Exercise therapy and physical activity promotion: do exercise therapists assess or receive information on clients’ relevant personal factors? A national survey from Germany

Abstract

Background: Physical activity promotion requires a multi-layered assessment that does not only assess body functions but which in particular also includes the measurement of personal factors (e.g. exercise self-efficacy).

Objectives: The purpose was to review the utilisation of standardised measurements (SMs), admission interviews and interdisciplinary information sharing, and to analyse the content of these practices with respect to physical activity promotion.

Design: Observational, cross-sectional national survey.

Method: A Germany-wide, quantitative survey, collecting information from 713 exercise therapy departments, was conducted. Measurements were classified as standardised or non-standardised and assigned to the International Classification of Functioning (ICF). Admission interviews and information from other professionals were analysed using a qualitative content analysis.

Results: In total, 1008 SMs included 9007 ICF concepts: 16% were classified as personal factors, but none were clearly related to physical activity promotion. Admission interviews contained several non-standardised assessments of personal factors: goals (40%), exercise experiences/activity bibliography (10%), activity level (5%), exercise preferences (2%). Information sharing does not contain relevant information for physical activity promotion.

Discussion: Exercise therapists have scant information about the personal factors that influence clients’ physical activity behaviour. An assessment for physical activity promotion that includes physical functioning and personal factors has, so far, barely been implemented in practice.

Keywords:

• Assessment
• physical therapy
• evidence-based practice
• clinical reasoning
• behaviour change
• personal contextual factors
• interprofessional practice

Acknowledgements

The authors wish to thank DRV for the financial support provided for this study. We extend our sincere thanks to all exercise therapists who took part in the study. Thanks to the members of the German Society of Rehabilitations Sciences’ exercise therapy working group and the expert advisory board for their valuable advice and support in carrying out the research. Many thanks to Lorena Miranda, Eriselda Mino and Anna Ryan for their support in creating tables, reference lists and formatting the paper.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethical approval

The study protocol and the data privacy concept were examined by the Independent Ethics Commission of the Medical Faculty of Friedrich-Alexander University Erlangen-Nuremberg (Invoice no. 182_16B) and approved without objection.

Additional information

Funding

The study is funded by the German Statutory Pension Insurance (Deutsche Rentenversicherung Bund: DRV; subsidy number: 0421/40-64-50-47). The project managers at DRV sent the questionnaire-based measuring instruments in phase one and the invitations to the workshops for data collection in phase two. The funder is represented by an individual who sits in the expert group and project advisory board. Otherwise, the funder was not involved in planning the methodology, data management, analysis or interpretation. The funder was also uninvolved in the writing and submission of the manuscript.