The Physical Therapist’s Role in Physical Activity Promotion

Original Editor - Wendy Walker

Top Contributors - Wendy Walker and Michelle Lee  

Opportunity

Patient expectations

The nature of a physiotherapist's (PT's) work makes us particularly well placed to initiate a discussion about the level of Physical Activity (PA) with each of our patients[1]. Our patients often expect us to talk about physical activity, and may volunteer information about their current level of activity without being asked. We are known to be experts in movement and physical performance, so people expect to have a discussion about these issues.

History of our profession

Historically the profession of physiotherapy/physical therapy has from its beginning encompassed massage, manipulation and exercise. PTs have a long history of providing exercise recommendation, and are uniquely well qualified to promote the health and wellbeing of both the general public and our patients throughh PA and exercise[2].

Exercise/Physical Activity Recommendations

WHO advises that a minimum of 30 minutes of moderate intensity exercise on 5 or more days per week is sufficient to bring about significant health benefits[3]; this adds up to a total of 150 minutes of exercise per week.

Physical Activity (PA) is defined as any bodily movement produced by skeletal muscles that require energy expenditure. Activities undertaken while working, playing, travelling, carrying out housework, gardening and engaging in recreational pursuits are included.

These pages have further specific information on PA reommendations for different age groups:

Physical Activity in Young People

Physical Activity and Older Adults

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Benefits of PA

The Benefits of Physical Activity page lists the positive health outcomes of exercise/physical activity.  PA reduces the risk of cardiovascular disease, diabetes and many cancers, helps control weight, and contributes to mental well-being. See specific Physiopedia pages on Physical Activity in different conditions (eg. Physical Activity and Cardiovascular Disease) for details of the benefits, with evidence and full references.

Individual Patients

As a Physiotherapist, when taking a history from our patients we routinely ask about sports and hobbies in the Social History section, and this provides a perfect opportunity to ask just how much PA the person does in a typical week. It can be as simple as asking a couple of quick questions about their work and recreation:

  1. "Does your work involve any physical activity?" This includes handling of heavy objects and/or use of tools (e.g. plumber, cleaner, electrician, joiner, nurse, gardener, postal delivery worker etc.)
  2. "During the last week, [or during an average week] how many hours did you spend doing PA?" This includes walking (for leisure, or to work, to the shops), cycling, swimming, vigorous housework, gardening, participating in sports, etc.

Then add up the time spent doing PA, and if the weekly total is less than 150 minutes, then seize the opportunity to have a brief discussion about the benefits of exercise.

Wider Community

On the Physical Activity Promotion in the Community page, it is stated: Physiotherapists can help with the development and implementation of environmental changes, policies and programs that promote active living. Bezner[4] advocates PTs being involved in community events and serving as consultants for the design of accessible public spaces. On an organizational level, she recommends participation in government initiatives, creation of resources to help PTs add promotion to their professional practice and better integration of health promotion competencies into PT education curriculum. In light of the current global health landscape, there's no better time for physical therapists to embrace the primary prevention of physical inactivity than now.

References

  1. Shirley D1, van der Ploeg HP, Bauman AE. Physical activity promotion in the physical therapy setting: perspectives from practitioners and students. Phys Ther. 2010 Sep;90(9):1311-22. doi: 10.2522/ptj.20090383. Epub 2010 Jul 22.
  2. Verhagen E1, Engbers L. The physical therapist's role in physical activity promotion. J Sports Med. 2009 Feb;43(2):99-101. doi: 10.1136/bjsm.2008.053801. Epub 2008 Oct 6.
  3. World Health Organization. Global recommendations on physical activity for health. Geneva, Switzerland: WHO Press; 2010
  4. Bezner JR. Promoting health and wellness: implications for physical therapist practice. Phys Ther. 2015; 95: 1433–1444