“How we move influence how we feel” Movement awareness in physiotherapy movement interventions addressing musculoskeletal pain: A systematic review of qualitative studies on patients’ experiences

Background: Musculoskeletal pain is one of the main contributors to sick leave and reduced daily-life functioning. The primary role of the physiotherapist is to promote functional movement. Physiotherapy interventions focusing on movement awareness are used to address musculoskeletal pain. Objective: To synthesize the existing knowledge and provide insight into how patients with musculoskeletal pain experience physiotherapy movement interventions that focused on movement awareness. Method: A systematic review of qualitative studies was conducted. Six electronic databases were searched for empirical qualitative studies investigating experiences from patients with musculoskeletal pain on physiotherapy movement interventions focusing on movement awareness. Two researchers independently assessed the identified studies for inclusion. Methodological quality of the included studies was assessed. Meta-ethnography was used to synthesizing the data across the studies and for a second-order interpretation of the original findings. Finally, a lines-of-argument synthesis was conducted. Findings: 1484 unique studies were identified. Eight studies were included, all assessed to have high methodological quality. The studies included a total of 87 participants from both psychiatric and somatic settings. From the movement awareness training, patients experienced new possibilities for their movements and body, and more functional movement habits were integrated in daily life. The new movement strategy led to relief of tension, reduced pain and more vitality. A clearer sense of “the self “was experienced to strengthen them in relating to others. Improved self-efficacy opened for finding more balanced strategies for taking care of both themselves and others. A model was developed illustrating the process of change during treatment. Conclusion: Patients experienced movement awareness training beneficial for improvement on pain and function in daily life. The process of change reflected a salutogenic perspective, involving the whole person in promoting own health and well-being and activating own resources for more functional movement quality.