Patient motivation and adherence to postsurgery rehabilitation exercise recommendations: The influence of physiotherapists' autonomy-supportive behaviors

Publication Date



Objective: To investigate the impact of physiotherapists' autonomy-supportive behaviors on patients' motivation and rehabilitation adherence after anterior cruciate ligament (ACL) reconstruction surgery. Design: Retrospective study. Setting: Outpatient orthopedic clinic of a university medical center. Participants: Postsurgery ACL reconstruction patients (N=115; minimum postsurgery interval, 6mo; mean ± SD postsurgery interval, 1.77±0.8y). Interventions: Not applicable. Main Outcome Measures: Questionnaires measuring autonomy support from physiotherapists (Health Care Climate Questionnaire), treatment motivation (Treatment Self-Regulation Questionnaire), and rehabilitation adherence (adapted from the Sport Injury Rehabilitation Adherence Scale and the Patient Self-Report Scales of Their Home-Based Rehabilitation Adherence). Results: Structural equation modeling analyses revealed that patients' treatment motivation mediated the relationship between physiotherapists' autonomy-supportive behaviors and rehabilitation adherence. Autonomy-supportive behavior positively predicted autonomous treatment motivation (β=.22, P < .05). Rehabilitation adherence (R2=.28) was predicted positively by autonomous motivation (β=.64, P < .05) and negatively predicted by controlled motivation (β=−.28, P < .05). Conclusions: These preliminary findings are promising and provide an empirical basis for further research to test the efficacy of autonomy support training designed to increase patients' rehabilitation adherence.


Institute for Positive Psychology and Education

Document Type

Journal Article

Access Rights

ERA Access

This document is currently not available here.