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

Abstract

Background The 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. Objectives The 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. Methods The 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. Results Of 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. Conclusion 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.