Survey on the role of physiotherapy in alcohol addiction recovery programme: a practitioner’s perspective

INTRODUCTION

Alcohol Use Disorder (AUD), commonly referred to as alcoholism, is a chronic disorder characterized by an impaired ability to control alcohol consumption despite its harmful physical, psychological, and social consequences.¹ According to the World Health Organization (WHO), approximately 2.3 billion people consumed alcohol worldwide in 2016, and the harmful use of alcohol accounted for nearly 3 million deaths during the same year.² These statistics highlight the substantial global public health burden associated with alcohol consumption.

Individuals with alcohol addiction frequently exhibit reduced levels of physical activity, poor cardiovascular fitness, and musculoskeletal degeneration.¹⁰ Chronic alcohol consumption has also been associated with reduced cerebral blood flow, brain atrophy, and neuronal cell loss, which may contribute to impaired cognitive function.¹⁰

A broader approach to the management of Alcohol Use Disorder has been advocated by behavioural health professionals, emphasizing overall health and wellness as essential components of the recovery process.¹ The attitude of physiotherapists towards addiction plays an important role in addressing both the physical impairments associated with alcohol dependence and the rehabilitation process.⁹ Physiotherapy rehabilitation has been recognized as a valuable lifestyle intervention that may facilitate both physical and psychological recovery in individuals with AUD.² Previous studies have demonstrated that regular physical exercise is associated with improvements in physical fitness, anxiety, depression, and overall well-being.⁵ Furthermore, exercise has been shown to enhance both physical and mental health outcomes among individuals recovering from alcohol addiction.^3,9 Conventional treatment approaches for alcohol addiction primarily include medical, psychological, and behavioural therapies.^3,7 However, the role of physiotherapy in alcohol addiction rehabilitation remains relatively underexplored, and its full therapeutic potential has not yet been adequately established.^3,4,10,12 Higher relapse rates, particularly among individuals with coexisting physical and psychological comorbidities, indicate the need for adjunctive therapies and long-term lifestyle interventions to support sustained abstinence.^4,6,8,9 Since recovery from alcohol addiction requires a multidisciplinary approach, the integration of physiotherapy into rehabilitation programmes may improve physical functioning, psychological well-being, treatment adherence, and overall quality of life.^4,5 Nevertheless, only limited research has evaluated the role of physiotherapy in alcohol addiction recovery.

Therefore, the present study was undertaken to address this knowledge gap by developing and validating a questionnaire to evaluate physiotherapists’ perspectives on the role of physiotherapy in alcohol addiction recovery programmes.

METHODS

Study design

A cross-sectional observational study was conducted to assess physiotherapists' perspectives on the role of physiotherapy in alcohol addiction recovery programmes. The study was carried out among practicing physiotherapists in and around Pune, Maharashtra, India. Ethical approval was obtained from the research and ethics committee of PES Modern College of Physiotherapy before commencement of the study.

Study population

The study population comprised registered physiotherapists practicing in hospitals, rehabilitation centres, private clinics, and other healthcare settings. Both male and female physiotherapists were eligible to participate.

Study duration

The study was conducted over a period of 6 months from, April 2025 - October 2025.

Inclusion criteria

Registered physiotherapists practicing in and around Pune. Physiotherapists willing to participate in the study.

Exclusion criteria

Incomplete questionnaire responses. Physiotherapists who did not provide informed consent.

Sample size

The required sample size was calculated using the formula:

n = 2(Z_α + Z_β)² × σ² / d²

where Z_α represents the probability of a type I error, Z_β represents the probability of a Type II error, σ denotes the standard deviation, and d represents the clinically significant effect size. Based on this calculation, a total sample of 273 physiotherapists was included in the study.

Sampling technique

A purposive sampling technique was adopted to recruit eligible participants.

Study procedure

The study was conducted in two phases.

Phase I: questionnaire development

A structured questionnaire was developed after reviewing the available literature to ensure that all relevant aspects of physiotherapy in alcohol addiction recovery were adequately represented.

Phase II: questionnaire validation

The developed questionnaire was evaluated for content validity by ten experienced physiotherapists. Each item was rated using a five-point Likert scale ranging from strongly disagree to strongly agree. Based on the feedback received, necessary modifications were incorporated to improve the clarity and relevance of the questionnaire. The final questionnaire was subsequently converted into a Google form and distributed electronically for data collection.

Statistical analysis

The data was collected through Google forms. The data collected through the survey was analyzed using Google forms, which provided descriptive statistics in the form of frequencies and percentages. Graphical representations such as pie charts and bar graphs were automatically generated to illustrate the distribution of responses. The analysis focused on identifying physiotherapists’ perspectives regarding the role of physiotherapy in alcohol addiction recovery programmes. The data was entered into Microsoft excel sheet, tabulated and subjected to statistical analysis. Statistical analysis was calculated by using IBM SPSS software and Gpower was used to calculate sample size.

