Knowledge about foot-specific foot falls risk factors and exercise among physiotherapists in the UK and Portugal: a cross-sectional survey

Monserrat Conde, Gordon J. Hendry, Jim Woodburn, Dawn A. Skelton

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BACKGROUND AND PURPOSE: Foot-related falls risk factors and specific foot and ankle exercise interventions are within the scope of Physiotherapy, yet little is known about United Kingdom (UK) and Portugal-based (PT) physiotherapists' self-perceived knowledge, confidence and practice of such interventions, or perceptions of patients' falls prevention knowledge. The purpose of this study was to assess levels of self-reported knowledge, confidence, and practices surrounding foot-specific falls risk and exercise for fall prevention in physiotherapists working in the UK and in Portugal. It also aimed to explore physiotherapists' views about their participants' falls prevention knowledge.

METHODS: A self-report online survey was developed, and pilot tested in both nations. Registered Physiotherapists were invited to participate through their professional associations, social media and snowballing. Mann-Whitney tests were used to compare mean ranks of ordinal variables between nations and Chi-square test to assess the independency between pairs of variables. Spearman's correlation coefficient (rs) was used to measure the association between pairs of variables (p < 0.05).

RESULTS: 682 physiotherapists participated in the survey [UK n = 229 (mean (SD) age = 43(10) years, 86.9% female]; PT n = 453 (mean (SD) age = 33(9) years, 78.3% female]. Among physiotherapists with a caseload of ≥70% older adults, more PT-based physiotherapists held postgraduate qualifications (p = 0.01). Most physiotherapists correctly identified generic and foot-specific risk factors (≥70% of participants for each item). More UK-based physiotherapists reported always prescribing ankle and foot exercises (42.6% vs. 33%, p =< 0.001) and displayed higher levels of self-reported confidence surrounding exercise-based interventions.

DISCUSSION: Our sample of UK and Portugal-based physiotherapists are aware of the contribution of foot-specific risk factors and exercise to falls prevention, with the former group being more confident in exercise-based interventions. Both groups of physiotherapists perceived that their older patients had little knowledge about these topics, with UK older adults having slightly better knowledge on generic falls risk factors at first contact. Future studies and strategies for knowledge translation and education in foot health and foot function screening and management for physiotherapists, within a falls prevention scope, may be informed by this study.

Original languageEnglish
Article numbere1958
JournalPhysiotherapy Research International
Issue number3
Early online date11 Jun 2022
Publication statusPublished - Jul 2022


  • falls prevention
  • feet
  • foot
  • knowledge
  • survey
  • cross-cultural
  • Portugal
  • physiotherapist
  • falls
  • physiotherapy
  • older adults
  • exercise
  • cross-sectional studies
  • humans
  • risk factors
  • male
  • United Kingdom
  • physical therapists/education
  • adult
  • female
  • aged

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation


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