Table 3.
Summary of findings and certainty of evidence GRADE.
| Effect of physical therapist-delivered MI with minimal intervention vs. minimal intervention alone | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Certainty assessment |
№ of patients |
Effect |
Certainty | Comments | |||||||||
| № of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | Intervention | Control | Absolute (95 % CI) |
||||
| Physical activity | |||||||||||||
| 3 | randomised trials | not serious | not serious | not serious | seriousa | noneb | 114 | 122 | SMD 0.21 SD higher (0.05 lower to 0.47 higher) |
⨁⨁⨁◯ Moderate |
Physical therapist-delivered MI likely increases physical activity slightly when combined with and compared to minimal intervention | ||
| Self efficacy | |||||||||||||
| 2 | randomised trials | not serious | seriousc | not serious | very seriousd | noneb | 50 | 45 | SMD 0.51 SD higher (0.35 lower to 1.38 higher) |
⨁◯◯◯ Very low |
Physical therapist-delivered MI may increase self-efficacy when combined with and compared to minimal intervention but the evidence is very uncertain | ||
| Health related QoL | |||||||||||||
| 2 | randomised trials | not serious | seriousc | not serious | very seriousd | noneb | 50 | 45 | SMD 0.73 SD higher (0.64 lower to 2.11 higher) |
⨁◯◯◯ Very low |
Physical therapist-delivered MI may increase health-related quality of life when combined with and compared to minimal intervention but the evidence is very uncertain | ||
| Effect of physical therapist-delivered MI and comprehensive rehabilitation vs. comprehensive rehabilitation alone | |||||||||||||
| Physical activity | |||||||||||||
| 3 | randomised trials | not serious | not serious | not serious | seriousa | noneb | 50 | 53 | SMD 0.02 SD higher (0.37 lower to 0.41 higher) |
⨁⨁⨁◯ Moderate |
Physical therapist-delivered MI likely results in no difference in physical activity when combined with and compared to comprehensive rehabilitation | ||
| Self-efficacy | |||||||||||||
| 2 | randomised trials | not serious | not serious | not serious | seriousa | noneb | 71 | 77 | SMD 0.23 SD higher (0.1 lower to 0.55 higher) |
⨁⨁⨁◯ Moderate |
Physical therapist-delivered MI likely increases self-efficacy slightly when combined with and compared to comprehensive rehabilitation | ||
| Health related QoL | |||||||||||||
| 2 | randomised trials | not serious | not serious | not serious | very seriousc | noneb | 34 | 44 | SMD 0.18 SD higher (0.27 lower to 0.63 higher) |
⨁⨁◯◯ Low |
Physical therapist-delivered MI may result in little to no difference in health-related QoL when combined with and compared to comprehensive rehabilitation | ||
| 6MWT | |||||||||||||
| 3 | randomised trials | not serious | not serious | not serious | seriousa | noneb | 53 | 64 | SMD 0.15 SD higher (0.21 lower to 0.52 higher) |
⨁⨁⨁◯ Moderate |
Physical therapist-delivered MI likely results in little to no difference in endurance when combined with and compared to comprehensive rehabilitation | ||
CI, confidence interval; MI, motivational interviewing; QoL, quality of life; SMD, standardised mean difference.
Explanations.
a. Downgraded by 1 as the CI of the SMD includes the possibility of no effect.
b. Publication bias was undetected, though the included studies were small, no trials had industry influence and the included trials showed a range of positive and negative effects, therefore we did not downgrade for publication bias .
c. Downgraded by 1 due to substantial heterogeneity (I2 >50 %).
d. Downgraded by 2 as the CI of the SMD is wide (i.e. >0.8) indicating imprecision and includes the possibility of no effect.
CI, confidence interval; MI, motivational interviewing; QoL, quality of life; SMD, standardised mean difference; 6MWT, 6 min walk test.
Explanations.
a. Downgraded by 1 as the CI of the SMD includes the possibility of no effect.
b. Publication bias was undetected, though the included studies were small, no trials had industry influence and the included trials showed a range of positive and negative effects, therefore we did not downgrade for publication bias.
c. Downgraded by 2 as the CI of the SMD is wide (i.e. >0.8) indicating imprecision and includes the possibility of no effect.