-to-day practice. It will be essential reading for scholars and students of physiotherapy, interprofessional and community rehabilitation, as well as appealing to those working in medical sociology, the medical humanities, medical history and health care policy.
Acknowledgements xi
Abbreviations xii
PART I
1(118)
1 Introduction
3(16)
The physiotherapy paradox
5(4)
The new economy of healthcare
9(5)
Design and structure of the book
14(3)
Notes
17(1)
References
17(2)
2 Physical therapies before 1894
19(23)
Introduction
19(1)
Ancient physical therapies
20(1)
Physical medicine from the Renaissance
21(4)
A particularly partial history
25(2)
Industrial bodies
27(3)
Women and the physical therapies
30(6)
Closing words
36(1)
Notes
37(1)
References
38(4)
3 The quest for legitimacy (1894--1914)
42(16)
Introduction
42(1)
The Massage Scandals
42(4)
The birth of the STM
46(3)
Courting medical patronage
49(1)
The creation of an examination system
50(2)
The registration of members
52(3)
Closing words
55(1)
Notes
56(1)
References
56(2)
4 The pursuit of orthodoxy (1914--1973)
58(26)
Introduction
58(1)
Serving the State
59(2)
A noble cause
61(5)
Practice innovations and sexual tensions
66(4)
Specialisation, differentiation and polio
70(4)
Welfare State and the creation of a profession
74(4)
Physiotherapy's white heat of technology
78(3)
Notes
81(1)
References
82(2)
5 Physiotherapy under neoliberalism (1973--present)
84(35)
Introduction
84(2)
Healthcare reforms since 1973
86(6)
Physiotherapy since 1973
92(15)
Specialisation and new doctors
92(5)
Clinical practice since 1973
97(10)
Closing words
107(1)
Notes
108(1)
References
109(10)
PART II
119(84)
6 The body
121(23)
Introduction
121(1)
The biomechanical body hiding in physiotherapy
122(1)
The body in Western culture
123(3)
Maintaining the body-as-machine
126(5)
The elusive body
131(2)
New bodies in physiotherapy
133(5)
Bodies in pain
134(2)
Fat bodies
136(1)
Cyborg bodies
137(1)
Closing words
138(2)
Notes
140(1)
References
140(4)
7 Posture and movement
144(25)
Introduction
144(3)
A brief history of posture and movement
147(8)
Defining physiotherapy's approach to posture and movement
155(2)
Posture, movement and physiotherapy
157(7)
Closing words
164(1)
Notes
164(1)
References
165(4)
8 Function and rehabilitation
169(34)
Introduction
169(3)
What are function and rehabilitation?
172(4)
Physiotherapy and the history of rehabilitation
176(7)
The classification of function and disability
183(5)
Function, rehabilitation and physiotherapy
188(5)
Closing words
193(2)
Notes
195(1)
References
196(7)
PART III
203(66)
9 Implications for education, practice, regulation and research
205(38)
Introduction
205(1)
Education
206(9)
Practice
215(5)
Regulation
220(7)
Research
227(4)
Closing words
231(1)
Notes
232(1)
References
233(10)
10 The end of physiotherapy
243(26)
Introduction
243(2)
The changing economy of healthcare
245(2)
The new health workforce
247(2)
Changing boundaries
249(3)
Technological fantasies
252(2)
Emerging opportunities for an `otherwise' profession
254(2)
Moving beyond the present
256(3)
Possibilities for radical change
259(3)
Closing words
262(3)
References
265(4)
Epilogue: Methodology
269(11)
Introduction
269(1)
Key influences
270(6)
A focus on ruptures, discontinuities and contingent history
272(1)
A concern with what discourses do, not what people say they do
273(1)
Power as productive
273(1)
Postmodern, poststructural research
274(1)
Not prescribing an answer
275(1)
Closing words
276(1)
Notes
276(1)
References
276(4)
Glossary of terms 280(2)
Index 282
David A. Nicholls is Associate Professor in the School of Clinical Sciences, Auckland University of Technology, New Zealand.