The role of patient treatment specific expectations on the outcomes of musculoskeletal physical therapy treatment: A scoping review

BackgroundIt is unknown how well patient treatment expectations are related to outcomes within musculoskeletal physical therapy. The purpose of this scoping review was to examine the association between patient treatment expectations and outcomes following physical therapy care for musculoskeletal injury and to identify gaps in the literature on this topic.Data SourcesPubMed, CINAHL Complete, PEDro, SPORTDiscus, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and PsycINFO were searched from January 2005. Concepts represented in the search included physical therapy, patient expectations, and patient outcomes, as well as their relevant synonyms.Data Extraction and SummaryA custom spreadsheet was used to chart demographic details, study design, and key findings from eligible studies. The critical appraisal skills programme (CASP) for cohort studies was used to determine reporting comprehensiveness and fit for inclusion into the review.ResultsTwelve (12) studies were included in this review representing 1855 patients across a variety of patients with musculoskeletal disorders. Studies were most commonly secondary analyses of controlled trials (n = 10) or controlled trials (n = 2) and yielded high CASP scores. A wide range of methods were used to determine patient expectations. The impact of patient treatment expectations was mixed, with some studies indicating a positive relationship between expectation fulfilment and improved outcomes, while others indicate no such relationship.ConclusionThe relationship between treatment expectations and outcomes within musculoskeletal physical therapy practice is not clear. Future studies with planned comparisons are needed to define appropriate methods to seek patient expectations and measure outcome differences between groups based on expectation fulfilment.