Goal setting in physiotherapy-led adult musculoskeletal care : a scoping review

Abstract

Introduction: Goal setting is a key part of rehabilitation across various fields of physiotherapy. It is less clear what evidence exists to underpin its effectiveness and to practically guide its use within musculoskeletal physiotherapy. Objectives: This scoping review provides an overview of current research regarding goal setting in adult physiotherapy-led musculoskeletal care with three aims: 1) to identify and analyse any gaps in the literature, 2) to identify relevant features of goal setting theory and 3) to make recommendations for future research. The principal research question was what does the literature tell us about the role of goal setting for adults over the age of 18 with musculoskeletal pain accessing outpatient physiotherapy services? Inclusion criteria: The population, concept and context framework was used to define the inclusion criteria. Key definitions were adults over the age of 18 with musculoskeletal conditions, goal setting, and physiotherapy-led interventions. Methods: This scoping review followed the guidance set out by the Joanna Briggs Institute Manual for Evidence Synthesis. Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature Plus with Full Text, MEDLINE, American Psychological Association PsycInfo and the Cochrane Database of Systematic Reviews, Protocols and Trials were searched using pre-defined search criteria. Data were extracted from screened full-text articles and presented in basic statistical and narrative form. Results: 41 articles were included in the review. Several broad themes and research methods were identified. The nature of the studies suggested that the clinical application of goal setting is complex and the depth of understanding is limited. Most studies suggested that goal setting is feasible and has a positive impact on outcomes. A common finding was a lack of clear definitions regarding goal setting terminology and approaches. Study samples were generally defined by biomedical categories, suggesting a pathoanatomical approach to researching a cognitive construct. Theoretical underpinning was lacking in many studies. No frameworks guiding goal setting in physiotherapy-led musculoskeletal rehabilitation have been identified. Conclusions: Goal setting is a popular tool within musculoskeletal outpatient physiotherapy. Further research is required to clarify its efficacy and provide guidance on its role and application in clinical practice.