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The physiotherapist role is important in behavioural changes

Published: 12 April 2018

New research at Luleå University of Technology shows that the physiotherapist has a significant role for people with long-term pain in behavioural change to increase their activity. The challenge is to use the physiotherapist's basic knowledge in behavioural science more consciously in the treatments.

– Two of my studies show that the physiotherapist has an important role in behavioural change and giving these people strategies and tools to deal with their pain, said Tommy Calner, who recently defended his thesis in physiotherapy.

Physiotherapist the most important link

In his dissertation he has looked at expectations and experiences of the physiotherapy treatment process.

In evaluating the web-based program, which will support behavioural changes in order to increase activity, the result showed that it did not affect people with long-term musculoskeletal pain in primary care.

– Important to note is that the web application was not used to the extent that was recommended or expected. The web program combined with coaching by a cognitive behavioural therapist and individual physiotherapy, the participants got strategies or new behaviours that helped them handle their pain. According to the participants, the physiotherapist was the most important part, followed by the coach and the lowest value was the web program, says Tommy Calner.

The web program was developed by two psychologists and was in 2010 reworked in collaboration with physiotherapists at Luleå University of Technology. In order to increase the usage rate of the web application, the researcher believes that it needs to be reworked or redesigned together with people who have long-term pain to get the content they need. There is also a great improvement potential regarding flexibility, feedback and interactivity. Even today's technology provides additional opportunities for increased use of the program.

– If you want to use programs like this, you need to do a lot to increase the use, motivate and support the people, and it might can as well be a physiotherapist as a KBT therapist, says Tommy Calner.

Physiotherapists affect behaviour

Movement is important for interaction between individuals as well as between the individual and the environment, which allows the person to handle situations and achieve his or her life goals. Physiotherapy focuses on movement and increased mobility and targets the needs and potential of individuals.

In the studies where expectations and experiences were studied before and after physiotherapy treatment, it was found that the participants appreciated a good communication and dialogue with the physiotherapist, expected to be taken seriously and get tailor-made help and training.

After completion of physiotherapeutic treatment, participants confirmed that they gained knowledge, movements and exercises to deal with their pain, improve their mobility and thereby changing their behaviours and improving their function. They also described the importance of an alliance with the physiotherapist as driving force and motivation throughout the treatment period.

– I think it shows that the physiotherapist has a significant role in influencing behaviors for people with long-term musculoskeletal pain, although we may not consider ourselves deliberately work in that direction. Our role in behavioural changes is more important than physiotherapists believe. For us, the challenge is to use the basic knowledge of behavioural change from the education more active and conscious in our treatments, says Tommy Calner.

Four studies have been carried out in close collaboration with 21 primary care units, both health centers and private physiotherapy units in the region of Norrbotten.