Objectives To i) identify physiotherapists’ needs for professional development support and ii) address the educational need to support mid-level physiotherapists to transition to a highly-developed physiotherapist within a specialty area, by creating a structured clinical education pathway. Design Experience-based co-design (EBCD) with three interactive co-design workshops (one to identify learning needs, two to develop the pathway) conducted over four months. Setting Large public hospital service Participants Physiotherapists of varied experience levels were included Data collection Workshops were audio-recorded and transcribed verbatim, and field notes taken. A clinical education pathway was developed iteratively through feedback provided at workshops and by key stakeholders. Results Nineteen physiotherapists participated in the workshops. The primary theme of Workshop 1 was, “Opportunities to advance are often serendipitous”, in which a tension emerged between clinical and non-clinical demands, impeding participation in professional development. A clinical education pathway was described as needing structure, clear expectations, and managerial support. The resulting clinical education pathway was comprised of four elements: 1) study days (with focus on specialty-specific and non-clinical skills), 2) mentoring, 3) experiential learning including project work, and 4) assessment of ‘on the job’ capabilities. Conclusion A clinical education pathway comprising study days, mentoring, experiential learning, and competency assessment was designed in collaboration with end-users to support transition of mid-level physiotherapists into specialty areas of practice. This pathway seeks to improve skills, confidence and evidence-based behaviours in specialty areas of physiotherapy. Contribution of the paper •Physiotherapists need structured professional development with clear expectations that is supported by managers to support career advancement.•Physiotherapists require knowledge and experience in both non-clinical and clinical skills when transitioning to areas of specialty practice.•Physiotherapists value experiential learning experiences supported by skilled mentors.
OBJECTIVES:Rotator cuff tendinopathy (RoCuTe) negatively impacts quality of life, occupations, and mental health. Despite inclusion of patients' values being recommended in evidence-based practice, they are rarely present in guidelines. We sought to inform clinical practice and guideline development by exploring patient's experience of, and perspectives on, RoCuTe management. DESIGN, SETTING AND PARTICIPANTS:Semi-structured online interviews with 14 people, with RoCuTe internationally (8F; age: 21-81 y; symptom duration: 18-300 m). Interviews were recorded, transcribed verbatim, and analysed thematically using the framework method. RESULTS:Thirty-three subthemes were identified across three themes. (A) Patients prioritised clarity around symptom onset and treatment outcomes, valuing clinicians who listened and validated their pain experience: One thing I say… [to] professionals who work in the medical field: listen to the patient, (P004) and When it comes to a pain like that oh it's impossible (P012). (B) Patient-clinician interactions shaped behaviour, with clinical recommendations facilitating greater engagement in rehabilitation activities: I don't think I would have pushed myself to do those things unless I'd been recommended to. (P016). (C) Treatment was perceived as most effective when delivered through structured demonstration, explanation, and supported practice: demonstrate, explain, imitate and practice. So that was part of what they were doing (P008). CONCLUSION:RoCuTe want to be included in the decision making around their diagnostic process and treatment. They value quality care, wanting their shoulder pain and its impact to be understood and addressed using treatment options with which they can engage. CONTRIBUTION OF THE PAPER.
BACKGROUND:Physical inactivity is prevalent among hospitalised patients despite effective interventions. Current literature lacks clarity on how inpatient movement behaviours are observed and recorded. Greater methodological clarity is needed to support evaluation and implementation of inpatient physical activity interventions. OBJECTIVES:To synthesise direct observation methods for assessing inpatient movement behaviour at ward level, enhancing consistency and utility for evaluating and promoting mobilisation in hospital settings. DATA SOURCES:MEDLINE, Embase, PsycINFO, CINHAL, Cochrane, Scopus, and Web of Science were searched (inception to 18/3/2026). ELIGIBILITY CRITERIA:We included studies investigating inpatient movement behaviour (physical activity and/or sedentary behaviour) through ward-level direct observation. Exclusions were studies on infants, undertaken in emergency departments, or targeting fixed-position limb activities. RESULTS:108 included studies were mostly conducted in acute settings (n = 47), involving stroke survivors (n = 44) and patients over 65 years (n = 52). Behavioural mapping (n = 75) was the most common technique with eight others identified. Commonly recorded outcomes included activity type, location, and social context (n = 63), documented using paper or electronic tools. Observation periods commonly spanned five days (Median 5, Range 1 to 68), nine hours per session (Median 9, Range 2 to 34) over twelve weeks (Median 90 days, Range 1 day to 3 years), involving two observers (Median 2, Range 1 to 13) per ward. LIMITATIONS:Evaluation of method performance and addressing methodological heterogeneity were beyond our scope, but future work could assess robustness and support standardisation across settings. CONCLUSIONS AND IMPLICATIONS:This review provides methodological guidance on ward-based direct observation of inpatient movement behaviour, supporting its use in development and evaluation of physical rehabilitation and broader hospital-based services to promote patient outcomes. The scoping review is not funded and is registered at the Open Science Framework via https://osf.io/t9bh5. CONTRIBUTION OF THE PAPER.
