This study aimed to investigate the attitudes, barriers, and practices of Swiss physiotherapists regarding lifestyle interventions and weight reduction in individuals with chronic pain and overweight or obesity.
An anonymous, self-developed cross-sectional online survey with 44 items was distributed among Swiss physiotherapists between December 2023 and March 2024. Eligible participants were required to speak German and work as a physiotherapy clinician in Switzerland. Survey access links were spread through Swiss physiotherapy networks, social media, educational platforms, and e-mail lists (snowball sampling). Descriptive statistics and frequency distributions were calculated.
A total of 501 complete questionnaires were analyzed. Respondents’ (80.4% female) mean age was 39.2 years (SD 11.8). Swiss physiotherapists generally agreed or strongly agreed that advice on nutrition (95.6%), physical activity (98.8%), and other lifestyle components (e.g. sleep and stress management) (97.6%) are important for weight reduction interventions in patients with chronic pain and overweight or obesity. Respondents believed that providing advice on lifestyle components (74.1%) and implementing weight reduction interventions (54.7%) are within their scope of practice. Only 57.1% of respondents rated their knowledge about weight reduction interventions as good. Moreover, respondents identified missing knowledge, lack of administrative time, duration of therapy sessions, financing restrictions, and poor patient adherence as main barriers to the implementation of these interventions in clinical practice.
While 57.3% of respondents recalled lifestyle topics from their physiotherapy education, only 35.2% rated their study program as good or very good. Despite this, 81.4% recommended weight reduction for patients with chronic pain and overweight or obesity, while 65.7% incorporated such interventions into the treatment. As strategies to improve the nutritional status of patients with chronic pain in the context of weight reduction interventions, respondents recommended increasing physical activity (90.4%), referring patients to dieticians (70.3%), providing information on stress (50.7%) and sleep management (48.7%), applying relaxation techniques (48.1%), and providing nutritional advice (46.9%).
Swiss physiotherapists seem to acknowledge the importance of nutrition, physical activity, and healthy lifestyle components in the weight management of patients with chronic pain and overweight or obesity. However, barriers such as lack of administrative time, financing restrictions, patient adherence and physiotherapy education appear to hinder the implementation of lifestyle modifications and weight reduction interventions within physiotherapy practice. Moreover, there is an ongoing debate among Swiss physiotherapists whether these interventions fall within their scope of practice.
Further research should focus on exploring strategies to overcome the identified barriers to implement lifestyle modifications and weight reduction interventions in physiotherapy practice. In addition, investigating the effectiveness of targeted educational programs for physiotherapists could address the gap between perceived importance and practical application of lifestyle modifications and weight reduction interventions.
Chronic pain
Physiotherapy
