According to these results, it is important to have various entrances to enhance change and to be aware of how these changes interact and can reinforce each other in order to facilitate the participants' empowerment processes toward a sense of increased living space. Implications for rehabilitation The efforts in MMR should be coordinated to be mutually reinforcing as changes in one area could facilitate in others and thus facilitate the participants' empowerment processes. Participants experience change after MMR in areas that standardized assessment questionnaires do not capture and consequently it would be useful to let the participants answer an open question about perceived changes together with standardized questionnaires.

Background This systematic review aimed to assess the certainty of evidence for digital versus conventional, face-to-face physiotherapy assessment of musculoskeletal disorders, concerning validity, reliability, feasibility, patient satisfaction, physiotherapist satisfaction, adverse events, clinical management, and cost-effectiveness. Methods Eligibility criteria: Original studies comparing digital physiotherapy assessment with face-to-face physiotherapy assessment of musculoskeletal disorders. Systematic database searches were performed in May 2021, and updated in May 2022, in Medline, Cochrane Library, Cinahl, AMED, and PEDro. Risk of bias and applicability of the included studies were appraised using the Quality Assessment of Diagnostic Accuracy Studies-2 tool and the Quality Appraisal of Reliability Studies tool. Included studies were synthesised narratively. Certainty of evidence was evaluated for each assessment component using GRADE. Results Ten repeated-measures studies were included, involving 193 participants aged 23–62 years. Reported validity of digital physiotherapy assessment ranged from moderate/acceptable to almost perfect/excellent for clinical tests, range of motion, patient-reported outcome measures (PROMs), pain, neck posture, and management decisions. Reported validity for assessing spinal posture varied and was for clinical observations unacceptably low. Reported validity and reliability for digital diagnosis ranged from moderate to almost perfect for exact+similar agreement, but was considerably lower when constrained to exact agreement. Reported reliability was excellent for digital assessment of clinical tests, range of motion, pain, neck posture, and PROMs. Certainty of evidence varied from very low to high, with PROMs and pain assessment obtaining the highest certainty. Patients were satisfied with their digital assessment, but did not perceive it as good as face-to-face assessment. Discussion Evidence ranging from very low to high certainty suggests that validity and reliability of digital physiotherapy assessments are acceptable to excellent for several assessment components. Digital physiotherapy assessment may be a viable alternative to face-to-face assessment for patients who are likely to benefit from the accessibility and convenience of remote access. Trial registration The review was registered in the PROSPERO database, CRD42021277624.

Background: The purpose of this study was to describe how patients with persistent pain experience physiotherapist-guided Free Movement Dance (FMD) as a physiotherapy intervention. Methods: Individual interviews were conducted with 20 patients who had participated in FMD for 1-6 semesters with different guiding physiotherapists. The interviews were transcribed and analysed using qualitative content analysis with an inductive approach as described by Graneheim and Lundman. Results: The analysis resulted in one overarching theme-Physiotherapist-guided Free Movement Dance is empowering in everyday living-and five subthemes: Breaking unhealthy patterns generates physical confidence and strength, Developing greater understanding of the body signals, Accepting pain is important but challenging, Taking responsibility for myself and my well-being and Feeling calmer and happier in life. Conclusions: FMD was experienced as a physiotherapy intervention that enabled the patients to develop an awareness of their own movement, and also leading to the feeling of being empowered in everyday living. FMD can be seen to be in concordance with the core values of physiotherapy that individuals have the capacity to change as a result of their responses to physical, psychological, social and environmental factors.