• Arch Phys Med Rehabil · Dec 2009

    Patient motivation and adherence to postsurgery rehabilitation exercise recommendations: the influence of physiotherapists' autonomy-supportive behaviors.

    • Derwin K Chan, Chris Lonsdale, Po Y Ho, Patrick S Yung, and Kai M Chan.
    • Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
    • Arch Phys Med Rehabil. 2009 Dec 1;90(12):1977-82.

    UnlabelledChan DK, Lonsdale C, Ho PY, Yung PS, Chan KM. Patient motivation and adherence to postsurgery rehabilitation exercise recommendations: the influence of physiotherapists' autonomy-supportive behaviors.ObjectiveTo investigate the impact of physiotherapists' autonomy-supportive behaviors on patients' motivation and rehabilitation adherence after anterior cruciate ligament (ACL) reconstruction surgery.DesignRetrospective study.SettingOutpatient orthopedic clinic of a university medical center.ParticipantsPostsurgery ACL reconstruction patients (N=115; minimum postsurgery interval, 6mo; mean +/- SD postsurgery interval, 1.77+/-0.8y).InterventionsNot applicable.Main Outcome MeasuresQuestionnaires measuring autonomy support from physiotherapists (Health Care Climate Questionnaire), treatment motivation (Treatment Self-Regulation Questionnaire), and rehabilitation adherence (adapted from the Sport Injury Rehabilitation Adherence Scale and the Patient Self-Report Scales of Their Home-Based Rehabilitation Adherence).ResultsStructural equation modeling analyses revealed that patients' treatment motivation mediated the relationship between physiotherapists' autonomy-supportive behaviors and rehabilitation adherence. Autonomy-supportive behavior positively predicted autonomous treatment motivation (beta=.22, P<.05). Rehabilitation adherence (R(2)=.28) was predicted positively by autonomous motivation (beta=.64, P<.05) and negatively predicted by controlled motivation (beta=-.28, P<.05).ConclusionsThese preliminary findings are promising and provide an empirical basis for further research to test the efficacy of autonomy support training designed to increase patients' rehabilitation adherence.

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