Physiotherapist-led health promotion interventions in primary care can reduce metabolic risk factors for people with or at risk of metabolic syndrome: a systematic review.

Background

Physiotherapists in primary care are well placed to provide health promotion interventions that target client metabolic risk factors.

Objective

To determine the effectiveness of health promotion interventions delivered by physiotherapists in primary care on metabolic outcomes for people with or at risk of metabolic syndrome.

Data sources

AMED, CINAHL, Cochrane, Medline, PEDro, PsycInfo, SPORTDiscus (searched up to February 2024).

Eligibility criteria

Studies evaluating physiotherapist-delivered health promotion interventions for adults with at least one metabolic risk factor (abdominal obesity, hypertension, elevated triglycerides, reduced HDL-C or elevated glucose) delivered in primary care settings were included.

Study appraisal and synthesis

Two reviewers extracted data, evaluated methodological quality using the Mixed Methods Appraisal Tool, and certainty of evidence using GRADE. Meta-analyses were conducted using a random effects model to calculate weighted mean differences (WMD) for outcomes on common scales, and standardised MD (SMD) for outcomes on different scales.

Results

Twenty-five studies (n = 3619 participants) were included. Moderate-high certainty evidence indicated that physiotherapist-delivered health promotion interventions reduced waist circumference (WMD -2.42 cm, 95%CI -4.31 to -0.53), diastolic blood pressure (WMD -2.34 mmHg, 95%CI -3.77 to -0.91), triglycerides (WMD -0.18 mmol/L, 95%CI -0.36 to 0.00) and fasting blood glucose (WMD -0.18 mmol/L, 95%CI -0.28 to -0.08), and increased physical activity (SMD 0.18, 95%CI 0.04 to 0.32) compared to usual care.

Conclusion

Physiotherapy-led health promotion interventions in primary care can improve metabolic risk factors and physical activity levels for people with or at risk of metabolic syndrome by small but clinically significant amounts.

Systematic review registration number

Systematic Review Registration Number PROSPERO CRD42022352725. CONTRIBUTION OF THE PAPER.