The 2017 Manchester Arena bombing exposed major gaps in the UK’s civilian trauma rehabilitation services. In response, the Enhanced Rehabilitation after Major Trauma Programme (ERP), a structured, multidisciplinary rehabilitation approach, was developed by the NHS, in collaboration with the Universities of XXX and XXX, and the XXX. This study employed the Normalisation Process Theory (NPT) framework to evaluate the integration and impact of ERP from the perspectives of physiotherapists and patients. Thirteen patients and four physiotherapists participated in semi-structured interviews and a focus group. Data were analysed using reflexive thematic analysis (RTA) and then deductively with NPT constructs. Both groups regarded ERP as a valuable alternative to standard NHS rehabilitation. Its structured, multidisciplinary design supported physical and psychological recovery, improved motivation, and enhanced physiotherapist expertise. However, concerns were raised about sustaining progress after ERP, difficulties transitioning back to NHS care, and the absence of long-term rehabilitation pathways. Despite its positive outcomes, the wider adoption of ERP in the NHS faces barriers, including limited resources and systemic constraints. This study demonstrates the potential of structured rehabilitation models for trauma survivors. Future research should explore cost-effective ways to sustain and expand enhanced trauma rehabilitation.
Aim To explore current obesity-education curriculum content in entry-level physiotherapy programmes across European higher education institutions (HEIs). Design In collaboration with ‘Europe Region of World Physiotherapy’, an online cross-sectional survey of European HEIs was conducted to explore obesity related content in entry-level physiotherapy curricula. The survey was informed by the Obesity Medicine Education Collaborative competencies, the Irish Society for Chartered Physiotherapists guidance document on the role of physiotherapy in managing adults with obesity and a PROMINENCE (Promoting Obesity and Metabolic Rehabilitation INclusion in EU entry-level Physiotherapy Curricula) project think tank discussion between the partners. Results Responses were received from 78 of 293 HEIs (27% response rate) across 32 European countries. Of these, 56% (44/78) reported including obesity-specific content in their entry-level physiotherapy curriculum, mainly covering obesity as a disease, physical activity promotion, and lifestyle management. However, significant gaps remain: only 32% (25/78) included staging of obesity severity, 39% (30/78) covered taking a comprehensive obesity history, and 18% (14/78) addressed physiotherapy post-bariatric surgery. Few curricula included multidisciplinary management (e.g., pharmacotherapy, 22/78, 28%), communication with people with obesity (14/78, 18%), or the physiotherapist's advocacy role (≤18/78, ≤23%). Only 28% (22/78) believed their curriculum adequately prepares graduates to provide evidence-based care for people with obesity. Conclusion Findings highlight the critical need to enhance obesity education for physiotherapists, in order to reflect the latest evidence which recognises the complexity of obesity as a disease and the need for a person-centred, multidisciplinary, biopsychosocial approach.
Objective To compare clinical characteristics of patients seeking primary care for hip osteoarthritis (OA) with and without concurrent low back pain (LBP), to evaluate changes in LBP intensity following participation in a supervised exercise therapy and patient education program targeting hip OA, and to assess whether hip OA responders experience greater LBP improvement. Design This longitudinal analysis included patients from the Good Life with osteoArthritis in Denmark (GLA:D®) program with symptoms primarily related to hip OA. The intervention included supervised education and neuromuscular exercise delivered over 8 weeks. Baseline demographic and clinical characteristics were compared between patients with and without LBP. Changes in LBP intensity (0–10 Numeric Rating Scale) at 3- and 12-month follow-up were analyzed using mixed-effects models. Hip OA pain responder status (≥15-point improvement on the HOOS-12 pain subscale) and its association with change in LBP intensity was assessed via multivariable linear regression analysis. Results Among 5,014 patients with hip OA, 3,079 (61%) reported comorbid LBP. Compared to patients without LBP, those with LBP had higher BMI, worse HOOS-12 pain and function scores, and greater analgesic use. Adjusted analyses showed significant reductions in LBP intensity at 3 months (19% improvement from baseline) and 12 months (21% improvement from baseline). Hip OA responders experienced greater LBP reductions than non-responders at both time points. Conclusions Patients with hip OA and comorbid LBP represent a subgroup with higher hip pain and lower function. Participation in the GLA:D® program was associated with statistically significant LBP improvement, particularly among hip OA responders.
Patients increasingly bring artificial intelligence-generated explanations, exercise suggestions and self-management advice into physiotherapy consultations. Commenting on Vancampfort and Van Damme’s recent article in Physiotherapy, this letter argues that physiotherapists should not treat AI as either a threat or an autonomous clinical authority. Instead, AI literacy should become part of safe, ethical and equity-ready physiotherapy practice. We propose an Ask–Appraise–Adapt–Audit pathway to help clinicians identify AI use, assess clinical safety, individualise recommendations and monitor outcomes. Future research should prioritise safety, digital exclusion, functional outcomes, cost-effectiveness and governance.
