Current Practice of Physical Activity Counselling within Physiotherapy Usual Care and Influences on Its Use: A Cross-Sectional Survey.

Shiyi Zhu,Sarah Dennis,Bernadette Brady,Lauren J Christie,Colin Greaves,Leanne Hassett,Catherine Sherrington,Abby Haynes,Marina Pinheiro,Matthew Jennings,Balwinder Sidhu

doi:10.3390/ijerph18094762

Abstract

Physical activity counselling has demonstrated effectiveness at increasing physical activity when delivered in healthcare, but is not routinely practised. This study aimed to determine (1) current use of physical activity counselling by physiotherapists working within publicly funded hospitals; and (2) influences on this behaviour. A cross-sectional survey of physiotherapists was conducted across five hospitals within a local health district in Sydney, Australia. The survey investigated physiotherapists’ frequency of incorporating 15 different elements of physical activity counselling into their usual healthcare interactions, and 53 potential influences on their behaviour framed by the COM-B (Capability, Opportunity, Motivation-Behaviour) model. The sample comprised 84 physiotherapists (79% female, 48% <5 years of experience). Physiotherapists reported using on average five (SD:3) elements of physical activity counselling with at least 50% of their patients who could be more active. A total of 70% of physiotherapists raised or discussed overall physical activity, but less than 10% measured physical activity or contacted community physical activity providers. Physiotherapists reported on average 25 (SD:9) barriers influencing their use of physical activity counselling. The most common barriers were related to “opportunity”, with 57% indicating difficulty locating suitable community physical activity opportunities and >90% indicating their patients lacked financial and transport opportunities. These findings confirm that physical activity counselling is not routinely incorporated in physiotherapy practice and help to identify implementation strategies to build clinicians’ opportunities and capabilities to deliver physical activity counselling.

Highlights

Evidence-based guidelines clearly specify the amount of physical activity required for health benefits [1]
We further explored the relationship between self-reported skills and the corresponding physical activity counselling elements
This study demonstrated that physiotherapists believe they should incorporate physical activity counselling into routine care, but reported barriers associated with their opportunity, capability, and to a lesser extent their motivation to deliver physical activity counselling

Summary

Introduction

Evidence-based guidelines clearly specify the amount of physical activity required for health benefits [1]. These guidelines are based on rigorous evidence that demonstrates strong links between physical inactivity and morbidity and mortality [2]. Scalable solutions are needed at global, community, and individual levels to address the important health problem of physical inactivity, for disadvantaged populations [7]. One scalable solution at the individual level is physical activity counselling from health professionals. Physical activity counselling refers to a component of patient consultation aimed at changing physical activity behaviour as a means of ameliorating chronic health conditions. Physical activity counselling interventions that are underpinned by theoretical models of behaviour change and incorporate behaviour change techniques (e.g., self-monitoring and goal setting) have been shown to increase physical activity in the general population [9,10,11], as well as in people with physical disabilities [12], and have been shown to be effective when delivered in healthcare settings [13,14]

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Conclusion