The impact of therapeutic alliance in physical therapy for chronic musculoskeletal pain: A systematic review of the literature
Abstract
Objective To systematically determine the specific impact of therapeutic alliance (TA) on chronic musculoskeletal pain, identify factors influencing TA between physical therapists and patients with chronic musculoskeletal pain, and determine the working definition of TA across studies. Data Sources: Databases, including PubMed, CINHAL, and Embase, were searched from inception to January 2017. Study Selection: The initial search resulted in 451 papers. After screening, seven studies were identified that examined the role of TA on chronic pain (> 12 weeks) management in physical therapy settings. Data Extraction: Authors extracted data into tables. Risk of bias was assessed using Cochrane Collaboration methodology. Data Synthesis: Three studies examined the influence of a strong TA coupled with physical therapy on pain outcomes. Four studies identified factors that positively and negatively influenced TA. The working definition of TA was identified in each study. Conclusions: Emerging evidence suggests that for individuals participating in physical therapy for chronic musculoskeletal pain, a strong TA may improve pain outcomes. In order to facilitate a strong TA, physical therapists must understand factors that positively and negatively influence the relationship. Studies demonstrate that the definition of TA remains consistent as it transitions to the physical therapy setting.
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A good therapeutic alliance may strengthen the outcomes of various interventional techniques.
“Furthermore, there is evidence that a good therapeutic alliance may strengthen the outcomes of various interventional techniques [130].”
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“Furthermore, there is evidence that a good therapeutic alliance may strengthen the outcomes of various interventional techniques [130].”
Background
- Authors
- Kinney, M., Seider, J., Beaty, A. F., Coughlin, K., Dyal, M., & Clewley, D.
- Affiliations
- Outpatient Physical Therapy Department, BreakThrough Physical Therapy, Wake Forest, NC, USA
- Outpatient Physical Therapy Department, Select Physical Therapy, Arlington, VA, USA
- Duke University Health System (US)
- Outpatient Physical Therapy Department, Back to Work Physical Therapy, Tampa, FL, USA
- Outpatient Physical Therapy Department, Korunda Medical LLC, Naples, FL, USA
- Duke University (US)
- Corresponding author
- Kinney, Meredith
- Venue
- Physiotherapy Theory and Practice
- Publisher
- Informa UK Limited
- Published
- 2018-09-28
- Volume
- 36
- Issue
- 8
- Pages
- 886-898
- ISSN
- 0959-3985 (ISSN-L)
- 1532-5040
- OpenAlex
- W2894436594
- Cited by
- 290
- References
- 39
- Citations by year
- 2026: 40 · 2025: 43 · 2024: 57 · 2023: 50 · 2022: 44 · 2021: 33 · 2020: 16 · 2019: 7
- FWCI
- 2.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Physiotherapy Theory and Practice (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Keywords
- therapeutic relationship, chronic musculoskeletal pain, physiotherapy, pain outcomes
- MeSH terms
- Therapeutic Alliance, Humans, Physical Therapy Modalities, Musculoskeletal Pain
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