Computerised Tailored Intervention Guide to Support Physiotherapists work with their Patients to Improve Pain and Function Related Health Outcomes

This project is developing a new tool to help physiotherapists treating people with musculoskeletal problems. The tool will help integrate patient beliefs and expectations into their individualised treatment and management.

The tool will be based on an algorithm. Patients will complete an online questionnaire about their beliefs, expectations and preferences for treatment. This will help the physiotherapist and patient tailor treatment and self-management to the patient’s needs.

M-TIG Project

For people with musculoskeletal problems, there is strong evidence that exercises, and advice on self-management, provided by physiotherapists, can be effective for reducing pain and improving function.

Four key factors that strongly influence the outcomes of people receiving physiotherapy for the management of musculoskeletal pain are:

  1. Adherence to exercises
  2. Physiotherapist confidence in addressing patient beliefs and expectations
  3. Pain self-efficacy
  4. Quality of the therapeutic alliance.

Many people do not adhere to their exercises with the agreed frequency and duration.

Physiotherapists base their advice and exercises on “biomechanical” principles. However, enabling and supporting patients with self-management and exercise requires interventions that consider more holistic factors. These are an important component of person-centred care.

Behaviour Change Techniques (BCTs) such as for example, goal setting, prompts and cues could be used by physiotherapists to support patients self-manage and improve their home exercise adherence. However these need to be appropriately selected and customised to the individual patient.

We will develop a “Behaviour Change Support Tool”. Our aim is to provide physiotherapists with real time support to assess and address these four key factors.

During the development stage we will:

1.            Identify barriers and facilitators to physiotherapists delivering person-centered care             

2.            Identify barriers and facilitators to the four key areas associated with outcome:      

  • Adherence to exercises
  • Physiotherapist confidence in addressing patient beliefs and expectations
  • Pain self-efficacy
  • Quality of the therapeutic alliance.

3.            Identify the key questions to be included in a behavioural diagnosis questionnaire,

4.            Develop the intervention guide which will signpost physiotherapists to the appropriate BCTs,

5.            Develop additional components, such as tailored advice reports

6.            Identify the outcome and process measures for future studies of effectiveness

We invite patients, the public, health professionals and stakeholders to be involved.

If you are interested please contact Rachel Chester or Helena Daniell