It was with great honour I accepted to write an editorial for the European Journal of Physiotherapy (EJP). I am pleased to see how the field of physiotherapy has evolved over the 20 years I have been a physiotherapist, in respect to both research and clinical practice. I will give a few examples of this related to work that I have had the privilege to be part of. The EJP publishes papers within all examples below.
The first example is the research and clinical work done by physiotherapists in the field of prevention of non-communicable diseases, by promoting physical activity using various behavioural change strategies. The Swedish Association of Physiotherapists has taken the lead in implementing the national guidelines on ‘methods that can prevent disease’. The organisation received funding by the National Board for Health and Social Welfare to implement these guidelines in the health care system. During that process, physiotherapists all over Sweden have been educated in disease preventing methods. In addition, easy-to-understand messages and material have been developed aimed at different target groups such as youth, a healthy workplace, elderly, patients preparing for surgery, staying healthy after a stroke or cardiac event. In relation to the release of the guidelines, our division at the Karolinska Institutet initiated several bachelor and master projects to support the implementation. We also started a highly appreciated freestanding course ‘Methods that can prevent disease’. The course is inter-professional, which enables each profession to identify its own role and to reflect on how collaboration between different professions can enhance healthy lifestyles. The focus of the course is to strengthen competence in behavioural change strategies.
The second example is the research on specific physical activity/physical exercises that can treat or relieve diseases. As experts in exercise physiology, physiotherapists have an important role here. An update of the handbook ‘Physical activity in prevention and treatment of disease’ (FYSS) has been conducted during the past year. Physiotherapists from all over Sweden, Norway and Denmark co-authored this work. The book includes 53 chapters of which 31 are disease specific and the rest general recommendations for prevention and related topics. The book is built upon the evidence for what dose and type of activity that can affect certain outcomes, making it possible to prevent or treat with an optimal dose of physical activity on an individual basis. Currently, work is in progress to make this information digital, thus being easy to search and possible to include in existing digital systems in health care (eFYSS). A prototype of the eFYSS will be tested during the fall 2017.
A third example is about moving from doing mainly efficacy trials to also study effectiveness and the implementation of evidence from interventions in health care settings. For an intervention to be effective in clinical practice, the process of implementation needs to be evaluated. This provides information regarding the feasibility of the intervention as well as providing contextual information which may help explain the success, or lack thereof, of the tested intervention. Many good examples of implementation studies of physiotherapy interventions can be found in the literature. This is promising for health care practice, and specifically for the patients who will more likely get the best care according to current evidence.
A fourth example is about improvement on outcome measures in both clinical and research areas. We are better at including a measure of the physical activity behaviour in addition to measures of physical function. I can see a clear trend that we also consider the whole spectrum of physical activity behaviour, from sedentary behaviour to light intensity and moderate or higher intensities. I am, when writing this, on my way to the International Congress of Ambulatory Monitoring of Physical Activity and Movement (ICAMPAM), hosted this year in Bethesda, USA. The congress was first initiated by a group of Dutch physiotherapists who identified a need to broaden laboratory-based measurement of movement quality and gait, to also measure this in free-living conditions as well as include objective measures on the physical activity behaviour. The use of valid and reliable measures of physical activity, preferably objective ones, can assist in prescribing the right dose of physical activity and is imperative when evaluating the effects of the physical activity interventions.
Finally, a fifth example is the involvement among physiotherapists for Global Health. In the editorial in EJP Issue 2, 2017 Stefan Jutterdal mentioned the Global Health and Sustainable Development Goals for 2030 (SDGs). The international organisation ISPAH (International Society for Physical activity and Health) has developed the Bangkok declaration on physical activity for sustainable development to be used for policy, prioritisation and implementation. The declaration addresses that increased physical activity to a large extent contributes to achieving the SDGs. The declaration is translated to several languages and is available on the ISPAH website (www.ispah.org). I believe physiotherapist all over the world can use the declaration for advocacy.
In summary, physiotherapists play an important role in supporting, maintaining and enhancing the physical activity level for better health on individual, group and societal levels. I will continue to live my vision ‘increase knowledge on the health effect of physical activity, methods to promote physical activity behaviour and improve measurements’. I hope you will join me in this work, and I hope you will find the scientific work reported in this issue inspiring for your research and/or clinical practice.
Disclosure statement
No potential conflict of interest was reported by the author.