Implementation of Motivational Interviewing in Physiotherapy Intervention for Patients with Musculoskeletal Conditions

Background

Musculoskeletal (MSK) conditions are complex and affect many individuals across the UK. While physiotherapists have increasingly adopted person-centred approaches, there remains a lack of clear strategies for implementing behaviour change in practice. As a result, adherence among patients with MSK conditions (pwMSK) is often poor. Motivational Interviewing (MI), effective in areas like substance misuse and education, has not been widely explored in MSK physiotherapy. This study aimed to develop and pilot an adapted MI training curriculum for physiotherapists working with pwMSK, with a view to future refinement.

Method

The research was conducted in three stages. Study one systematically reviewed existing literature on MI in MSK physiotherapy, assessing the evidence base and fidelity to MI. Study two used a mixed methods service evaluation to explore current physiotherapy practices and patient perspectives, informing the development of a tailored MI training curriculum. Study three piloted this curriculum in a two-part mixed methods feasibility study, evaluating its implementation and impact.

Findings

Although some studies support MI’s effectiveness in MSK physiotherapy, many lack fidelity and transparency in training quality. Study two revealed that physiotherapists were not proficient in MI but valued person-centred care and were eager to learn. PwMSK highlighted the importance of listening, partnership, and professionalism. Study three showed that delivering quality MI training was feasible, leading to improved MI adherence among physiotherapists. Both patients and clinicians found MI valuable and implementable with appropriate support.

Conclusion

An optimised MI curriculum is feasible and enhances physiotherapists’ adherence to MI. A larger-scale cluster pre-post randomised controlled trial is recommended to establish the impact of MI training on patient health. Training should include reflective practice, a focus on relational elements and be tailored to clinical contexts. Pre-and-post-registration education programmes should align with MI philosophy. Long-term implementation strategies and patient involvement are essential for future research and practice.