Knowledge, attitude and practice of physical activity promotion among physiotherapists in India during COVID 19

Are the physical activity habits of healthcare professionals associated with their physical activity promotion and counselling?: A systematic review

OBJECTIVE

Healthcare professionals (HCPs) play an important role in conducting brief physical activity counselling during consultations, representing one of the population's most cost-effective interventions for its promotion. Despite this, their clinical practice often falls short in addressing physical activity with the necessary depth and frequency. This study aimed to synthesise the literature concerning the association between the physical activity habits of HCPs and their attitudes toward physical activity promotion and counselling.

METHODS

The systematic review followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Its protocol was registered in PROSPERO under ID: CRD42023408302. In March 2023, a comprehensive search was conducted using key terms related to physical activity levels and HCPs counselling practices across the Web of Science, Scopus, PubMed, SPORTDiscus, APA PsycInfo, and CINAHL databases. Registered HCPs classified under the International Standard Classification of Occupations (ISCO) were included. The Newcastle-Ottawa Scale was used for assessing articles quality.

RESULTS

The search yielded 6618 articles, with 51 meeting the inclusion criteria after filtering and cross-referencing. Predominantly cross-sectional studies were included, mainly involving HCPs responding to questionnaires regarding their physical activity habits and promotion and counselling practices. Heterogeneous results were found.

CONCLUSION

High-quality studies mainly concluded that higher physical activity levels among HCPs were associated with more physical activity promotion and counselling practices. These findings are an important contribution to the relevance of the physical activity practice by HCPs and highlighting the importance of promoting its counselling in clinical practice.

How did COVID-19 pandemic impact on healthy behaviours among Polish professionally active physiotherapists aged 20-50?

BACKGROUND

Due to the introduction of a number of changes to the health care system and the work nature of medical staff, theCOVID-19 pandemic still pose a public health challenge. The objective of the study was to characterize the health behaviours of Polish professionally active physiotherapists during the COVID-19 pandemic.

METHODS

The study included 104 Polish licensed and professionally active physiotherapists in whom health behaviours were assessed using an original questionnaire contained, among others, questions from the Global Physical Activity Questionnaire (GPAQ), the Pittsburgh Sleep Quality Index (PSQI) and the Perceived Stress Scale (PSS), available via social media platforms.

RESULTS

Among the physiotherapists, 34% worked directly with COVID-19 patients and 49% with those who had survived COVID-19. There were no statistically significant differences in most of the rates of physical activity undertaken by the physiotherapists surveyed (P > 0.05). Men were more likely to report taking up movement-related physical activity than women (P > 0.05). However, they spent more time sitting or lying down on a typical day (P > 0.05). The average time spent on the above-mentioned physical activities was also higher among the male participants than in the group of women (P > 0.05). There was an increase in the proportion of physiotherapists working over 40 h per week, from 29% before the pandemic to 38% during the pandemic. Statistically significant differences were observed for the products constituting the basison which of the diet of the examined physiotherapists was based (P < 0.05). The majority of the respondents reported no problems with falling asleep (p > 0.05). Stress related to the risk of contracting COVID-19, as well as concerns about the health of loved ones were more common and severe in the group of female subjects (P < 0.05).

CONCLUSIONS

During the COVID-19 pandemic, the health behaviours in some physiotherapists changed. Further studies are required to assess whether physiotherapists' health behaviours returned to baseline levels or slightly improved compared to the initial results. Also, it is necessary to introduce health-promoting initiatives that would focus on physiotherapists, support their positive health behaviours and provide special recommendations helping them to maintain health during a pandemic.

Knowledge translation in rehabilitation settings in low, lower-middle and upper-middle-income countries: a scoping review

PURPOSE

This review aims to identify the barriers and facilitators to knowledge use and Knowledge Translation (KT) strategies in rehabilitation in low, lower-middle, and upper-middle-income countries (LMICs).

MATERIALS AND METHODS

A scoping review of studies of KT in rehabilitation in LMICs contexts using the Arksey and O'Malley Framework was conducted. A comprehensive search of MEDLINE and 10 other databases was undertaken to identify studies conducted primarily in LMICs.

RESULTS

From the initial 15.606 titles identified; 27 articles were included for final analysis. Our analysis identified the following themes: Professional culture and context; KT interventions; and the conceptualization and application of KT and Evidence Based Practice (EBP). Individual-level barriers to KT included lack of skills, knowledge about EBP and English language, lack of motivation, and decision-making power. Facilitators to KT included positive attitudes and motivation. Organization-level barriers included lack of time, lack of financial resources, limited access to scientific journals, and applicability of research to rural settings. Facilitators included adequate financial and physical resources, a supportive management environment, and the existence of training and continuing education programs.

