OBJECTIVES: This study investigated the extent to which physiotherapists collaborating in a randomised trial comparing the McKenzie approach with a Solution Finding Approach (SFA) for back pain or neck pain involved patients in the consultation, and empowered patients to develop self-management strategies. The aims were to develop a tool for this purpose and to identify any observed differences between the consultations in these two approaches. DESIGN: An observational study, conducted within a randomised trial (McKABI trial). SETTING: Patients referred to seven National Health Service physiotherapy departments in West and East Yorkshire. PARTICIPANTS: The observational study collected data from 10 of the 28 physiotherapists participating in the McKABI trial. MEAN OUTCOME MEASURES: The involvement and empowerment scales of the Involvement and Empowerment of Patients in Physiotherapy Assessment Rating Tool (IMPART). RESULTS: Although not widely used, physiotherapists employed significantly more patient involvement and empowerment strategies with the SFA compared with the McKenzie approach. The median (interquartile range)/total possible scores were: SFA 19 (18), McKenzie 10 (4.5)/60 for involvement; and SFA 27 (8), McKenzie 11 (10)/64 for empowerment. CONCLUSIONS: Most physiotherapists were able to switch between the two approaches without significant overlap in techniques. Psychosocial questioning and goal-setting were under-utilised by most physiotherapists. Implementing the SFA protocol appeared to be more difficult than the McKenzie approach, possibly because the SFA was less reliant on a structured format. Physiotherapists may have required more training to enable them to deliver the SFA effectively. The IMPART was a reliable measure of physiotherapists' involvement and empowerment strategies.

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