THE ROLE OF PHYSICAL THERAPIST CHARACTERISTICS AND THERAPEUTIC RELATIONSHIP PROCESSES IN OPTIMIZING PATIENT HEALTH OUTCOMES: A SYSTEMATIC REVIEW

Abstract

Background: The quality of the relationship between physical therapists and their patients has become a key factor in the success of rehabilitation. Although evidence-based treatments are still vital in physical therapy, recent research highlights that the personal qualities of therapists—such as communication skills, empathy, professional knowledge, emotional intelligence, patient-centered care, and shared decision-making—play a major role in influencing patient adherence, satisfaction, pain reduction, functional recovery, and overall quality of life.Recognizing and understanding these qualities and the dynamics of the therapeutic relationship is now seen as essential for improving patient-centered outcomes in rehabilitation.

Objective: This systematic review aims to gather and summarize the existing evidence about the characteristics of physical therapists and the processes of therapeutic relationships that lead to better patient health outcomes in various rehabilitation settings, including musculoskeletal, neurological, cardiopulmonary, pediatric, geriatric, and sports rehabilitation.

Methods: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines.

Relevant studies were found using electronic databases such as PubMed, Scopus, Web of Science, PEDro, CINAHL, and Embase.The studies focused on therapist characteristics, therapeutic alliance, patient-provider communication, trust, empathy, shared decision-making, and patient-centered rehabilitation.The data collected included information about study design, participant details, rehabilitation settings, therapist attributes, therapeutic relationship elements, and reported patient outcomes.

Results: The findings show that therapist empathy, effective communication, interpersonal skills, patient-centered practices, collaborative goal setting, motivational support, and strong therapeutic alliances have a positive impact on patient adherence, satisfaction, improvement in function, reduction in pain, and overall success in rehabilitation.

Strong therapeutic relationships were linked to higher patient involvement, better treatment compliance, less fear-avoidance behavior, increased self-efficacy, and improved long-term functional results across a variety of rehabilitation groups.

Conclusion: The personal qualities of physical therapists are important non-technical factors that affect rehabilitation outcomes.

Incorporating communication training, emotional intelligence, patient-centered care, and the development of therapeutic alliances into professional education and daily practice could greatly enhance patient health outcomes.Future research, including high-quality longitudinal and multi-center studies, is needed to determine the cause-and-effect relationships and develop standardized ways to measure the quality of therapeutic relationships.