Self-management interventions for chronic disease: a systematic scoping review

Clin Rehabil. 2014 Nov;28(11):1067-77. doi: 10.1177/0269215514532478. Epub 2014 Apr 30.


Objective: To investigate the contributions of physiotherapy and occupational therapy to self-management interventions and the theoretical models used to support these interventions in chronic disease.

Data sources: We conducted two literature searches to identify studies that evaluated self-management interventions involving physiotherapists and occupational therapists in MEDLINE, the Cochrane Library, CINAHL, EMBASE, AMED (Allied and Complementary Medicine), SPORTdiscus, and REHABDATA databases.

Study selection: Four investigator pairs screened article title and abstract, then full text with inclusion criteria. Selected articles (n = 57) included adults who received a chronic disease self-management intervention, developed or delivered by a physiotherapist and/or an occupational therapist compared with a control group.

Data extraction: Four pairs of investigators performed independent reviews of each article and data extraction included: (a) participant characteristics, (b) the self-management intervention, (c) the comparison intervention, (d) outcome measures, construct measured and results.

Data synthesis: A total of 47 articles reported the involvement of physiotherapy in self-management compared with 10 occupational therapy articles. The type of chronic condition produced different yields: arthritis n = 21 articles; chronic obstructive pulmonary disease and chronic pain n = 9 articles each. The theoretical frameworks most frequently cited were social cognitive theory and self-efficacy theory. Physical activity was the predominant focus of the self-management interventions. Physiotherapy programmes included disease-specific education, fatigue, posture, and pain management, while occupational therapists concentrated on joint protection, fatigue, and stress management.

Conclusions: Physiotherapists and occupational therapists make moderate contributions to self-management interventions. Most of these interventions are disease-specific and are most frequently based on the principles of behaviour change theories.

Keywords: Chronic disease; occupational therapy; physical therapy modalities; rehabilitation; scoping review; self-care.

Publication types

  • Comparative Study
  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Aged
  • Chronic Disease / rehabilitation*
  • Evidence-Based Medicine
  • Female
  • Humans
  • Male
  • Middle Aged
  • Occupational Therapy / methods
  • Pain Management / methods*
  • Pain Measurement
  • Patient Education as Topic / methods*
  • Physical Therapy Modalities
  • Prognosis
  • Self Care / methods*
  • Treatment Outcome