Rehabilitation or Leisure? Physical Exercise in the Practice of Physiotherapy with Young Persons with Profound Intellectual and Multiple Disabilities

During ethnographical fieldwork for a study concerning the opportunities of young people with profound intellectual and multiple disabilities (PIMD) to have sports and physical exercise as leisure, we recognized that the practice of medical physiotherapy is essential to enhancing their physical wellbeing. In this article we ask how that practice relates to their rights to physical exercise, and tackle the question empirically by analyzing interviews of physiotherapists with critical discourse analysis. Our analysis shows that medical reasoning dominates the practice of medical physiotherapy, but discourses based on rights, such as that underlining participation, are ascendant in this field of disability services, providing people with PIMD stronger agency than those relying on medical knowledge and expertise. These results indicate that the medical paradigm in understanding disability is still powerful, but that emphasizing equality in disability legislation and policies contributes to aims to improve opportunities for participation of people with disabilities.