The literature suggests self-efficacy (SE), outcome expectations (OE), mood and pain are important in physiotherapy adherence. SE and OE have been found to be important in healthcare including physiotherapy. The influences of mood and pain on physiotherapy adherence are less well studied. The aim of this study was to assess the contribution of SE, OE, mood and pain on performance at a simulated physiotherapy task.
A physiotherapy computer simulation required participants to respond at a steady speed over an extended period to achieve virtual recovery. Performance feedback was given in an auditory (loud ‘scream’ whenever a physiotherapy ‘movement’ was performed, that decreased in volume with recovery), visual (on-screen red bar which reduced with recovery) or combined, auditory plus visual form. This manipulation enabled separation of the informative value and aversive components of pain in real therapy (simulated by visual and auditory feedback respectively). Eighty-four student participants completed SE, OE, and mood questionnaires at baseline and five further points.
Results showed that those in the visual condition recovered more than those in the auditory and combined conditions, as a result of the participants in the visual condition more closely following exercise instructions. Regressions showed more positive OE, SE and mood were associated with better adherence.
It was concluded that in this simulation positive mood, aversive feedback and SE and OE were important to performance. This may have implications for patients undergoing physiotherapy in that it may be beneficial to manage early expectations and mood since aversive feedback (e.g. pain) influences performance.