A Systematic Review and Meta-Analysis of the Effectiveness of Psychological Interventions Delivered by Physiotherapists on Pain, Disability and Psychological Outcomes in Musculoskeletal Pain Conditions
Abstract
Objective: This systematic review and meta-analysis examined the effectiveness of physiotherapist delivered psychological interventions combined with physiotherapy on pain, disability, and psychological outcomes for patients with musculoskeletal pain conditions. Methods: The review was conducted in accordance with the (PRISMA) guidelines. Five databases were systematically searched for randomized controlled trials from inception to May 2016. Studies were required to compare a psychological intervention delivered by physiotherapists combined with physiotherapy to physiotherapy alone or usual care. Physiotherapists delivering the interventions must have undergone training by a psychologist or a health professional trained in the delivery of psychological interventions. Results: A total of 34 articles met the eligibility criteria, of those, 30 were suitable for meta-analysis. There was low to high quality evidence that physiotherapist delivered psychological intervention combined with physiotherapy decreased pain in the short (26 studies, mean difference=−0.37; 95% confidence interval [CI], −0.65 to −0.09) and long term (22 studies, mean difference=−0.38; 95% CI, −0.67 to −0.10) and decreased disability in the short term (29 studies, standardized mean difference =−0.14; 95% CI, −0.26 to −0.01). Effect sizes were small. Low to high quality evidence demonstrated small to medium effects for some psychological outcomes at short-term and long-term follow-ups. Discussion: The results indicate that psychological interventions delivered by physiotherapist show promise to improve health outcomes, particularly psychological outcomes, in musculoskeletal pain conditions.
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Several authors have identified that transdisciplinary care may provide opportunities to improve utilisation of all members of an allied health team.
“Several authors have identified that transdisciplinary care (ie, opportunities to deliver different domains of care by allied health professions whose scope of practice overlap) may provide opportunities to improve utilisation of all members of an allied health team.82 120”
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The inclusion of patient-centered communication, such as motivational interviewing, aids in supporting a healthy therapeutic alliance and self-efficacy for change.
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Typical components of PiPT interventions include some combination of education, cognitive-behavioral techniques for addressing coping strategies and responses to pain, and practices that influence psychophysiology such as body awareness and mindful movement.
“Typical components of PiPT interventions include some combination of education, cognitive-behavioral techniques for addressing coping strategies and responses to pain, and practices that influence psychophysiology such as body awareness and mindful movement.31-34”
From Remotely Delivered Psychologically Informed Mindful Movement Physical Therapy for Pain Care: A Framework for Operationalization (2023) · cites this paper as [34]
Challenges to implementation and delivery of PiPT include wide variability in programs with no clear rationale or framework for inclusion or exclusion of specific components.
“Challenges to implementation and delivery of PiPT include wide variability in programs with no clear rationale or framework for inclusion, or exclusion, of specific components.22,31-34”
From Remotely Delivered Psychologically Informed Mindful Movement Physical Therapy for Pain Care: A Framework for Operationalization (2023) · cites this paper as [34]
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- Authors
- Silva Guerrero, A. V., Maujean, A., Campbell, L., & Sterling, M.
- Affiliations
- Menzies Health Institute Queensland, Griffith University, Gold Coast
- Griffith University (AU)
- Corresponding author
- Maujean, Annick
- Campbell, Letitia
- Sterling, Michele
- Venue
- The Clinical Journal of Pain
- Published
- 2018-09
- Volume
- 34
- Issue
- 9
- Pages
- 838-857
- ISSN
- 0749-8047 (ISSN-L)
- OpenAlex
- W2791515116
- Cited by
- 116
- References
- 83
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 19 · 2023: 22 · 2022: 14 · 2021: 21 · 2020: 16 · 2019: 8 · 2018: 3
- FWCI
- 1.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- Griffith Research Online (submittedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Keywords
- musculoskeletal pain, analgesia, disability, psychological outcomes
- MeSH terms
- Disability Evaluation, Humans, Psychotherapy, Randomized Controlled Trials as Topic, Treatment Outcome, Musculoskeletal Pain, Physical Therapists
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