Patient- and Physical Therapist–Level Predictors of Patient-Reported Therapeutic Alliance: An Observational, Exploratory Study of Cohorts With Knee and Low Back Pain

Beneciuk, Jason M.; Brown‐Taylor, Lindsey; Alodaibi, Faris; Kareha, Stephen; Holmes, Rett; Fritz, Julie M.

doi:10.1016/j.apmr.2021.05.018

Cited by 5 publications

(6 citation statements)

References 52 publications

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“…Twenty-two of the 75 included studies comprised qualitative research designs (12 patient perspective31 41–51; 5 physiotherapist perspective52–56; 5 mixed perspectives57–61), followed by quantitative designs (n=15) (longitudinal cohort studies n=11,22 62–71 secondary analysis of RCTs n=472–75), RCTs (n=15),76–90 systematic reviews (n=15),21 32 47 91–102 mixed methods (n=3),30 103 104 commentary (n=2),105 106 case reports (n=2)107 108 and narrative reviews (n=1) 109. See online supplement 4) for details of included studies and their quality appraisal.…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-two of the 75 included studies comprised qualitative research designs [12 patient perspective;(31,41-51) 5 physiotherapist perspective;(52-56) 5 mixed perspectives (57-61)], followed by quantitative designs (n=15) [longitudinal cohort studies n=11, (22,(62)(63)(64)(65)(66)(67)(68)(69)(70)(71) secondary analysis of randomised controlled trials n=4 (72-75)), randomised controlled trials (n=15) (76)(77)(78)(79)(80)(81)(82)(83)(84)(85)(86)(87)(88)(89)(90), systematic reviews (n=15) (21,32,47,(91)(92)(93)(94)(95)(96)(97)(98)(99)(100)(101)(102), mixed methods (n=3) (30,103,104), commentary (n=2) (105,106), case reports (n=2) (107,…”

Section: Included Studiesmentioning

confidence: 99%

“…When the clinician and patient develop a positive therapeutic relationship built on trust (C) this leads to collaboration (M) which allows the patient to feel supported (O) (43,54,69)…”

Section: Feeling Of Supportmentioning

confidence: 99%

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Contexts, behavioural mechanisms and outcomes to optimise therapeutic exercise prescription for persistent low back pain: a realist review

Wood,

Foster,

Dean

et al. 2024

Br J Sports Med

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ObjectiveTherapeutic exercises are a core treatment for low back pain (LBP), but it is uncertain how rehabilitative exercise facilitates change in outcomes. Realist reviews explore how the context (C) of certain settings or populations and underlying mechanisms (M) create intended or unintended outcomes (O). Our objective was to explore and understand the behavioural mechanisms by which therapeutic exercise creates change in outcomes of adherence, engagement and clinical outcomes for patients with LBP.MethodsThis was a realist review reported following the Realist and Meta-narrative Evidence Syntheses: Evolving Standards guidance. We developed initial programme theories, modified with input from a steering group (experts, n=5), stakeholder group (patients and clinicians, n=10) and a scoping search of the published literature (n=37). Subsequently, an information specialist designed and undertook an iterative search strategy, and we refined and tested CMO configurations.ResultsOf 522 initial papers identified, 75 papers were included to modify and test CMO configurations. We found that the patient–clinician therapeutic consultation builds a foundation of trust and was associated with improved adherence, engagement and clinical outcomes, and that individualised exercise prescription increases motivation to adhere to exercise and thus also impacts clinical outcomes. Provision of support such as timely follow-up and supervision can further facilitate motivation and confidence to improve adherence to therapeutic exercises for LBP.ConclusionsEngagement in and adherence to therapeutic exercises for LBP, as well as clinical outcomes, may be optimised using mechanisms of trust, motivation and confidence. These CMO configurations provide a deeper understanding of ways to optimise exercise prescription for patients with LBP.

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Section: Resultsmentioning

confidence: 99%

Section: Included Studiesmentioning

confidence: 99%

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Contexts, behavioural mechanisms and outcomes to optimise therapeutic exercise prescription for persistent low back pain: a realist review

Wood,

Foster,

Dean

et al. 2024

Br J Sports Med

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“…PTs appear to form a strong therapeutic alliance with their patients with musculoskeletal conditions. 28,29 This strong therapeutic alliance may suggest that the physical therapy setting is an ideal setting with which to address opioid misuse. An additional explanation is that media coverage 30-32 about the opioid crises in the United States could have made physical therapy patients generally aware that using prescription opioids in ways other than prescribed can lead to undesirable outcomes such as opioid use disorder, opioid overdose, and death.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Patients’ Perceptions of Physical Therapists Addressing Opioid Misuse

et al. 2023

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Introduction: In the US, rising numbers of patients who misuse illicit or prescribed opioids provides opportunities for physical therapists (PTs) to be engaged in their care. Prior to this engagement, it is necessary to understand the perceptions of patients who access physical therapy services about their PTs playing such a role. This project examined patients’ perceptions of PTs addressing opioid misuse. Methods: We surveyed patients, newly encountering outpatient physical therapy services in a large University-based healthcare setting, via anonymous, web-based survey. Within the survey, questions were rated on a Likert scale (1 = completely disagree to 7 = completely agree) and we evaluated responses of patients who were prescribed opioids versus those who were not. Results: Among 839 respondents, the highest mean score was 6.2 (SD = 1.5) for “It is OK for physical therapists to refer their patients with prescription opioid misuse to a specialist to address the opioid misuse.” The lowest mean score was 5.6 (SD = 1.9) for “It is OK for physical therapists to ask their patient why they are misusing prescription opioids.” Compared to those with no prescription opioid exposure while attending physical therapy, patients with prescription opioid exposure had lower agreement that it was OK for the physical therapist to refer their patients with opioid misuse to a specialist (β = −.33, 95% CI = −0.63 to −0.03). Conclusions: Patients attending outpatient physical therapy seem to support PTs addressing opioid misuse and there are differences in support based on whether the patients had exposure to opioids.

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Outcomes of Telehealth Physical Therapy Provided Using Real-Time, Videoconferencing for Patients With Chronic Low Back Pain: A Longitudinal Observational Study

Fritz¹,

Minick²,

Brennan³

et al. 2022

Archives of Physical Medicine and Rehabilitation

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Patient- and Physical Therapist–Level Predictors of Patient-Reported Therapeutic Alliance: An Observational, Exploratory Study of Cohorts With Knee and Low Back Pain

Cited by 5 publications

References 52 publications

Contexts, behavioural mechanisms and outcomes to optimise therapeutic exercise prescription for persistent low back pain: a realist review

Contexts, behavioural mechanisms and outcomes to optimise therapeutic exercise prescription for persistent low back pain: a realist review

Patients’ Perceptions of Physical Therapists Addressing Opioid Misuse

Outcomes of Telehealth Physical Therapy Provided Using Real-Time, Videoconferencing for Patients With Chronic Low Back Pain: A Longitudinal Observational Study

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