Physical Therapists' Use of Psychological Skills Training in Rehabilitation Following Traumatic Knee Injury: An Online Survey Study.

Background: Rehabilitation following traumatic knee injury often focuses primarily on physical aspects. Lack of knowledge of psychological factors and appropriate strategies may be a barrier to meeting treatment recommendations to address these factors.

Purpose: The aim of this study was to investigate whether, and to what extent, Scandinavian physical therapists address psychological factors in treatment of physically active people with traumatic knee injury.

Study design: Cross-sectional online survey study.

Methods: This 32-item study-specific online survey examined physical therapists' use of goal-setting, imagery, and arousal regulation to address psychological factors during rehabilitation following traumatic knee injury.

Results: Results from n=143 physical therapists indicate that they consider it very important to use goal-setting (median 4 [IQR 1]), imagery (median 4 [IQR 1]), and stress management (median 4 [IQR 1]) during rehabilitation on a scale of 1 (lowest) to 5 (highest). Goal-setting was used by n=143 (100%); imagery by n=67 (47%), and arousal regulation by 76 (53%). Lack of knowledge was the most commonly cited reason for not using imagery (n=61; 43%) and arousal regulation (n=55; 38%). Participants rated workshops, courses, or formal education as the most useful methods of learning to use psychological skills training in clinical work.

Conclusion: Goal-setting is commonly used by Scandinavian physical therapists. However, only approximately half of participants report using imagery and/or arousal regulation in knee injury rehabilitation. This may indicate that best-evidence recommendations for treatment are not being met. Future research should explore methods for providing education and practical strategies for encouraging clinical use of psychological interventions.

Level of evidence: 3.