Physical activity and physiotherapy: moving forwards

Background Physical inactivity affects every system in the body and is associated with many chronic diseases. This impacts on the lives of individuals and has substantial social and economic implications. A large proportion of the UK population is insufficiently active and system-wide approaches to promoting physical activity are required. There are over 55,000 physiotherapists in the United Kingdom, yet little is known about physical activity promotion in this domain of healthcare. The overarching research aim is to explore physical activity promotion in physiotherapy practice and to understand the factors that influence current practice. Method This programme of research is underpinned by a philosophical position of pragmatism. Within this methodological framework, a systematic scoping review was first undertaken to assess the state of the existing global evidence. Following this, a mixed methods study, was completed using a sequential explanatory design. Phase 1 involved a national, cross-sectional survey of UK physiotherapists. Phase 2 involved a qualitative, explanatory follow-up which aimed to further explain the quantitative findings. Findings Thirty-one studies were included in the systematic scoping review. Findings from Phase 1 of the mixed methods study indicated that respondents (n=514) initiate conversations with patients about physical activity but lack a systematic approach. Physical activity status was not routinely assessed, signposting to other services was inconsistent, and knowledge of the physical activity guidelines was poor. These findings were further explained in Phase 2; participants (n=12) highlighted a lack of understanding of key concepts which underpinned the inconsistent approach to physical activity promotion. Phase 2 also identified that physiotherapists focus on short-term restoration of function over longer-term promotion of health. Conclusion Physical inactivity is a major public health issue, and physiotherapists have the potential to contribute to tackling inactivity. However, the current approaches identified within this programme of research were inconsistent and unsystematic. Changes in demography necessitate holistic physiotherapy approaches that promote long-term health and wellbeing. Recommendations are made to improve physiotherapy practice in line with the aspiration of orientating healthcare toward prevention.