Introduction Dementia is a leading cause of disability. Physiotherapists play a crucial role in caring for people with dementia. However, previous research has found that physiotherapists have low knowledge and confidence working with people with dementia. Objective To determine: 1) What are the components of effective physiotherapy care for people with dementia; and 2) What can be done to facilitate the provision of effective physiotherapy care. Methods This was a qualitative study using an interpretive description approach. Sixteen physiotherapists experienced in dementia care participated in semi-structured interviews. Researchers analyzed data using thematic analysis. Results Two themes were created for each research objective. The themes explaining the components of effective physiotherapy care were: 1) engaging the person with dementia (subthemes: knowing the person with dementia; using knowledge to adapt the approach to successfully deliver physiotherapy treatments; optimizing the physical environment) and 2) collaborative care (subthemes: working with care partners; working as an interdisciplinary team). The themes describing how to facilitate provision of effective care were: 1) Physiotherapists require "greater opportunity for mentoring and education on dementia care" and 2) Physiotherapists must "advocate for the role of physiotherapy in dementia care." Conclusion These findings provide important information regarding the components of effective dementia care for physiotherapists and will help guide clinical practice, inform future dementia education, research, and professional organization advocacy initiatives.

Purpose: To determine (1) what dementia education is provided to entry-to-professional practice physiotherapy students in Canada and Australia; (2) how this education is delivered; and (3) the challenges in delivering this education. Methods: A designated education provider from each university who offered entry-to-professional practice physiotherapy programs received a web-based questionnaire. Data were analyzed using descriptive statistics and qualitative content analysis. Results: Responses from 30/36 eligible universities resulted in 35 physiotherapy programs included for analysis. Canadian programs had a median of 5.5 hours (range, min-max, 0.5–13.0 hours), and Australia 4.0 hours (range, min-max, 2.0–22.0 hours) of dementia education. Lectures and tutorials were the most common method of delivery. There were varying amounts of education on topics such as cognition, communication, and behavioural symptoms and strategies. Challenges included dementia being difficult to teach, student stigma about people with dementia, difficulty providing students with real-life exposure to people with dementia, engaging students in the topic, and integrating dementia education into full programs. Conclusion: Dementia education across programs varies, with some programs lacking content on key topics such as cognitive, communication, and behavioural symptoms and strategies. These results may help physiotherapy accreditation organizations and universities develop dementia education standards and content.

Clinical care for people with dementia as a primary diagnosis, or as a co-morbidity, can be complex. Physiotherapists play a key role in the care of people living with dementia in multiple settings. The aim of this systematic review was to understand the attitudes, beliefs, knowledge and confidence of physiotherapists and physiotherapy students when working with people living with dementia. This was a mixed-methods systematic review that included qualitative and quantitative studies. Participants were physiotherapists working in any clinical specialty (e.g. gerontology, orthopaedic, neurological), and physiotherapy students who had completed at least 5 weeks of clinical placement. The phenomena of interest were attitudes, beliefs, knowledge and confidence when working with people with dementia in any setting. Eleven databases were searched. Data synthesis followed a convergent integrated approach according to Joanna Briggs Institute methodology for mixed methods systematic reviews. Fifteen studies were included (9 quantitative and 6 qualitative studies). Seven key themes evolved. Five related to the belief that (1) working with people with dementia is complex and challenging; (2) opportunities for education in dementia care are lacking; (3) working with people with dementia is a specialized area of practice; (4) there are unsupportive systems for working with people with dementia; and (5) people with dementia deserve rehabilitation, but their potential to improve is less certain. One theme related to knowledge (lack of knowledge in some areas of dementia care), and one theme related to confidence (lack of confidence in working with people with dementia). Physiotherapists and physiotherapy students have low levels of knowledge and confidence in areas including cognition, communication and management of behavioural symptoms. Given that higher levels of knowledge and confidence may be associated with more positive attitudes and beliefs, dementia education needs of physiotherapists at all levels needs to be addressed.

