Physical therapist characteristics and therapeutic relationship process construct factors that improve patient health outcomes in physical therapy: a systematic review.

Background: It appears that the therapeutic relationship in physiotherapy practice facilitates the success of patient health outcomes, although the process by which it is carried out has been poorly studied.

Objective: To explore the influence of the therapeutic relationship on any patient health outcomes in physical therapy settings.

Methods: PubMed, Web of Science, Scopus, CINAHL, LILACS and Dialnet databases were systematically searched following PRISMA guidelines. The searches were completed in August 2024. Qualitative and quantitative studies measuring the therapeutic relationship and assessing its influence on health outcomes of patients treated with physical therapy were included.

Results: The search yielded a total of 769 results. 13 studies ultimately retained for analysis. A total of 1555 individuals were studied who had suffered injuries such as low back pain; osteoarthritis; underwent cardiac surgery; hip fracture and elite athletes recovering from injuries. The results obtained were classified into three main themes: characteristics and skills of physical therapists (interpersonal, organizational, leadership and communication skills), therapeutic relationship factors (shared decision making, trusting relationships, motivating the patient and individualization of care) and patient health outcomes influenced by therapeutic relationship (functional outcomes, disability, pain intensity, outcome expectations, perceived global effect, adherence, self-efficacy, sports performance and lung function).

Conclusions: Through physical therapist's soft skills, therapeutic relationship factors are built under the paradigm of person-centered care and shared decision making, having a positive influence on certain patient health outcomes. Therefore, evidence support that therapeutic relationship contributes to improved patient health outcomes.