The ability of physiotherapists to identify psychosocial factors in patients with musculoskeletal pain: A scoping review

Musculoskeletal Care. 2023 Jun;21(2):502-515. doi: 10.1002/msc.1725. Epub 2022 Dec 23.

Abstract

Background: It is not known how well physiotherapists identify psychosocial factors in people with musculoskeletal pain, when using clinical judgement. The purpose of this scoping review was to examine the research related to physiotherapist ability in identifying psychosocial factors and to subsequently identify gaps in the literature to help direct future research.

Data sources: Searches using relevant key words, were conducted of Medline, Cinahl, the Cochrane Library, PEDro, PubMed, Scopus and Google Scholar. All primary quantitative and qualitative research from the year 2000 onwards, which met the search criteria, were included.

Data extraction and synthesis: A data extraction tool was used to tabulate data regarding demographics, study design and key findings of the included papers. The Mixed Methods Appraisals Tool (MMAT) was utilised to help examine the quality of included studies.

Results: Overall, the quality of the included studies was moderate. The total number of studies which met the inclusion criteria was relatively small (n = 20). The most common method for determining ability was comparison of physiotherapist estimations with validated screening tools or questionnaires. Physiotherapist estimates of psychosocial factors were poor and in the qualitative research, the lack of clinician confidence in psychosocial assessment was evident.

Conclusion: The available research suggests that physiotherapists lack confidence and ability in identifying psychosocial factors. More rigorous, mixed-methods research is warranted to capture the complexity of the research question.

Keywords: physiotherapy; psychosocial; scoping review; yellow flag.

Publication types

  • Review

MeSH terms

  • Humans
  • Musculoskeletal Pain* / diagnosis
  • Physical Therapists*
  • Surveys and Questionnaires