An exploration of UK student physiotherapists' goal setting practices within anterior cruciate ligament rehabilitation

Abstract

Background Anterior cruciate ligament (ACL) injuries are a common and complex injury coupled with a lengthy rehabilitation. Goal setting is said to be an effective psychological tool within ACL rehabilitation due to its simplicity and is commonly used amongst sport and health professionals. To date, literature surrounding goal setting practices has only focused on qualified therapists. Purpose The central aim of this study was to explore UK student physiotherapists' perceptions towards goal setting practices used in ACL rehabilitation and whether they feel prepared for practice. Method Semi‐structured interviews involving 11 participants from one UK university was conducted using an inductive approach. Data analysis included thematic analysis with triangulation and a comprehensive five‐stage analysis process to enhance confirmability and credibility, whilst respecting ethical considerations. Results/Discussion Participants reported some understanding of goal setting and the importance of involving the patient during this process. However, participants negatively experienced goal setting practices as being mainly therapist/protocol led. The training participants received on goal setting was minimal, but further training was welcomed by all participants. The findings were consistent with previous UK and international research surrounding inadequate education and training across sport and health professionals when applying goal setting practice within ACL rehabilitation. Conclusion These findings suggest that, initially, a review of the psychological content of sport and health professional courses is warranted to clearly identify potential knowledge gaps. There is also an opportunity whereby a global specialist interest group could be designed to share psychological practices and globally connect like‐minded sport and health professionals together.

Goal setting in physiotherapy‐led adult musculoskeletal care: A scoping review

“…Five studies examined the processes and practices of the goal setting conversation (Mullis & Hay, 2010; Pashley et al., 2010; Schoeb, 2009; Schoeb et al., 2014; Åsenlöf et al., 2005b). Three studies related to current training and physiotherapists' perceptions of their skills for goal setting (Alexanders, Chesterton, et al., 2021; Alexanders, Chesterton, et al., 2021; Keogh et al., 2018). Three studies attempted to match individually elicited goals to existing patient‐reported outcome measures (PROMs) (Blackburn & Kaplan, 2019; Soukup & Vøllestad, 2001; Stevens et al., 2017).…”

“…1318 -GAYTON and MONGA Åsenlöf et al, 2004, 2005a, 2005b, 2009). Others referred to operant conditioning (Emilson et al, 2017;Linton et al, 1999;Ostelo et al, 2000;Pool et al, 2006), self-determination theory (Alexanders & Douglas, 2018;Gardner et al, 2018;Keogh et al, 2018) and goal setting theory (Alexanders, Chesterton, et al, 2021;Nicolson et al, 2018;Schoeb et al, 2014). Other…”

“…Undefined Linton et al, 1999;Ostelo et al, 2000;Åsenlof et al, 2005a;Åsenlof et al, 2005b;Pool et al, 2006;Åsenlof et al, 2009;Mannion et al, 2010;Sandborgh et al, 2010;Mullis & Hay, 2010;Schoeb et al, 2014;Schmidt, 2016;Emilson et al, 2017;Christiansen et al, 2018;Gardner et al, 2019;Wolf et al, 2019;Witjes et al, 2019;Gustavsson and von Koch, 2022 Adherence to treatment programme Bassett & Petrie, 1999;Scherzer et al, 2001;Coppack et al, 2012;Nicolson et al, 2018 Behavioural change Keogh et al, 2018;Cederbom et al, 2020Motivational tool Åsenlof et al, 2004Schmidt, 2016;Alexanders, Chesterton, et al, 2021;Alexanders et al, 2021b Treatment targets Soukup & Vøllestad, 2001;Schonstein et al, 2002;Gardner et al, 2016 GAYTON and MONGA -1319…”

“…One of the notable findings of this study is that there is only fleeting consideration given to the various types of goals discussed in the broader literature. This is important as the failure to distinguish between different goal setting approaches may be one reason behind mixed findings in empirical studies (Swann et al, 2021) , 2004;Åsenlof et al, 2005a;Åsenlof et al, 2005b;Åsenlof et al, 2009;Emilson et al, 2017;Gustavsson and von Koch, 2022 Patient-specific complaint instrument Stevens et al, 2017 Patient specific functional scale Gardner et al, 2015;Schmidt, 2016;Gustavsson and von Koch, 2022 Physical activity tracking device Christiansen et al, 2018SMART Mannion et al, 2010Schoeb et al, 2014;Gardner et al, 2015;Gardner et al, 2016;Schmidt, 2016;Gardner et al, 2018;Alexanders et al, 2018;Gardner et al, 2019;Alexanders et al, 2019;Alexanders, Chesterton, et al, 2021;Alexanders et al, 2021b performance and learning goals (Locke & Latham, 2013), consideration of these different goal types is absent from the musculoskeletal literature. The study included by Gardner et al (2018) also highlights that this lack of clarity is common in clinical practice as well as in research.…”

Goal setting practices used within anterior cruciate ligament rehabilitation: An exploration of physiotherapists understanding, training and experiences

“…From a curriculum perspective, undergraduate and postgraduate physiotherapy training is said to be inconsistent across the UK (Alexanders et al, 2020;Heaney et al, 2012). These inconsistencies are associated with insufficient content in certain areas, with limited psychological skill training being the main area of concern (Baddeley & Bithell, 1989;Holopainen et al, 2020).…”