Motivational Interviewing and Physical Exercise

Intro
Physical exercise is a regular challenge that many patients (and OTs like us) struggle with starting or maintaining.

Sometimes it seems like a constant battle to take action and do what we know is right; something our patients struggle with all the time.

The thing is, physical activity is probably the closest thing we have to a magic pill; it's effective with major benefits for a wide range of chronic health conditions; not to mention longevity and thriving.

So how can we help our patients get active when they know it’s something they ‘should’ do but feel stuck?

Today's Paper
O’Halloran, P. D., Blackstock, F., Shields, N., Holland, A., Iles, R., Kingsley, M., ... & Taylor, N. F. (2014). Motivational interviewing to increase physical activity in people with chronic health conditions: a systematic review and meta-analysis. Clinical Rehabilitation, 28(12), 1159-1171.

The Study
Today’s study looks at Motivational Interviewing as a behaviour change strategy to help patients with chronic health issues exercise.

  • Systematic review conducted in accordance with the PRISMA guidelinesand quality assessed using GRADE

  • Included 10 randomized controlled trials (published between 2008-2013)

  • Intervention consisted of between 1-11 individualized sessions, in person or via phone

Each session incorporated at least these 3 characteristics of Motivational Interviewing:

  • A clear focus on behavioural change

  • Empathic and reflective listening

  • Evoking the patient’s internal motivation for change and their own arguments for change


Results

  • Moderate level evidence (GRADE) that Motivational Interviewing increases physical activity levels in people with chronic health conditions, with a small but significant effect observed immediately following the intervention

  • Small to moderate positive effects for people who were overweight, obese, or who had hypertension or hypercholesterolemia, cardiovascular conditions or multiple sclerosis

  • Dose (duration / frequency) of Motivational Interviewing required is unclear, however MI typically requires less contact hours relative to other behavior change strategies

  • No evidence that mode of delivery impacted effect sizes

Summary
Motivational Interviewing is a promising tool for your OT toolbox to help patients increase their physical activity levels with possibly small but immediate effects. 

This still matters because even small increases in physical activity levels for people with chronic health conditions can lead to significant positive impacts on health and disease burden

Motivational Interviewing also seems to have more “bang for buck” compared to other behavioral change strategies: It may require less treatment hours, can be delivered in person or via phone, and is person-centred in nature so has relatively high levels of acceptability among patients.

Key Takeaway
Motivational Interviewing may provide you with a toolset to help your patients motivate themselves to get moving.