Coming to Terms with the Limited Body: The Role of Physical Therapy in Improving Self-esteem of Stroke Survivors in Salvador-Bahia, Brazil

Objective: The aim of this study is to explore the role of the physical therapy offered by public health sectors in Salvador in improving stroke survivors’ self-esteem. This study also intends identify components of physical therapy that contribute most to patients’ perceived recovery. Methods: Participant observation was conducted at Clinica da Fisioterapia in Escola Bahiana de Medicina e Saúde Púlica. Interviews were conducted with 4 professionals and 7 patients, of which 3 professionals and 6 patients are affiliated to Escola Bahiana. The patients participated in this study were also asked to evaluate their self-esteem via a questionnaire adapted from Rosenberg self-esteem scale. Results: Patients in this study were self-conscious about their physical disabilities, yet it did not affect the overall evaluation of their characteristics and qualities. The level of self-esteem indicated by patients’ responses to the questionnaires indicates that this group of patients were able to adjust to their bodily changes and integrate them into their self-perception. Based on the interviews with professionals and patients, both the instrumental and affectionate components of the physical therapy treatment are considered as important contributors for patients’ acceptance of their disabled bodies, leading to improved self-esteem. Conclusion: Depending on the different life experiences and recovery level of the patients, instrumental and affectionate components of physical therapy treatment are effective in different ways. For patients who are responding well to the techniques and could visually perceive their physical improvement by mastering important tasks, they are more inclined to value instrumental component. On the other hand, patients who are at the initial stage of recovery or have difficulty in doing exercises tend to value the affectionate component. Nonetheless, physical therapy helps patients rebuild the connection between their body and self, and lead to an improvement of self-esteem