Socio-affective characteristics and properties of extrinsic feedback in physiotherapy.
BACKGROUND AND PURPOSE: The usual approach in physiotherapy is to communicate the desired action by means of some combination of verbal instruction and explanation, visual demonstration and manual assistance. Patients' and physiotherapists' communication and acts express socio-affective elements which influence the atmosphere governing this interaction. The purpose of this study was to investigate the socio-affective characteristics of the verbal, visual and manual feedback given to their patients by physiotherapists in the performance of their duties. METHOD: Data were collected by videotaping patient-physiotherapist interaction. Systematic observation was used to depict physiotherapists' and patients' verbal and physical communications. The observation instrument consisted of the categories of verbal communication, physical activities and the socio-affective features of communication. RESULTS: The physiotherapists used verbal and physical guidance more and visual guidance less. In the main, the properties of the feedback given were motivational and reinforcing. Information feedback appeared very seldom. Verbal cues were mostly short comments. The main significance of manual cueing was in the tactile input that was used in orienting patients to produce the correct movement. The most effective way of helping patients to understand the purpose of the action and the sequential organization of the subroutine of the movement was to give a demonstration containing the relevant visual and verbal cues. CONCLUSIONS: The extensive use of verbal and manual guidance found in this study needs to be thought over carefully, especially as physiotherapists seemed to use these techniques more as routine than as a result of careful consideration. The socio-affective atmosphere seems to influence physiotherapists' ways of giving feedback to their patients. Further research is needed to determine the most effective way of arranging guidance strategies for physiotherapists to produce effective feedback.