The goal of this observational study is to evaluate the extent to which physiotherapy sessions in Flemish nursing homes adhere to the IAGG-GARN guidelines and to explore factors influencing clinical practice among physiotherapists. The study targets multiple nursing homes across Flanders, with 3 to 5 centers in each of the provinces of Limburg, Antwerp, and Flemish Brabant. This selection ensures variation in geographic location and organizational context. The participants in this study are physiotherapists working in the participating nursing homes. The main questions it aims to answer are: * To what extent do the physiotherapy sessions align with the IAGG-GARN guidelines? * Are there differences in physiotherapy session content and volume according to physiotherapist characteristics and resident characteristics? * What barriers and facilitators do physiotherapists experience when implementing guideline-based practice in Flemish nursing homes? Researchers will observe physiotherapy sessions delivered as part of routine care and document session content and duration using structured observation diaries. Participating physiotherapists will also take part in focus groups discussing experiences with guideline implementation, barriers, facilitators, and clinical decision-making.
Study Type
OBSERVATIONAL
Enrollment
40
Mapping therapy sessions provided by physical therapists in Flemish nursing homes
Nursing home
Deurne, Antwerpen, Belgium
NOT_YET_RECRUITINGNursing home
Zoersel, Antwerpen, Belgium
RECRUITINGNursing home
Tongeren, Limburg, Belgium
RECRUITINGGuideline Adherence to IAGG-GARN Recommendations
Overall adherence of physiotherapy sessions in Flemish nursing homes to IAGG-GARN recommendations. Adherence is assessed through structured direct observation of the routine physiotherapy sessions. The secondary outcomes are operationalize adherence to the guideline (frequency, exercise intensity, exercise duration, exercise type and personalization)
Time frame: 2 weeks
Exercise Description
Narrative description of each exercise performed during a physiotherapy sessions.
Time frame: 2 weeks
Use of Equipment, Aids or Materials
Type of equipment, aids or materials used during each exercise.
Time frame: 2 weeks
Exercise format
Whether the exercise is performed individually or in a group setting.
Time frame: 2 weeks
Group Size
Number of participants involved in group-based exercises.
Time frame: 2 weeks
Level of supervision
Level of supervision provided by the physiotherapist during exercises (none, intermittent, continuous)
Time frame: 2 weeks
Exercise Start and End Time
Start and end time of each exercise performed during physiotherapy sessions
Time frame: 2 weeks
Rest Periods During Exercises
Rest periods during physiotherapy exercises, recorded separately as (1) rest periods instructed or allowed by the physiotherapist and (2) rest periods actually taken by the resident during exercise.
Time frame: 2 weeks
Exercise Category
Category of each exercise performed during physiotherapy sessions (strength, endurance, mobility/flexibility, balance/coordination, or other)
Time frame: 2 weeks
Exercise Volume - Repetitions
Number of repetitions per exercise, recorded separately as (1) repetitions prescribed by the physiotherapist and (2) repetitions actually performed by the resident during the exercise.
Time frame: 2 weeks
Exercise Intensity
Intensity of each exercise performed during physiotherapy sessions, including whether intensity was explicitly determined during the exercise, the method used to determine intensity, the recorded intensity value, and the observer's interpretation (high, medium or low intensity).
Time frame: 2 weeks
Walking or Treadmill parameters
Parameters during walking or treadmill exercises (incline and speed).
Time frame: 2 weeks
Cycling Parameters
Parameters recorded during cycling exercises (rounds per minute, resistance and distance)
Time frame: 2 weeks
Speed of movement
Speed of movement during exercises, classified according to the observed execution pace (slow, controlled or fast).
Time frame: 2 weeks
External Load (Resistance)
External load applied during exercises (kg).
Time frame: 2 weeks
Contextual Factors
Contextual elements influencing physiotherapy sessions, such as disturbances (e.g., noise, interruptions) and other relevant observations.
Time frame: 2 weeks
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