OBJECTIVES:To 1) explore physiotherapy students' experience in caring for people with dementia; 2) develop a rich understanding of their perceived preparedness to work with people with dementia upon graduation; and 3) identify opportunities to improve dementia education from the perspectives of students.DESIGN:A qualitative study comprised of semi-structured interviews via web conferencing software. Thematic analysis was undertaken, with themes/subthemes derived and a qualitative framework generated.SETTING:Three Victorian Universities in Australia.PARTICIPANTS:Physiotherapy students of entry-to-professional practice education programs (n = 17; mean age 23.7 years, 65% female), having completed at least 15 weeks of clinical placements.RESULTS:The overarching theme was that students' experience of providing care for people with dementia was variable. The three sub-themes were: 1) students experience significant challenges when working with people with dementia, 2) students experience a range of emotions when working with people with dementia, and 3) the quality of dementia learning experiences during entry-to-professional practice training is mostly inadequate. Students described the importance of the supervisor during clinical placements, and suggested incorporating 'real-life' scenario training in the classroom to assist them learn to manage the challenging symptoms of dementia.CONCLUSION:Physiotherapy students believe that entry-to-practice dementia education is insufficient. These findings have important implications for the future planning and delivery of physiotherapy dementia education. CONTRIBUTION OF THE PAPER.

Physiotherapy interventions can improve mobility and prevent falls in people with dementia. However, physiotherapists have been found to have low knowledge and confidence in working with people with dementia. Excellence in dementia physiotherapy has not been described in the literature, and it is important to establish with dementia considered a global health priority. Therefore, the aims of this study were to determine 1) what is excellence in physiotherapy dementia care and 2) how can excellence be achieved. This was a qualitative study using an interpretive description approach. Participants were 16 physiotherapists from around Australia considered to be experienced in the field of dementia care. Snowball sampling was utilised from the starting group of physiotherapists practicing in Australia, who were recognised by the National Gerontology Committee of the Australian Physiotherapy Association as experienced experts in dementia care. Physiotherapists participated in semi-structured interviews. Thematic analysis was undertaken, with themes/subthemes derived and a qualitative thematic framework generated. The four themes (and subthemes) were: 1) engaging the person with dementia (knowing the person, using knowledge to adapt the approach to successfully deliver physiotherapy interventions, optimising the physical environment), 2) collaborative care (working with care partners, working as an interdisciplinary team), 3) development of clinical skills and expertise on the job and 4) advocating for the role of physiotherapy in dementia care. Physiotherapists believe that excellence in dementia care involves being able to effectively engage the person with dementia in therapy, training and supporting care partners, and providing interdisciplinary care. Excellence in care was less about the application of evidence-based practice, but more about providing patient-centred care, achieved mainly through on-the-job learning from both physiotherapy and other health professional peers.

Dementia is a major cause of disability, and physiotherapists play a vital role in the care of people with this condition. Entry-to-professional practice physiotherapy students have been found to be ‘somewhat confident’ in working with this population, however comprehensive data about their practice experiences, their preparedness to care for people living with dementia and any educational gaps have not been previously reported. The aims of this study were to 1) determine physiotherapy students’ experiences in caring for people who have dementia, 2) determine how prepared students were to work with people who have dementia upon graduation and 3) determine if there any areas where students require further education regarding dementia, and how this would be provided. This was a qualitative study using an interpretive description approach. Participants were 17 physiotherapy students from entry-to-professional practice education programs in three universities in Victoria, Australia, in their final year of study, having completed at least 15 weeks of clinical placements. Students participated in semi-structured interviews. Thematic analysis was undertaken, with themes/subthemes derived and a qualitative thematic framework generated. The overarching theme was that students’ experience of providing care for people with dementia was overwhelming. The three sub-themes were: 1) students experience significant challenges when working with people with dementia, 2) students experience a range of emotions when working with people with dementia, and 3) the quality of dementia learning experiences during entry-to-professional practice training was perceived by students as mostly inadequate. Students described the importance of supervisors during clinical placements, and suggested incorporating ‘real-life’ scenario classroom training to assist them to learn to manage the challenging symptoms of dementia. Physiotherapy students believe that entry-to-practice dementia education is currently insufficient. These findings have important implications for the future planning and delivery of physiotherapy dementia education.

