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A qualitative investigation into the variables which affect the physiotherapy group treatment sessions in the rheumatology unit


Intensive physiotherapy rehabilitation is reported to improve the physical outcomes of children with rheumatological conditions. These treatments are provided as group therapies and different communication techniques are vital in assuring the effectiveness of the group.

Materials and methods

Observational analysis was conducted within daily group treatments over a 4 week period. Frequency of verbal and non-verbal communications between physiotherapists and patients were recorded for two stages; the introductory rehabilitation session and the consecutive sessions. Semi-structured interviews were undertaken with the therapists to determine their views of important communication strategies.


A number of themes emerged as significant factors in influencing the children in the groups. These included touch, facial expressions, emotional distraction (such as humour), thought distraction (such as no mention of pain) and group distraction (talking with the other children). Respect for the therapists was common as well as response to change of voice, tone and volume and eye contact. These factors influenced behaviour including adherence, confidence, responsibility, reluctance and compliance. Patient engagement, empowerment and peer encouragement were also important factors. The therapists were aware that distraction techniques, facial expressions and tone of voice were important in order to ensure the group was cohesive and effective.


Group treatments are an effective way of providing physiotherapy and offer many unique benefits that one to one therapy cannot offer. They should be considered when developing a physiotherapy service for rheumatology.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Sian, S., Mato, H., Pearce, L. et al. A qualitative investigation into the variables which affect the physiotherapy group treatment sessions in the rheumatology unit. Pediatr Rheumatol 6 (Suppl 1), P165 (2008).

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