Deconstructing the Role of the Physical Therapy Profession in Disability Acceptance for People with Stroke.

Abstract

The lowest degree of disability acceptance has been found among people with a history of stroke. Disability acceptance involves adapting to disability-related changes and coming to terms with losses to redefine and live a meaningful new life. Across many movement-related disabilities and chronic conditions, disability acceptance has been positively associated with psychological well-being, social and physical functioning, and adjustment. Further, self-acceptance of disability is an important factor in rehabilitation and recovery. There is a growing need for physical therapy to engage with disability acceptance and understand the role of physical therapists and physical therapist assistants in facilitating disability acceptance after stroke. The purpose of this Perspective article is to critically evaluate the role of the physical therapy profession in disability acceptance for people with stroke. The article first reflects on ways in which the physical therapy profession has historically (and unintentionally) created obstructions to disability acceptance after stroke. The authors discuss assumptions implicitly underpinning physical therapist practices for stroke that are consistent with normalization tendencies, medicalized approaches to disability, and the mechanical body. The authors then present new and alternative approaches that can be applied in physical therapy to better facilitate disability acceptance after stroke, focusing on mindfulness-based interventions and a celebration of unique movement strategies of people with disability (ie, movement "improvisation"). The Perspective concludes with practical strategies for clinicians to employ in an effort to better foster disability acceptance poststroke.

Impact: The physical therapy profession may play an important and unique role in facilitating disability acceptance poststroke. Supporting disability acceptance after stroke requires physical therapists and physical therapist assistants to critically reflect on ways in which the profession may unintentionally impede acceptance and consider new and alternative approaches to promote acceptance in clinical practice.