Download PDF
physioscience 2025; 21(04): 184-185
DOI: 10.1055/a-2608-0392
gelesen und kommentiert

Die Rolle der Erwartungen an die Genesung von Patient*innen für die Ergebnisse physiotherapeutischer Maßnahmen: eine systematische Übersichtsarbeit

Article in several languages: deutsch | English

Authors

    Contributor(s):

  • Lara Güntert

Further Information
Also available at
   Permissions and Reprints

Summary

Background

Recovery expectations are defined as a person’s individual beliefs that a certain future state will come into being regarding a health treatment [1] [2]. Patient recovery expectations can play a crucial role in the success of physical therapist interventions [3] [4] [5]. Prior studies have identified a link between patient expectations and therapy outcomes [4] [6] [7] [8]. The evidence for this is still limited and somewhat contradictory in physical therapy. Previous studies have mainly focused on musculoskeletal disorders [9] [10] [11], while other clinical areas have been studied less extensively [12]. In addition, there are no reliable instruments to measure patient expectations regarding their recovery process [13] [14]. With their paper, Wassinger et al. have filled this gap by providing a systematic review of the relationship between patient expectations and treatment outcomes in physical therapy [15].


Objective

The systematic review by Wassinger et al. examines if and to what degree the outcome of physical therapy treatments is influenced by patient expectations.


Methods

The systematic review, which evaluated 21 studies representing a total of 4,879 patients, included prospective and retrospective cohort studies as well as controlled studies that examined the relationship between patient expectations and treatment outcomes. The review included adults (> 18 years) who had received physical therapy. Interventions from all specialist areas were included (musculoskeletal, neurological, cardiopulmonary, etc.). Expectations of the therapy had to be recorded before and after the interventions, using various assessment tools to record expectations and therapy outcomes. The methods included Likert scales, standardized questionnaires and individual ratings. Tools used to assess treatment outcomes included both subjective patient-reported outcomes (e. g., Oswestry Disability Index) and functional tests (e. g., TUG).

Studies were excluded if they involved underage participants, were case studies or commentaries, did not assess recovery expectations or lacked a physical therapy intervention.

Wassinger et al. conducted a literature search across several databases (PubMed, CINAHL, PEDro, Cochrane, PsycINFO), including studies published up to February 2021. The methodological quality of the included studies was evaluated using the Critical Appraisal Skills Programme. Findings were synthesized narratively, as the heterogeneity of study designs precluded a meta-analysis.


Results

In most of the included studies (16/21), higher recovery expectations were positively correlated with better therapy outcomes. One study, however, reported that greater expectations were associated with a poorer outcome. The study on cardiopulmonary interventions did not reveal significant results. Overall, the majority of studies (18/21) demonstrated high internal validity, suggesting a low risk of bias.

Limitations

Comparability of results was limited by the heterogeneity of study designs. The methodological diversity precluded a meta-analysis, as the data varied too widely. Another limitation is that many of the included studies relied on self-reported patient data, which increases the risk of bias and may reduce the objectivity of findings.



Conclusions

The systematic review by Wassinger et al. demonstrates that patient expectations are an important factor in the success of physical therapy. Although included studies reported varying findings, the overall evidence suggests that patients recovery expectations should be routinely assessed and considered in clinical practice. Physical therapists can record and monitor patient expectations using simple questionnaires. Wassinger et al. even propose a baseline question: “Please indicate your agreement (agree, unknown, disagree) with the following statement: I believe I will recover from my current injury or health condition” [15] . Recovery expectations should be regarded as relevant outcome predictors and incorporated in the clinical history-taking process in physical therapy.

To gain deeper understanding of the relationship between patient expectations and treatment outcomes, future research should address several key aspects. First, standardized assessment tools are needed to capture expectations in a consistent and comparable manner. Second, long-term studies are required to analyze the durability of the effects of expectations on treatment outcomes. Finally, intervention studies should be conducted to test strategies aimed at influencing patient expectations and to systematically evaluate their effectiveness.




Publication History

Article published online:
08 December 2025

© 2025. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany