Striving to provide high-value care as a physiotherapist is one of the core principles and passions at Physio Development.
It doesn’t get much bigger than the opportunity to improve our patients’ quality of life through prescribing exercise.
This week saw the release of the World Health Organization (WHO) 2020 guidelines on physical activity and sedentary behaviour. The potential for improving public health outcomes through these guidelines is huge.
What a great opportunity we have as physiotherapists to promote these guidelines to our patients and colleagues where indicated. The more people that can access these guidelines and enjoy the health benefits that come from them, the better!
There will be more to expand on with these WHO 2020 guidelines, but below is a summary and link to the guidelines as well as a British Journal of Sports Medicine (BJSM) podcast with two of the authors to chat through the main updates and recommendations.
These latest guidelines give recommendations for all age groups (children, adolescents, adults and older adults) and also include new specific recommendations for pregnant and postpartum women and people living with chronic conditions or disability.1
A direct quote from the guidelines:1
All adults should undertake 150–300 min of moderate-intensity, or 75–150 min of vigorous-intensity physical activity, or some equivalent combination of moderate-intensity and vigorous-intensity aerobic physical activity, per week.
Among children and adolescents, an average of 60 min/day of moderate-to-vigorous intensity aerobic physical activity across the week provides health benefits.
The guidelines recommend regular muscle-strengthening activity for all age groups.
Additionally, reducing sedentary behaviours is recommended across all age groups and abilities, although evidence was insufficient to quantify a sedentary behaviour threshold.”1
To coincide with the release of these latest guidelines, Daniel Friedman from BJSM interviewed Professor Fiona Bull and Dr Juana Willumsen to chat through the latest recommendations.
(Duration: ~21 minutes)
This systematic review looks at the comparative effectiveness of education, physical treatments (exercise, orthoses or patellar taping/mobilisation) and wait-and-see as treatments for patellofemoral pain at both 3-months and 12-months.3
(Duration: ~19 minutes)
This is another great episode from Physio Network, a chat with Michael Rizk and Ben Cormack on exercise prescription in our clinical practice.
- Focus on the person in front of you to determine what the patient wants to achieve and how they can achieve this
- Be more person-focused rather than intervention-focused
- Consider whether a particular exercise (or any intervention) is relevant for them and their goals
- Exercise and movement are tools that help patients achieve their goals
- Consider the magnitude of effects of an intervention, rather than just the conclusion
Out of the Box:
– By Lisa Feldman Barrett – TEDxCambridge (18th May 2018)
(Duration: ~22 minutes)
The biopsychosocial model encourages us to take time to understand a person’s story.
Our contemporary understanding of pain is that it is a multi-factorial experience unique to each individual.
This TED talk by psychologist Lisa Feldman Barrett got me thinking.
A key message in this talk is:
What you see is influenced by how you feel.
Your mood influences what you see (your vision), what you hear (your hearing), and every sense that you have (smell, taste and touch).”5
This mood is better described as ‘affect’.
This affect is a lens through which we experience the world and is influenced by the sum of all of our life experiences, as well as what circumstances we are facing at the moment.
It reminds me of the Lorimer Moseley bushwalk story involving both real and perceived danger during two different bushwalks.
This topic is a nice prompt for us as physiotherapists to keep taking the time to listen to our patients. To listen to their understanding of their pain and to aspects of their story that they are comfortable sharing with you in a consult.
This improved understanding of a patient can help determine if further investigation is needed to assess for red flags or specific pathologies, or if a referral to another health practitioner with more expertise is relevant.
It can also help guide us in how we provide education to a patient to improve their understanding of their pain and how they can be more empowered and in control of their situation.
Please feel free to share these clinical resources with physiotherapists in your circle to help promote high-value care in physiotherapy around the world.
All the best!
1. Bull FC, Al-Ansari SS, Biddle S, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. British Journal of Sports Medicine 2020;54:1451-1462. https://creativecommons.org/licenses/by/4.0/ [link]
2. Podcast: The 2020 WHO Guidelines on Physical Activity with Prof Fiona Bull and Dr Juana Willumsen. Ep #456. British Journal of Sports Medicine – 25th November 2020 [link]
3. Winters M, Holden S, Lura CB, et al. Comparative effectiveness of treatments for patellofemoral pain: a living systematic review with network meta-analysis. British Journal of Sports Medicine Published Online First: 26 October 2020. doi: 10.1136/bjsports-2020-102819. http://creativecommons.org/licenses/by-nc/4.0/ [link]
4. Podcast: #5 – Is exercise a magic bullet? With Ben Cormack. Physio Explained by Physio Network – 20th November 2020 [link]
5. TEDx Talks: Cultivating Wisdom: The Power Of Mood | Lisa Feldman Barrett | TEDxCambridge – 18th May 2018 [link]