Factors of subjective assessment of the effectiveness of physiotherapy: a study on patients with degenerative disease of the spine

Background
Successful physiotherapy depends on many factors, including the conditions associated with the disease, the process of physiotherapy, and psychological variables, as these are known to have a strong influence on the motivation of the patient to continue treatment.

Objectives
To evaluate the role of depression symptoms, acceptance of illness, and level of pain for the assessment of the effectiveness of physiotherapy.

Material and methods
The study involved 83 patients (31 men and 52 women) who had received physical therapy as outpatients. The mean age of the study population was 45.63 years (SD = 12.94). The patients completed a set of self-reporting questionnaires: questionnaire with demographic information, Acceptance of Illness Scale, The Center for Epidemiologic Studies Depression Scale, and the Visual-Analogue Scale.

Results
The majority of respondents (42.2%) reported no improvement associated with treatment, even though the level of pain experienced after treatment was significantly lower than before. Regression analysis showed that the effectiveness of treatment was explained in 63% of cases by the severity of depression symptoms, the level of acceptance of illness, severity of pain after physiotherapy, and the level of pain before treatment.

Conclusions
Depression symptoms can greatly delay the process of physiotherapy and determine the evaluation of its effectiveness. Acceptance of illness and pain result in a more positive assessment of the treatments. Collaboration between a physiotherapist and a psychologist in recognizing the symptoms of depression and providing support in dealing with them, and fostering the development of a positive attitude towards the disease, can positively influence the efficiency of physiotherapy.