Examining physiotherapist use of structured aerobic exercise testing to decrease barriers to aerobic exercise

ABSTRACT

Objective: To determine the frequency of physiotherapist-administered aerobic exercise testing/training, the proportion of physiotherapists who administer this testing/training, and the barriers that currently exist across different practice environments. A secondary objective is to identify the learning needs of physiotherapists for the development of an education curriculum in aerobic exercise testing and training with electrocardiograph (ECG) administration and interpretation. Design: National, cross-sectional survey. Participants: Registered physiotherapists practicing in Canada. Results: Out of 137 participants, most (75%) physiotherapists prescribed aerobic exercise on a regular basis (weekly); however, 65% had never conducted an aerobic exercise test. There were no significant differences in frequency of aerobic exercise testing across different practice environments or across years of physiotherapy experience. Physiotherapists perceived the main barriers to aerobic exercise testing as being a lack of equipment/space (78%), time (65%), and knowledge (56%). Although most (82%) were uncomfortable administering 12-lead ECG-monitored aerobic exercise tests, 60% stated they would be interested in learning more about ECG interpretation. Conclusion: This study found that physiotherapists are regularly implementing aerobic exercise. This exercise was infrequently guided by formal aerobic exercise testing, which could increase access to safe and effective exercise within the optimal aerobic training zone. As well, this could facilitate training in patients with cardiovascular diagnoses that require additional testing for medical clearance. Increased ECG training and access to equipment for physiotherapists may augment pre-screening aerobic exercise testing. This training should include learning the key arrhythmias for aerobic exercise test termination as defined by the American College of Sports Medicine.

KEYWORDS:

• Electrocardiography
• delivery of care
• exercise
• exercise test
• health-care surveys
• rehabilitation

Acknowledgments

EF was supported by the Toronto Rehab Foundation in the form of a Summer Studentship. At the time of this research, EI was funded by the Canadian Institutes of Health Research (Health Professions) Post-Doctoral Fellowship. SM has been supported by a Heart and Stroke Canada Focus on Stroke Fellowship and is currently supported by a Canadian Institutes of Health Research Fellowship and the Toronto Rehabilitation Institute-University Health Network.

Declaration of interest

All authors declare that they have no conflict of interest.

Additional information

Funding

This work was supported by the Canadian Institutes of Health Research (Health Professions) Post-Doctoral Fellowship; Toronto Rehab Foundation - Summer Studentship; Heart and Stroke Canada Focus on Stroke Fellowship; and Canadian Institutes of Health Research Fellowship.