Self-determination theory in physiotherapy practice: A rapid review of randomized controlled trials and systematic reviews

BackgroundThe self-determination theory (SDT) is a theory on motivation proposing to support needs of autonomy, competence, and relatedness to improves autonomous motivation, which leads to adherence and compliance. Little is known about how SDT-driven physiotherapy interventions are implemented. PurposeThe objectives of this rapid review were to identify the type of physiotherapy contexts in which SDT is being used and describe how SDT-based physiotherapy interventions are being measured. MethodsThe Cochrane Rapid Review Methods was followed to synthesize evidence from systematic reviews (SR) and randomized controlled trials (RCTs) on the use of SDT-related research in physiotherapy. We conducted a search on four databases between 1990 and September 17th, 2024. Two reviewers independently screened titles and abstracts, one reviewer completed the full-text screening while another screened all excluded full-text to ensure consensus. Findings were synthesized narratively following the review objectives. ResultsOf 184 identified SR or RCT, we included 8 RCTs and 1 SR targeting various health conditions. 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 impact of SDT-driven physiotherapy interventions was most assessed for physical activity levels. ConclusionOur 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.