Understanding exercise promotion in rheumatic diseases: A qualitative study among physical therapists

Background: Physical therapists have unique expertise in planning, prescribing, and supporting exercise for patients with rheumatic diseases. Promoting exercise can be a challenge, but descriptions of physical therapists? experiences within the field of rheumatology are limited. Objective: The purpose of this study was to explore and describe ways of understanding exercise promotion among physical therapists working in rheumatology. Design and Method: A phenomenographic approach was used to analyze semi-structured interviews with 25 physical therapists working primarily within the field of rheumatology from eight different physical therapy departments at hospitals across Sweden. Results: Four ways of understanding exercise promotion were identified. These were named: exercise promotion as information and monitoring of the behavior, as facilitation of skills building, as co-creation of awareness, and as the development of independence and self-reflection. Conclusion: Physical therapists in rheumatology understand exercise promotion in various ways that differ with respect to comprehensiveness and patient-centeredness. The physical therapists? use of behavior change techniques serves different purposes in exercise promotion, varying from external control to self-management. The present results might thus be used to develop awareness, knowledge, and skills for more deliberate exercise promotion among physical therapists working with patients having rheumatic diseases.