Associations Between Patients' Perceptions of Physiotherapist Communication and Psychological Responses in Frozen Shoulder: A Multicentre Cross‐Sectional Study

INTRODUCTION: Frozen shoulder (FS) is often accompanied by uncertainty, low mood, and catastrophizing thoughts. Communication during physiotherapy consultations may influence psychological responses and recovery expectations, although how patients perceive clinician-delivered information remains unclear. Understanding these perceptions may help optimise patient-centred rehabilitation and improve communication strategies during clinical encounters. AIM: To investigate the associations between patients' perceptions of clinician-delivered information and recovery expectations, perceived need for reassurance, emotional state, and pain magnification and helplessness in individuals with FS. METHODS: A multicenter, cross-sectional online survey was conducted. Individuals with a diagnosis of FS completed a 31-item multiple-choice questionnaire administered via Google Forms. Participants were recruited from three physiotherapy clinics in Italy between April and July 2023. RESULTS: Following a formal diagnosis of FS, a total of 110 Italian participants were prospectively recruited. Participants who perceived clinician-delivered information as worrying, anxiety-inducing, unhelpful, unreassuring, or discouraging were significantly more likely to report less favourable recovery expectations (p = 0.002 and p < 0.001). Overall, these perceptions were consistently associated with negative emotional states (p < 0.01), although some associations appeared paradoxical. Associations with catastrophizing were heterogeneous, with some catastrophizing-related thoughts showing significant associations with negatively perceived communication, whereas others did not. CONCLUSIONS: Patients' perceptions of clinician-delivered information were associated with recovery expectations and selected catastrophizing-related thoughts in individuals with FS. Emotional state showed less consistent associations, suggesting that additional factors may contribute to emotional responses. Given the cross-sectional design, causal inferences cannot be drawn, and longitudinal and interventional studies are warranted to clarify the prognostic significance, and potential clinical implications of these associations.