CONCLUSION

This review identified common and unique barriers and facilitators to KT in LMICs when compared to KT studies conducted in high-income settings.IMPLICATIONS FOR REHABILITATIONKnowledge Translation from academic institutions to rehabilitation clinical practice in low and upper-middle-income countries is important to support evidence-based practice and patient outcomes.Barriers at the individual level include professionals' ability to understand English and knowledge of the evidence-based practice.Organization-level barriers included lack of time to access and implement new practices, lack of financial and personal resources, limited access to scientific journals, and applicability of research to rural settings.Training and continuing education programs are needed to support rehabilitation professionals' efforts to achieve the application of evidence-based practice in clinical practice.

Nigerian physiotherapists' knowledge, current practice and perceptions of their role for promoting physical activity: A cross-sectional survey

BACKGROUND

Nigeria has the highest rates of physical inactivity in Africa. As physical inactivity is a leading global risk factor for non-communicable diseases (NCD), physical activity promotion is a strategy for their mitigation. Physiotherapists are already ideally situated to undertake this role and can assist in the reversal of NCD. Gaining insight into how physiotherapists in Nigeria perceive their role in relation to physical activity promotion is needed to ensure this undertaking will be effective. This national survey aimed to investigate Nigerian physiotherapists' knowledge and current practice for promoting physical activity across Nigeria and perceptions of their role related to this.

METHODS

Following ethical approval, a cross-sectional, online questionnaire survey design was employed to investigate the aim. 330 qualified physiotherapists, working across Nigeria were recruited. Internal consistency of the survey was examined using Cronbach's alpha. Descriptive statistics were used to analyse closed questions. Thematic content analysis was used to analyse open-ended questions. Chi-square inferential statistic was used to investigate the association between variables with alpha interpreted at a level of 0.05.

RESULTS

The internal consistency of the questionnaire survey was good overall (Cronbach Alpha α = 0.71). 330 physiotherapists participated. 99.4% agreed that discussing the benefits of a physically active lifestyle with patients is part of their role. However, over 60% did not feel confident in suggesting specific physical activity programs for their patients. 59.7% were aware of one or more physical activity guideline. However, only 49.1% were incorporating it into their practice. 85.5% felt that developing a physical activity guideline specifically for Nigeria would promote physical activity. 63.3% of respondents did not use any resource in promoting physical activity. An association was found between the physiotherapist's awareness of physical activity guidelines and male sex (χ2 = 8.95, df = 2, p = 0.01).

CONCLUSION

Whilst most physiotherapists had a positive perception of their role in promoting physical activity, translating this into practice would seem to be challenging. A systems approach to physical activity health promotion is recommended with the need for a commitment by the Nigerian Government to the development and implementation of national guidelines. Incorporating more training in physiotherapy education could foster more confidence in the delivery of these guidelines. Greater use of resources and working with community organisations could help to optimise physical activity uptake in Nigeria.

Physical Therapists' Knowledge, Skills, Beliefs, and Organizations Impact Physical Activity Promotion: A Systematic Review and Meta-Analysis

OBJECTIVE

The purpose of this study was to characterize factors that influence physical therapists' physical activity (PA) promotion practices and map these factors to the Theoretical Domains Framework (TDF) to inform future implementation efforts.

METHODS

Six databases (MEDLINE, EMBASE, Scopus, CINAHL, PsychInfo, and Web of Science) were searched from inception to March 11, 2021. Studies were included if they reported physical therapists' PA promotion practices and factors influencing these practices. Study quality was assessed with a modified Newcastle-Ottawa Scale and the Critical Appraisal Skills Programme checklist. Studies were excluded if they did not separate physical therapist PA promotion practices and influencing factors from other health professionals.

RESULTS

The search yielded 12,835 references and 27 included studies. Twenty studies were included in a meta-analysis of proportions, whereas 15 studies were included in a meta-analysis of correlations. Very-low to moderate-quality evidence suggests that factors at the individual and organizational levels have very small to moderate associations with PA promotion practices.

CONCLUSION

Efforts to improve PA promotion by physical therapists should consider incorporating combinations of individual and organizational factors. Limitations to the body of evidence highlight the need for future research.

IMPACT

With PA projected to decrease in the general population by an additional 20% by 2050, PA promotion is urgently needed to maximize physical therapists' impact on the health of society. This study identifies factors that may prove useful for guiding the development of strategies to encourage greater engagement in PA promotion by physical therapists.