RESULTS

A total of 273 physiotherapists participated in the study. The content validity of the questionnaire was assessed by 10 expert physiotherapists using a five-point Likert scale. The questionnaire demonstrated good content validity, with a scale-level content validity index based on the average method (S-CVI/Ave) of 0.85 and a universal agreement index (S-CVI/UA) of 0.10.

The questionnaire consisted of 10 items evaluating physiotherapists’ perspectives on the role of physiotherapy in alcohol addiction recovery programmes. Most respondents (95.1%) agreed that physiotherapy plays a crucial role in the recovery of individuals with alcohol addiction. Similarly, 95.8% believed that physiotherapy improves the overall quality of life of individuals recovering from alcohol addiction.

A large majority of respondents (90.6%) reported that physiotherapy helps reduce the risk of relapse, while 93.1% supported the integration of physiotherapy as a standard component of alcohol addiction recovery programmes. However, 62.8% believed that the role of physiotherapy in alcohol addiction recovery is not adequately recognized or utilized in current clinical practice.

Most physiotherapists (94.1%) reported that patients receiving physiotherapy demonstrated better treatment engagement and adherence. Furthermore, 95.5% agreed that incorporating physiotherapy into comprehensive addiction recovery programmes improves treatment outcomes, and an equal proportion believed that physiotherapy contributes to improvements in both physical and mental health among individuals recovering from alcohol addiction.

Regarding interdisciplinary practice, 83.3% of respondents reported that they had not collaborated with other healthcare professionals in the management of patients with alcohol addiction. Additionally, 75.3% stated that they had not personally encountered a case in which physiotherapy had significantly contributed to recovery, highlighting the limited clinical exposure of many respondents despite their positive perceptions of physiotherapy’s role.

DISCUSSION

The present study aimed to explore the role of physiotherapy in alcohol addiction recovery programmes from the perspective of practicing physiotherapists. The findings revealed that an overwhelming majority (95.1%) of respondents acknowledged physiotherapy as an important component of the rehabilitation of individuals recovering from alcohol addiction. This finding suggests that physiotherapy contributes not only to physical recovery but also to psychological and social well-being throughout the recovery process.

The findings are consistent with previous literature highlighting the beneficial effects of physical activity and exercise-based interventions in addiction recovery. Wang et al and Giesen et al reported that exercise-based interventions enhance treatment adherence, reduce cravings, and improve physical fitness and mood among individuals undergoing recovery. Similarly, Manthou et al and Montón-Martínez et al demonstrated that regular physical activity improves emotional regulation, self-efficacy, and quality of life, all of which are essential for maintaining long-term abstinence. Therefore, the findings of the present study reinforce previous evidence by demonstrating that practicing physiotherapists recognize and value the therapeutic role of physiotherapy within multidisciplinary addiction rehabilitation programmes.^{4,6,8,9,11-14} Physiotherapists working in multidisciplinary rehabilitation settings may have greater opportunities to incorporate therapeutic exercise, pain management strategies, breathing exercises, and relaxation techniques into patient care, which may explain their strong agreement regarding the role of physiotherapy in alcohol addiction recovery. These findings are consistent with those of Lardier et al, who reported that collaboration between physiotherapists and mental health professionals improves patient engagement and overall treatment outcomes.^4,5,17

The present study also highlights that physiotherapy may help address several complications associated with alcohol dependence, including fatigue, muscle weakness, impaired posture, reduced physical fitness, and withdrawal-related stress. Through structured exercise programmes, breathing retraining, relaxation therapy, and postural correction, physiotherapy may facilitate physical rehabilitation while reducing anxiety and enhancing motivation, thereby contributing to relapse prevention. These findings support the multidimensional role of physiotherapy in promoting both physical recovery and psychological well-being among individuals recovering from alcohol dependence.^10,16

Despite the positive perceptions of physiotherapy, many respondents reported limited collaboration with multidisciplinary teams and limited direct clinical experience in managing individuals with alcohol addiction. This finding may indicate that physiotherapy remains underutilized within addiction rehabilitation services despite its perceived benefits. Strengthening collaboration among physiotherapists, physicians, psychiatrists, psychologists, and other rehabilitation professionals may facilitate the integration of physiotherapy into comprehensive alcohol addiction recovery programmes.

