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Physiotherapy Touch Types & Informed Consent

Common Types of Touch Used by Physiotherapists

  • Assistive Touch (AI)

    • Defined as touch used to physically aid a patient.
    • Examples:
    • Guiding a specific movement (active assistive range of motion)
    • Guarding during ambulation
    • Assisting during transfers and positioning

  • Touch to Provide Information (PRO)

    • Used for communication between physiotherapists and patients.
    • Examples of activities:
    • Exercise instruction
    • Transfer training
    • Aids in patient positioning and attention-seeking.

  • Caring Touch (CAR)

    • Designed to comfort and encourage patients; express empathy and support.
    • Common forms:
    • Pat or tap on the shoulder, arm, or back.
    • Used during or after exercises or therapeutic tasks.

  • Perceiving Information (PER)

    • Touch used to gain diagnostic or symptom-related information.
    • Activities include:
    • Taking vital signs
    • Performing palpation or manual muscle tests.

  • Therapeutic Intervention (TI)

    • Touch oriented toward direct, manual treatment approaches.
    • Includes:
    • Massage
    • Joint mobilization
    • Positioning techniques
    • Use of thermal agents
    • Muscle facilitation techniques
    • Stretching.

  • Preparation Touch (PREP)

    • Non-therapeutic touch meant to ready patients for therapy.
    • Activities include:
    • Donning slippers
    • Draping the patient.
    • Often used to minimize delay before therapy sessions.

  • Security Touch (SEC)

    • Provides safety or reassurance for patients.
    • May not always be physically necessary but instills confidence.
    • Often used in combination with assistive touch during transfers and ambulation.

  • Building Rapport (RAP)

    • Focuses on establishing interpersonal relationships.
    • Characterized by gentle touches on various body parts.
    • Helps physiotherapists gauge patient comfort with touch.

Multiple Intent Use of Touch

  • Physiotherapists reported 33 types of touch combining multiple intents, leveraging two or more single intent categories.
  • Only those multiple intent categories recognized by five or more physiotherapists and occurring more than 10 times are considered in detail.

Informed Consent Process

  1. Explain the procedure clearly.
  2. Discuss the benefits and risks involved.
  3. Present alternatives available.
  4. Verify understanding with: "Do you understand what I have said to you?"
  5. Encourage questions: "Do you have any questions?"
  6. Confirm willingness to proceed: "Are you happy to proceed?"