Perceptions and experiences of Italian physiotherapists in managing patients' mental and cognitive health: a cross-sectional study.
Inaihá Laureano Benincá, Maria Gattuso, Stefania Butti and 2 others
96% of Italian physiotherapists believe exercise benefits cognition, yet 39.4% feel unprepared to manage cognitive deficits. 60.7% feel unprepared for mental health patients, and 84.6% have never received a referral for one.
Key findings
196% of respondents believed motor rehabilitation provides cognitive benefits, but 39.4% reported not feeling competent to manage patients with cognitive deficits, and 60.7% reported the same for mental health conditions.
2Physiotherapists in the neurological field had significantly higher odds of reporting competence in managing cognitive deficits (OR = 2.47; 95% CI: 1.52-3.99) and mental health conditions (OR = 1.90; 95% CI: 1.15-3.14), and were more likely to receive cognitive referrals (OR = 1.94; 95% CI: 1.24-3.05). Musculoskeletal physiotherapists were significantly less likely to report cognitive referrals (OR = 0.41; 95% CI: 0.26-0.65).
388.4% had been introduced to physiotherapy's role in cognitive functioning during training, but only 26.2% had been specifically informed about the mental health role. Years of experience predicted cognitive training exposure (p = 0.010) but did not significantly affect perceived competence in mental health (p = 0.204).
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What it does not show
All competence data are self-reported; no validated tool was used to assess actual skill, so the findings reflect perception rather than measured ability. 88.5% of respondents were from Northern Italy, so the results may not represent physiotherapists in Central or Southern Italy, where healthcare organisation and resource availability differ. Multiple recruitment channels were used and the number of people who actually saw the invitation is unknown, so the sample may overrepresent physiotherapists who are more engaged with professional networks. The survey was voluntary with no incentives, which may have attracted respondents with stronger opinions about the topic.
Declared interests
The authors declare no conflict of interest. Four authors received partial funding from the European Union Next Generation EU programme (grant PRIN2022RAESSJ). The funder played no role in the design, conduct, or reporting of the study.
The easy way to misread this
This is a survey of how Italian physiotherapists feel about their training and the referrals they receive. It is not a test of whether exercise or rehabilitation improves mental or cognitive health. The competence gaps it identifies describe a training and referral problem, not evidence that the treatments fail to work for your patients.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →