The suitability and utility of the pain and movement reasoning model for physiotherapy: A qualitative study

ABSTRACT

Introduction

The Pain and Movement Reasoning Model is a tool to assist clinical reasoning. It was created for physiotherapists to use in musculoskeletal outpatient clinics but may be appropriate in other clinical contexts. The Model has also been used in physiotherapy education.

Objective

To determine physiotherapists' perceptions of the appropriateness (suitability) and benefit (utility) of the Pain and Movement Reasoning Model across clinical contexts in hospital and community practice. Methods Physiotherapists from two health networks in Melbourne, Australia, received training in using the Model and over 4-6 weeks applied it in their clinical interactions. Drawing on a deductive phenomenological approach, transcripts from focus groups and interviews were analysed to determine the suitability and utility of the Model across clinical areas.

Results

Twenty-nine physiotherapists from 12 different clinical areas participated. Two themes represented the participants' comments: Suitability for Practice and Utility in Practice. Participants reported the approach to clinical reasoning, promoted by the Model, aligned with existing physiotherapy practice. Enhancements to practice included more comprehensive assessment, selection of broader management techniques and increased confidence with reasoning and explaining the complexity of pain to patients. Participants described using the Model for developing junior staff and training postgraduate students. They also saw potential in adapting the Model for other disciplines and for other multifactorial conditions.

Conclusion

Physiotherapists working in a range of clinical contexts considered the Pain and Movement Reasoning Model appropriate and beneficial in clinical practice and in teaching. Further evaluation of the Model in wider settings is warranted.

KEYWORDS:

• Pain science
• education
• clinical reasoning
• physiotherapy
• psychologically informed

Notes*participant numbers in focus groups ranged from 2 to 5

Acknowledgments

We are grateful to Professor Rhonda Small and Ilka Barr for their assistance with planning of the study, management and staff at the two health networks included in the study and Des O’Shaughnessy, co-creator of Pain and Movement Reasoning Model. Funding was provided by the Social Research Assistance Platform at La Trobe University.

Declaration of interest

Lester Jones is the co-creator of the Pain and Movement Reasoning Model. The other authors declare no conflict of interest.