Abstract Objective The purpose of this study was to determine physical therapists’ and physical therapist students’ attitudes and beliefs, knowledge, and confidence in working with people with dementia. Methods This was a mixed-methods systematic review. Participants included physical therapists working in any clinical specialty and physical therapist students who had completed at least 1 clinical placement. Eleven databases were searched. The evidence was evaluated using the Joanna Briggs Institute Critical Appraisal Checklists. Data synthesis followed a convergent integrated approach according to Joanna Briggs Institute methodology for mixed-methods systematic reviews. Quantitative data were “qualitized” using thematic analysis and synthesized with qualitative data using thematic synthesis. Results Fifteen studies were included (9 quantitative and 6 qualitative studies). Seven key themes evolved. Five related to the belief that (1) working with people with dementia is complex and challenging; (2) opportunities for education in dementia care are lacking; (3) working with people with dementia is a specialized area of practice; (4) there are unsupportive systems for working with people with dementia; and (5) people with dementia deserve rehabilitation, but their potential to improve is less certain. One theme related to knowledge (lack of knowledge in some areas of dementia care), and 1 theme related to confidence (lack of confidence in working with people with dementia). Conclusions Physical therapists and physical therapist students believe that working with people with dementia can be challenging. The low levels of knowledge and confidence in areas important to working with people who have dementia suggest that more education about dementia is needed. Impact This mixed-methods systematic review highlights that physical therapists and physical therapist students believe that working with people who have dementia is complex and challenging. Physical therapists want more training and support in this growing area of practice.

OBJECTIVE The objective of this review is to explore the attitudes and beliefs of physiotherapists and physiotherapy students working with people with dementia. A second objective is to explore their knowledge and confidence in this area. INTRODUCTION Dementia is a leading cause of disability. It poses a challenge to individuals and health systems due to the complex nature of its presentation. With a growing body of evidence supporting physiotherapists' role in the care of people with dementia, it is important to understand their knowledge, confidence, attitudes, and beliefs in managing this role. INCLUSION CRITERIA The review will consider quantitative, qualitative, and mixed-methods studies that include physiotherapists and physiotherapy students who have worked or had a clinical placement in any setting where people with dementia might access physiotherapy care. Studies investigating one or more of the following topics will be included: knowledge, confidence, attitudes, and beliefs about working with people with any type of dementia. METHODS MEDLINE (Ovid), CINAHL (EBSCO), Embase (Ovid), Emcare, PsycINFO (Ovid), Scopus, Web of Science, Informit, ERIC (ProQuest), ProQuest Dissertations, and Google Scholar will be searched without a date limit for studies published in English. All study types will be screened for inclusion and critically appraised for methodological quality by two independent reviewers. Methodological quality will be assessed using the appropriate JBI critical appraisal checklist for each study type. Data will be extracted using standardized JBI tools for mixed methods systematic reviews. A convergent integrated approach to synthesis and integration will be used. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42020181845.

Purpose: We systematically reviewed the effectiveness of interventions to increase physical activity in older adults (aged >= 60 y), admitted for inpatient rehabilitation, without increasing the amount of therapy. Method: Five electronic databases were systematically searched to identify English-language articles reporting controlled trials of interventions to increase the physical activity (through participation or behavioural change) of older adults receiving inpatient rehabilitation. Trials were excluded if an intervention increased the intensity of usual care, either during the week or on the weekend. Two reviewers independently completed trial selection, quality assessment, and data extraction. Data were synthesized descriptively, and effect sizes with 95% CIs were calculated. Results: Of the 316 articles identified, 3 were included. Two were activity-based, and 1 was a behavioural change intervention. Physical activity was significantly improved in the behavioural change intervention trial that occurred during therapy (d = 0.27; 95% CI: 0.02, 0.52) and non-therapy time (d = 0.43; 95% CI: 0.19, 0.68). Participants in all trials were sedentary for the vast majority of the day. Conclusions: Older adults in inpatient rehabilitation have a high level of inactivity. Evidence is lacking that interventions increase physical activity in older adults admitted to inpatient rehabilitation without increasing the amount of time in therapy. Evidence from one trial indicates that behaviour-based strategies are effective for increasing physical activity levels in the inpatient rehabilitation setting.