Consideration of Executive Functioning for Physiotherapy Rehabilitation: Studies of Physiotherapists’ Knowledge, Normative Data, and a Practice Application
Executive functioning (EF) refers to cognitive abilities involved in decision-making and self-regulation and can be impaired in many patients referred for physiotherapy, including older adults and people living with chronic pain. This dissertation aimed to determine what physiotherapists understood about EF, to summarize normative data for application in physiotherapy practice, and to provide an assessment of feasibility for studying EF impairments in people living with chronic pain. Study one surveyed what physiotherapists understood about EF as a concept, what EF assessments they used, and if this was influenced by their primary area of practice. Respondents (N = 262) subjectively reported that they understood what EF is, but this only moderately correlated with objective understanding, r = 0.43 (p \u3c 0.001).Physiotherapists reported an awareness of some measures of EF; however, were unsure about interpreting patient scores among the multiple sets of available normative data. Study two presented summarized normative data (N = 35) for three assessments of EF in older adults based on a systematic review. Normative data were stratified by age, education, and sex in summary tables for accessible referencing by physiotherapists. Study three described the feasibility of recruitment and data collection in females living with Chronic Pelvic Pain, a musculoskeletal chronic pain condition not examined in previous EF research. Results (N = 35) indicated impaired EF, high central sensitization, pain catastrophizing, depression, anxiety, and stress. These findings demonstrated impaired EF in a patient population treated by physiotherapists, revealing an overlooked variable with the potential to impact physiotherapy rehabilitation outcomes
