The primary objective of this rapid review was to identify in which type of physiotherapy contexts SDT is being used. Our secondary objective was to describe in which health conditions SDT-driven physiotherapy was being used and what are the types of SDT interventions more likely to be effective. Identifying this information will lead to the development of more effective SDT-driven physiotherapy interventions.
We followed the Cochrane Rapid Review Methods to synthesize evidence from systematic reviews (SR) and randomized controlled trials (RCTs) on the use of SDT in physiotherapy. We conducted a search using specific MeSH terminology on four databases (i.e., Medline, Cochrane Library (OVID), PsycINFO, Embase) between 1990 and September 17th, 2024. Two reviewers independently screened titles and abstracts, and one reviewer completed the screening of all full text while another independently screened all excluded full text to ensure consensus. Findings were extracted and synthesized narratively following the review objectives. The protocol for this review was registered a priori on the Open Science Framework repository.
Of 184 identified SR or RCT (58 duplicates), we reviewed 126 titles and abstracts, and 44 full texts. Overall, we included 10 studies of which 8 were RCTs and two SRs targeting various health conditions including autism spectrum disorder, cerebral palsy, Huntington's disease, HIV, chronic heart conditions, chronic low back pain, hip and knee replacements, and stress-related disorders. Physiotherapy interventions included strength and aerobic exercise, therapeutic modalities, yoga or tai chi, virtual therapy, coaching, and equine-assisted therapy. SDT interventions included communication training, autonomy supportive feedback, education and goal setting, provision of choices, and intrinsic motivation with the use of virtual reality, robotics, circus-themed games, music, and behaviour change strategies. The included studies mostly assessed the impact of SDT-driven physiotherapy interventions on physical activity levels, and engagement towards physical activity.
Our rapid review suggests that SDT-driven physiotherapy is being used across a broad range of health conditions, using various physiotherapy and SDT principles derived from the theory. Our findings demonstrate the feasibility and acceptability of using SDT-driven physiotherapy interventions that are likely to improve the physical and psychological well-being of people and identified current gaps around measuring its impact on outcomes other than physical activity.
Results from our review suggest that SDT-driven interventions may be used in the development of future efficacy research protocols. Physiotherapists may wish to consider including SDT in their clinical practice, however, further research is needed to assess the effectiveness of SDT-driven physiotherapy on physical function, and participation; and their impact on service delivery and adherence.
Behaviour change
Service delivery
