Psychomotor Physical Therapy

Original Editor - Oluwabunmi Akinnagbe

Top Contributors - Oluwabunmi Akinnagbe  

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Psychomotor physical therapy is an approach that uses body awareness and physical activities. It is popular in Scandinavian countries and has been established to aid in the relief of pain as well as psychosomatic disorders.[1]Also known as Norwegian Psychomotor Physiotherapy (NPMP). It was formed by Aadel Bülow-Hansen (1906–2001); a physiotherapist and Trygve Braatøy (1904–1953); a psychiatrist in the late 1940s[2].


It is based on the premise that stress resulting from physical, psychological and social situations may have effects on the body. Affecting muscle tension, breathing, posture, flexibility, balance, and movements.[1] During assessment and treatment, all these elements are considered in order to achieve effective management.

No standardized procedure exists for this treatment[4]. This treatment approach combines massage,[5] balance exercises, active exercises, and relaxation to normalize respiration, aid muscular control and awareness of mind-body interaction[2]. The Psychomotor physiotherapist is able to use tools within the theoretical model of this approach in the management of the patient based on a proper assessment[4]. The goal of Norwegian psychomotor physiotherapy is reduction and eventual pain relief.[2]

Evidence has shown improved quality of life within 6months of psychomotor physiotherapy and overall improvement in subjective health complaints such as; depression, insomnia, and fatigue after 12 months[4]. Also, improvement in self esteem, coping behaviours and pain was observed after intervention using NPMP.[6]

The Process[edit | edit source]

Referral[edit | edit source]

This is the foremost step. The referral for treatment is usually by the doctor. Prior to treatment a physical examination, it is necessary to determine whether the pain is chronic and if there's a history or predisposition to any psychotic episodes. [7]

Intervention[edit | edit source]

Assessment[edit | edit source]

Intervention begins with assessment. The psychomotor physiotherapist examines respiration, posture, movements and consistency of muscles. Findings on respiration and movements are considered most important. If notable deviations from ideal body conditions are observed, another type of physiotherapy is advised.[2]

During assessment, the therapist aids the patient in recognising body responses (body awareness) and controlling highlighted responses through discovering appropriate body habits. The patient has to consciously achieve a change in tension pattern. Also, the physiotherapist's attitude (sensitivity, empathy and friendly touch) can help the patient's body adjustment and self-acceptance. [2]

There's a reduction or disappearance of symptoms when inhibition on respiration and movements caused as a result of muscle tension is resolved and there's increased postural stability.[2]

Massage[edit | edit source]

Psychomotor massage is mostly comfortable. A small and short-term pain is inflicted through a small pinch; this is to determine the structures under tension when that pain is felt and also the patient's responses (whether the body is limp and numb or tight). The patient is encouraged to move towards the pain ('mark the pain') and stretch rather than withdrawing from the pain. This is to aid tension release (muscular relaxation) from the body and to help patient gain a sort of hold over the pain (this boosts self confidence). If the small pinch raises patient's anxiety (maybe as a result of prior exposure to violence) it should be omitted. Attention is paid to respiration with short intervals during treatment to allow patient expire ('natural relaxation').[2]

Exercises[edit | edit source]

Identified weakened muscles are stimulated using exercises. Treatment begins in the lower extremities, as it is believed that the lower extremities contribute greatly to posture and an improvement in the lower extremities would influence muscles of the back as well as the neck.[7]

Duration[edit | edit source]

NPMP treatment sessions usually last for one hour consisting of 45 minutes of treatment (includes massage and exercises), ten minutes of rest(intervals during 45 minutes) and five minutes to end the session. Frequency of treatment sessions reduces progressively. The expectation from long-term intervention includes the adjustment in the body becoming less painful and more lasting. [2]

Ultimately, treatment serves as aid to self-help[7]. Care must be taken so that the optimistic atmosphere associated with NPMP does not become exaggerated or unrealistic.[2]

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Clinical Presentation[edit | edit source]

Subjective health complaints[9]: Absence of objective findings to corroborate patient's symptoms[4].

References[edit | edit source]

  1. 1.0 1.1 Dragesund T, Kvåle A. Study protocol for Norwegian Psychomotor Physiotherapy versus Cognitive Patient Education in combination with active individualized physiotherapy in patients with long-lasting musculoskeletal pain–a randomized controlled trial. BMC musculoskeletal disorders. 2016 Dec;17(1):1-9.
  2. 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 Bunkan BH. Psykomotorisk fysioterapi–prinsipper og retningslinjer. Tidsskrift for Den norske legeforening. 2001 Oct 10.
  3. Faggruppen for psykomotorisk fysioterapi . Informational video about Norwegian Psychomotor Physiotherapy. Available from: [last accessed 18/11/2021]
  4. 4.0 4.1 4.2 4.3 Breitve MH, Hynninen MJ, Kvåle A. The effect of psychomotor physical therapy on subjective health complaints and psychological symptoms. Physiotherapy research international. 2010 Dec;15(4):212-21.
  5. Ekerholt K, Bergland A. Massage as interaction and a source of information. Advances in physiotherapy. 2006 Jan 1;8(3):137-44.
  6. Bergland A, Olsen CF, Ekerholt K. The effect of psychomotor physical therapy on health‐related quality of life, pain, coping, self‐esteem, and social support. Physiotherapy Research International. 2018 Oct;23(4):e1723.
  7. 7.0 7.1 7.2 Houge NH. Physiotherapy in certain aspects of psychosomatic medicine. Psychotherapy and psychosomatics. 1979;32(1-4):302-5.
  8. 8.0 8.1 Bergland A, Olsen CF, Ekerholt K. The effect of psychomotor physical therapy on health‐related quality of life, pain, coping, self‐esteem, and social support. Physiotherapy Research International. 2018 Oct;23(4):e1723.
  9. Eriksen HR, Ursin H. Sensitization and subjective health complaints. Scandinavian journal of psychology. 2002 Apr;43(2):189-96.