Behaviour change techniques used by physiotherapists for physical activity promotion

Ms Breanne Kunstler1, Professor Jill Cook2, Dr Nicole Freene3, Professor Caroline Finch1, Dr Joanne Kemp2, Dr Paul O’Halloran4, Dr James Gaida5

1Australian Collaboration for Research into Injury in Sport and its Prevention (ACRISP) and Federation University Australia

2Latrobe Sports and Exercise Medicine Research Centre, School of Allied Health, Latrobe University, Melbourne, Australia

3Department of Physiotherapy, Faculty of Health, University of Canberra, Canberra, Australia

4School of Psychology and Public Health, La Trobe University, Melbourne, Australia

5University of Canberra Research Institute for Sport and Exercise (UC-RISE), Canberra, Australia

Aim: Identify the behaviour change techniques (BCTs) physiotherapists use when promoting physical activity (PA) experimentally and clinically.

Methods: Twelve online databases were searched for experimental and observational studies. Experimental studies reporting the efficacy of physiotherapist-led PA (PLPA) interventions delivered to adults in clinic-based private practice and outpatient settings with, or at risk of, non-communicable diseases were included. Observational studies reporting the techniques used by physiotherapists when promoting PA in these settings were also included. Experimental interventions and observational study results were coded using the BCT Taxonomy to identify the BCTs used by physiotherapists when delivering PLPA interventions and promoting PA clinically. The BCTs used in efficacious interventions were identified.

Results: Eleven studies, ranging from low to high risk of bias, were retained from the search yield of 4140. Two study types were identified: experimental studies (n=8) reporting the efficacy of PLPA interventions; and observational studies (n=3) reporting the techniques used when promoting PA clinically. Seven BCTs were used when promoting PA clinically, whereas 26 BCTs were used in interventions. Four BCTs were used in both settings. Social support (unspecified) was the most frequently identified BCT in both study types. Efficacious PA interventions used more BCTs (n=24), and functioned in more ways (n=6) than inefficacious interventions and interventions without a true control group (BCTs=12 and functions=2).

Significance of the findings to allied health: Experimental studies show that physiotherapists can increase patient PA levels by using interventions with many BCTs and functions. However, physiotherapists report using a small number of BCTs when promoting PA clinically, potentially producing poor ‘real world’ outcomes.