Physical therapist-delivered motivational interviewing and health-related behaviour change: A systematic review and meta-analysis

Background: Motivational interviewing (MI) promotes health-related behaviour change and improves patient health outcomes, but the effect of physical therapist-delivered MI is unclear.

Objective: To evaluate the effect of physical therapist-delivered MI on health-related behaviour change in adults attending physical therapy or rehabilitation.

Methods: CINAHL, Medline, PubMed, PEDro, Embase, and Cochrane databases were searched in August 2023. Randomised controlled trials evaluating physical therapist-delivered MI and health-related behaviour change were included. Internal validity was evaluated using the PEDro scale. GRADE approach was used for each meta-analysis.

Results: Ten publications from nine randomised controlled trials involving 909 participants were included. Physical therapist-delivered MI likely increased physical activity slightly (SMD 0.21, 95 % CI -0.05, 0.47) when compared to minimal intervention; however the evidence is very uncertain in relation to self-efficacy (SMD 0.51, 95 % CI -0.35, 1.38) and health-related quality of life (SMD 0.73, 95 % CI -0.64, 2.11). When physical therapist-delivered MI was combined with and compared to rehabilitation, there were no additional effects on physical activity (SMD 0.02, 95 % CI -0.37, 0.41), health-related quality of life (SMD 0.18, 95 % CI -0.27, 0.63), or endurance (SMD 0.15, 95 % CI -0.21, 0.52) and a likely small effect on self-efficacy (SMD 0.23, 95 % CI -0.1, 0.55).

Conclusion: Physical therapist-delivered MI is likely to produce a small improvement in physical activity, but only in the absence of other comprehensive rehabilitation. The most beneficial application of MI may be for patients who are not receiving rehabilitation or who have low levels of motivation and self-efficacy.