Exercise therapy in routine management of peripheral arterial disease and intermittent claudication: a scoping review.

BACKGROUND: Little is known about the extent to which routine care management of peripheral arterial disease (PAD) and intermittent claudication (IC) align with best practice recommendations on exercise therapy. We conducted a scoping review to examine the published literature on the availability and workings of exercise therapy in the routine management of patients with PAD and IC, and the attitude and practice of health professionals and patients. METHODS: A systematic search was conducted in February 2018. The Cumulative Index of Nursing and Allied Health Literature, Ovid MEDLINE, Allied and Complementary Medicine Database, ScienceDirect, Web of Science and the Directory of Open Access Repositories were searched. Hand searching of reference lists of identified studies was also performed. Inclusion criteria were based on study aim, and included studies that reported on the perceptions, practices, and workings of routine exercise programs for patients with IC, their availability, access, and perceived barriers. RESULTS: Eight studies met the eligibility criteria and were included in the review. Studies conducted within Europe were included. Findings indicated that vascular surgeons in parts of Europe generally recognize supervised exercise therapy as a best practice treatment for IC, but do not often refer their patients for supervised exercise therapy due to the unavailability of, or lack of access to supervised exercise therapy programs. Available supervised exercise therapy programs do not implement best practice recommendations, and in the majority, patients only undergo one session per week. Some challenges were cited as the cause of the suboptimal program implementation. These included issues related to patients' engagement and adherence as well as resource constraints. CONCLUSION: There is a dearth of published research on exercise therapy in the routine management of PAD and IC. Available data from a few countries within Europe indicated that supervised exercise is underutilized despite health professionals recognizing the benefits. Research is needed to understand how to improve the availability, access, uptake, and adherence to the best exercise recommendations in the routine management of people with PAD and IC.

Knowledge, Attitudes, and the Practice of Health Promotion among Physiotherapists in Nigeria.

Purpose: In spite of the growing epidemic of non-communicable diseases in Nigeria and the compelling need for the active participation of physiotherapists in health promotion activities around the world, there is no evidence that physiotherapists in Nigeria are engaged in health promotion activities. This study aimed to investigate the knowledge of, attitudes toward, and practice of health promotion among physiotherapists practising in Nigeria. Method: This was a cross-sectional study. We contacted members of the Nigeria Society of Physiotherapy (n = 368) by email; the message contained a link to an online questionnaire. Results: A total of 229 (62%) physiotherapists responded. Most demonstrated a good knowledge of health promotion (approximately 70%) and indicated that they often incorporated aspects of health promotion into their patients' treatment (63%). However, fewer than one-fifth strongly agreed that health promotion was taught in their entry-level programme and had equipped them with the necessary health promotion skills. Conclusions: The majority of the physiotherapists surveyed demonstrated good knowledge and often incorporated health promotion into their routine daily practice. Nevertheless, the respondents stated that their entry-level physiotherapy education had not sufficiently equipped them for health promotion practice. These findings provide a baseline reference that can be used to track capacity building for health promotion practices. The results also highlight important gaps in the physiotherapy entry-level curriculum and the health promotion training needs of physiotherapists in Nigeria.

Objectif : malgré l'épidémie croissante de maladies non transmissibles au Nigeria et le besoin pressant de compter sur la participation active de physiothérapeutes aux activités de promotion de la santé dans le monde, rien n'indique que les physiothérapeutes du Nigeria s'investissent dans la promotion de la santé. La présente étude visait à examiner les connaissances, les attitudes et la pratique des physiothérapeutes qui exercent au Nigeria en matière de promotion la santé. Méthodologie : le présent sondage transversal a été distribué aux membres de la société de physiothérapie du Nigeria (n = 368) dans un message courriel contenant un lien vers un questionnaire en ligne. Résultats : au total, 229 physiothérapeutes (62 %) ont répondu. La plupart ont démontré une bonne connaissance de la promotion de la santé (environ 70 %) et indiqué qu'ils en intégraient souvent des aspects au traitement de leurs patients (63 %). Cependant, moins du cinquième était fortement en accord avec l'affirmation selon laquelle leur programme de base leur avait inculqué les compétences nécessaires en promotion de la santé. Conclusions : la majorité des physiothérapeutes sondés ont démontré de bonnes connaissances en promotion de la santé, qu'ils intégraient souvent à leur pratique quotidienne. Les répondants ont tout de même indiqué que leur formation de base en physiothérapie ne les outillait pas suffisamment pour qu'ils exercent des activités de promotion de la santé. Ces constatations serviront de référence à des mesures de renforcement des capacités dans les pratiques de promotion de la santé. Elles démontrent également des lacunes importantes dans le programme de base et la formation en promotion de la santé des physiothérapeutes du Nigeria.