The present study has certain limitations. The study population was limited to practicing physiotherapists from Pune and nearby regions, which may restrict the generalizability of the findings. Furthermore, the cross-sectional study design does not permit the establishment of causal relationships between physiotherapy interventions and recovery outcomes. Future multicentre studies involving larger and more diverse populations are recommended. In addition, longitudinal and interventional studies should be conducted to evaluate the effectiveness of physiotherapy-based interventions in improving physical function, psychological well-being, treatment adherence, and relapse prevention among individuals with alcohol use disorder. Collaborative research involving physiotherapists, psychologists, psychiatrists, and rehabilitation specialists may further strengthen the evidence supporting the integration of physiotherapy into multidisciplinary addiction rehabilitation programmes.

CONCLUSION

The present study concludes that physiotherapy plays a significant supportive role in alcohol addiction recovery programmes. The majority of physiotherapists (95.1%) recognized the importance of physiotherapy in improving physical health, psychological well-being, treatment engagement, and overall recovery outcomes. The findings support the integration of physiotherapy into multidisciplinary alcohol addiction rehabilitation programmes as a complementary approach to conventional treatment. Further multicentre and longitudinal studies are recommended to establish the long-term effectiveness of physiotherapy interventions in individuals with alcohol use disorder.

ACKNOWLEDGEMENTS

Authors extend gratitude to the physiotherapists in and around Pune who were involved in the study.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee of PES Modern College of Physiotherapy, Pune

REFERENCES

1. 1. Physiopedia. Alcoholism. 2023. Available from: https://www.physio-pedia.com/Alcoholism. Accessed on 7 April 2026.
2. 2. Edwards G, Gross MM, Keller M, Moser J, Room R, World Health Organization. Alcohol-related disabilities. World Health Organization; 1977.
3. 3. Read JP, Brown RA. The role of physical exercise in alcoholism treatment and recovery. Profess Psychol Res Pract. 2003;34(1):49.
4. 4. Stoutenberg M, Warne J, Vidot D, Jimenez E, Read JP. Attitudes and preferences towards exercise training in individuals with alcohol use disorders in a residential treatment setting. J Subs Abuse Treat. 2015;49:43-9.
5. 5. Read JP, Brown RA, Marcus BH, Kahler CW, Ramsey SE, Dubreuil ME, et al. Exercise attitudes and behaviors among persons in treatment for alcohol use disorders. J Subs Abuse Treat. 2001;21(4):199-206.
6. 6. Hallgren M, Vancampfort D, Schuch F, Lundin A, Stubbs B. More reasons to move: exercise in the treatment of alcohol use disorders. Front Psychiatr. 2017;8:160.
7. 7. Zangeneh M, Barmaki R, Ala-leppilampi K, Peric T. Commentary: the potential role of physical exercise in addiction treatment and recovery: the social costs of substance misuse. Int J Mental Health Addict. 2007;5:210-8.
8. 8. Zschucke E, Heinz A, Ströhle A. Exercise and physical activity in the therapy of substance use disorders. Sci World J. 2012;2012(1):901741.
9. 9. Hallgren M, Vancampfort D, Giesen ES, Lundin A, Stubbs B. Exercise as treatment for alcohol use disorders: systematic review and meta-analysis. Br J Sports Med. 2017;51(14):1058-64.
10. 10. Conaty J. Physiotherapy with alcohol and drug dependent patients: implications for general settings. Physiother Can. 1992;44(1):31-4.
11. 11. Wang D, Zhang Z, Huang J, Liang Y, Xu C. Effects of exercise-based interventions on substance use disorders: a systematic review and meta-analysis. Front Psychol. 2024;15:1352846.
12. 12. Giesen ES, Deimel H, Bloch W. Clinical exercise interventions in alcohol use disorders: a systematic review. J Subst Abuse Treat. 2015;52:1-9.
13. 13. Manthou E, Georgakouli K, Fatouros IG, Gianoulakis C, Theodorakis Y, Jamurtas AZ. Role of exercise in the treatment of alcohol use disorders. J Addict Res Ther. 2016;7(2):1000275
14. 14. Montón-Martínez A, Echeverría C, López-Torres J, García-Molina V. Effects of physical activity programmes on self-efficacy and relapse prevention in alcohol use disorder: a randomized controlled trial. Addict Behav Rep. 2025;21:101650.
15. 15. Lardier DT Jr, Barrios V, Garcia-Reid P, Reid RJ. The role of physical activity in mental health recovery and resilience among individuals with substance use disorder. Int J Environ Res Public Health. 2021;18(3):1048.
16. 16. Physiotutors. The role of physiotherapy in addiction recovery: a biopsychosocial approach. 2023 Available from: https://www.physiotutors.com. Accessed on 7 April 2026.
17. 17. Frontiers in Psychology. Exercise and addiction recovery: A review of mechanisms and outcomes. Front Psychol. 2021;12:690493.
18. 18. Journal of Substance Abuse Treatment. Physical activity as an adjunct to substance abuse treatment: Evidence and recommendations. J Subst Abuse Treat. 2015;57:36–44.