The experiences of physical therapists delivering a very low energy diet and exercise intervention for weight loss in people with knee osteoarthritis: A qualitative study.
Kim Allison, Rachel K Nelligan, Belinda Lawford and 10 others
PMID 39923311WHAT IT FOUND
Six physical therapists delivering a combined diet and exercise program for knee osteoarthritis felt the training and strict protocol made it manageable.
They believed it fit their scope for simple cases but warned that complex patients need medical or dietetic oversight.
Key findings
01Physical therapists viewed the combined diet and exercise intervention as a holistic 'one-stop shop' that leveraged their existing rapport with patients.
02While the structured protocol and training resources were valued, therapists lost confidence and felt outside their scope when patients deviated from the plan or had complex needs.
03Therapists believed integrating this into private practice was feasible but emphasized the need for additional practical training and external medical or dietetic support for safety.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The sample was very small (6 therapists), and all had participated in a controlled trial, which may not reflect real-world practice conditions. Therapists had limited clinical experience (median 3.5 years) and were paid for their time and training, which could bias their willingness to take on the role. The intervention was highly protocolized; therapists explicitly stated they felt out of scope when patients deviated from the plan, limiting generalizability to flexible clinical scenarios. Findings were not returned to participants for verification (member checking).
Declared interests
The authors declared no competing interests.
The easy way to misread this
Do not interpret these findings as evidence that physical therapists can independently manage weight loss in patients with complex comorbidities. The therapists explicitly stated that individualizing the diet and managing patients who deviate from the protocol was beyond their scope without additional medical or dietetic support.