Physical therapist-delivered motivational interviewing and health-related behaviour change: A systematic review and meta-analysis.
Elizabeth Wintle, Nicholas F Taylor, Katherine Harding and 2 others
PMID 39742737WHAT IT FOUND
Adding motivational interviewing to minimal care nudges physical activity up slightly.
But when patients are already in full rehabilitation, it adds little to their activity or endurance, and only a small bump to self-efficacy.
Key findings
01When motivational interviewing was added to minimal care (such as a pamphlet or routine GP visits), physical activity increased slightly compared to minimal care alone (SMD 0.21, 95% CI 0.05 lower to 0.47 higher), rated moderate certainty.
02When motivational interviewing was added to comprehensive rehabilitation, it made no difference to physical activity (SMD 0.02, 95% CI 0.37 lower to 0.41 higher), rated moderate certainty.
03Previous reviews of motivational interviewing in physical therapy included trials where the intervention was delivered by counsellors, researchers, and nurses, with only 3 of 14 trials using a physical therapist.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 9 trials with 909 participants total, so each meta-analysis pooled very few studies and the confidence intervals are wide. Few trials followed patients beyond 12 weeks, so nothing is known about whether any benefit lasts. The strict requirement for validated MI fidelity measures may have excluded trials that delivered MI well but did not report fidelity data. The included trials covered very different populations (COPD, cancer, cardiac, post-surgical, community-dwelling older adults), so the pooled effect blends quite different clinical situations.
Declared interests
The authors declare no conflicts of competing interest.
The easy way to misread this
Do not read the 0.21 effect size as proof that motivational interviewing works. The confidence interval crosses zero (0.05 lower to 0.47 higher), the effect is small, and the same intervention showed no benefit at all when added to full rehabilitation. The finding is that MI adds a little when the patient is getting very little else, not that MI is a treatment that changes outcomes.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →