Abstract
Chan 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.
Objective
To investigate the impact of physiotherapists' autonomy-supportive behaviors on patients'
motivation and rehabilitation adherence after anterior cruciate ligament (ACL) reconstruction
surgery.
Design
Retrospective study.
Setting
Outpatient orthopedic clinic of a university medical center.
Participants
Postsurgery ACL reconstruction patients (N=115; minimum postsurgery interval, 6mo;
mean ± SD postsurgery interval, 1.77±0.8y).
Interventions
Not applicable.
Main Outcome Measures
Questionnaires 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).
Results
Structural 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 (β=.22, P<.05). Rehabilitation adherence (R2=.28) was predicted positively by autonomous motivation (β=.64, P<.05) and negatively predicted by controlled motivation (β=−.28, P<.05).
Conclusions
These 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.
Key Words
List of Abbreviations:
ACL (anterior cruciate ligament), CFI (comparative fit index), HCCQ (Health Care Climate Questionnaire), RMSEA (root mean squared error of approximation), SDT (self-determination theory), SEM (structural equation modeling), SRMR (standardized root mean square residual), TLI (Tucker-Lewis index), TSRQ (Treatment Self-Regulation Questionnaire)To read this article in full you will need to make a payment
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Article info
Footnotes
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
Reprints are not available from the author.
Identification
Copyright
© 2009 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
