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Physical activity promotion in chiropractic: a systematic review of clinician-based surveys

BACKGROUND: Physical inactivity is a global health pandemic. Allied healthcare providers, including chiropractors, are well placed to integrate individual physical activity (PA) promotion into routine care. A previous systematic review identified that approximately 90% of chiropractors held a positi...

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Autores principales: Fernandez, Matthew, Young, Anika, Milton, Karen, Pinhiero, Marina, de Luca, Katie, Ferreira, Paulo, Hebert, Jeffrey
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9749165/
https://www.ncbi.nlm.nih.gov/pubmed/36514061
http://dx.doi.org/10.1186/s12998-022-00467-9
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author Fernandez, Matthew
Young, Anika
Milton, Karen
Pinhiero, Marina
de Luca, Katie
Ferreira, Paulo
Hebert, Jeffrey
author_facet Fernandez, Matthew
Young, Anika
Milton, Karen
Pinhiero, Marina
de Luca, Katie
Ferreira, Paulo
Hebert, Jeffrey
author_sort Fernandez, Matthew
collection PubMed
description BACKGROUND: Physical inactivity is a global health pandemic. Allied healthcare providers, including chiropractors, are well placed to integrate individual physical activity (PA) promotion into routine care. A previous systematic review identified that approximately 90% of chiropractors held a positive opinion towards healthier patient lifestyles; however, the extent to which chiropractors promote PA to their patients within routine care is unclear. This systematic review aimed to describe chiropractors' attitudes towards and current practice in advising, counselling, discussing, supporting, or recommending PA to patients. METHODS: Five databases were searched from inception to December 2021 for cross-sectional surveys that explored PA promotion by chiropractors in practice. We assessed the risk of bias of the included studies with the ‘Risk of Bias in Cross-Sectional Surveys of Attitudes and Practices’ tool. Descriptive data were extracted, grouping similar survey questions and responses into emerging categories. Chiropractors’ views regarding the perceived importance and/or their preparedness to counsel and provide PA or exercise information are reported. RESULTS: From 661 studies, 15 met the selection criteria. Surveys included 7999 chiropractors primarily from the USA, UK, Australia, and Sweden. All studies were rated as moderate-to-high risk of bias, with methodological weaknesses characterised by inconsistent reporting of missing data, non-representative samples, low response rates (i.e., less than 60%), and unknown validity of survey instruments. Chiropractors frequently recognised the importance of PA promotion, as demonstrated by the proportion of respondents reporting that they: (1) support the importance of providing PA or exercise information and counselling (64% to 100%); (2) are prepared to provide PA or exercise information and/or counselling to patients (91% to 92%,); (3) frequently obtain PA or exercise information from patients (87% to 97%,); 4) frequently discuss PA or exercise and/or provide PA or exercise information to patients (68% to 99%); and 5) frequently provide PA counselling to patients (50% to 81%.). CONCLUSION: A large majority of practising chiropractors actively engage with PA promotion. However, the results should be interpreted with caution owing to the moderate-to-high risk of bias of the included studies. Forthcoming research initiatives should explore unbiased surveys, further PA education and training as well as capitalising on chiropractors’ own PA participation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12998-022-00467-9.
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spelling pubmed-97491652022-12-15 Physical activity promotion in chiropractic: a systematic review of clinician-based surveys Fernandez, Matthew Young, Anika Milton, Karen Pinhiero, Marina de Luca, Katie Ferreira, Paulo Hebert, Jeffrey Chiropr Man Therap Systematic Review BACKGROUND: Physical inactivity is a global health pandemic. Allied healthcare providers, including chiropractors, are well placed to integrate individual physical activity (PA) promotion into routine care. A previous systematic review identified that approximately 90% of chiropractors held a positive opinion towards healthier patient lifestyles; however, the extent to which chiropractors promote PA to their patients within routine care is unclear. This systematic review aimed to describe chiropractors' attitudes towards and current practice in advising, counselling, discussing, supporting, or recommending PA to patients. METHODS: Five databases were searched from inception to December 2021 for cross-sectional surveys that explored PA promotion by chiropractors in practice. We assessed the risk of bias of the included studies with the ‘Risk of Bias in Cross-Sectional Surveys of Attitudes and Practices’ tool. Descriptive data were extracted, grouping similar survey questions and responses into emerging categories. Chiropractors’ views regarding the perceived importance and/or their preparedness to counsel and provide PA or exercise information are reported. RESULTS: From 661 studies, 15 met the selection criteria. Surveys included 7999 chiropractors primarily from the USA, UK, Australia, and Sweden. All studies were rated as moderate-to-high risk of bias, with methodological weaknesses characterised by inconsistent reporting of missing data, non-representative samples, low response rates (i.e., less than 60%), and unknown validity of survey instruments. Chiropractors frequently recognised the importance of PA promotion, as demonstrated by the proportion of respondents reporting that they: (1) support the importance of providing PA or exercise information and counselling (64% to 100%); (2) are prepared to provide PA or exercise information and/or counselling to patients (91% to 92%,); (3) frequently obtain PA or exercise information from patients (87% to 97%,); 4) frequently discuss PA or exercise and/or provide PA or exercise information to patients (68% to 99%); and 5) frequently provide PA counselling to patients (50% to 81%.). CONCLUSION: A large majority of practising chiropractors actively engage with PA promotion. However, the results should be interpreted with caution owing to the moderate-to-high risk of bias of the included studies. Forthcoming research initiatives should explore unbiased surveys, further PA education and training as well as capitalising on chiropractors’ own PA participation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12998-022-00467-9. BioMed Central 2022-12-13 /pmc/articles/PMC9749165/ /pubmed/36514061 http://dx.doi.org/10.1186/s12998-022-00467-9 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Systematic Review
Fernandez, Matthew
Young, Anika
Milton, Karen
Pinhiero, Marina
de Luca, Katie
Ferreira, Paulo
Hebert, Jeffrey
Physical activity promotion in chiropractic: a systematic review of clinician-based surveys
title Physical activity promotion in chiropractic: a systematic review of clinician-based surveys
title_full Physical activity promotion in chiropractic: a systematic review of clinician-based surveys
title_fullStr Physical activity promotion in chiropractic: a systematic review of clinician-based surveys
title_full_unstemmed Physical activity promotion in chiropractic: a systematic review of clinician-based surveys
title_short Physical activity promotion in chiropractic: a systematic review of clinician-based surveys
title_sort physical activity promotion in chiropractic: a systematic review of clinician-based surveys
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9749165/
https://www.ncbi.nlm.nih.gov/pubmed/36514061
http://dx.doi.org/10.1186/s12998-022-00467-9
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