Healthcare professionals consensus on purpose, content and frequency of physical activity for older adults during the non-weight-bearing rehabilitation: an iterative consensus study

BACKGROUND: Among older adults who are temporarily restricted from weight-bearing on a lower extremity, inactivity is prevalent, and there is limited evidence-based guidance available regarding physical activity programs for older adults with such restrictions. However, healthcare professionals do have ample experience working with those patients. This study explored their experiences and aimed to reach consensus among healthcare professionals on the purpose, desired content, and frequency of physical activity for older adults during non-weight-bearing rehabilitation. METHODS: A three-phase iterative design was followed. Phase one consisted of focus group discussions with healthcare professionals. In phase two, panel discussions were used to extract relevant information from phase one. The relevant information was used as statements in phase three, a Delphi consensus study aimed to reach consensus among healthcare professionals. RESULTS: In total, 76 healthcare professionals participated in the first Delphi round. 47 consensus statements, based on the first two phases, were grouped under eight themes derived from the focus group and panel discussions. Consensus was reached on 38 of 47 statements in round one. In round two, 51 participants reviewed eight revised or new statements, of which six reached consensus. The final two statements that did not reach consensus were revised based on the participants' comments and expert feedback. CONCLUSION: This study provides a consensus-based foundation for developing physical activity interventions for older adults during non-weight-bearing rehabilitation. Although there was broad agreement on most statements, participants emphasized the importance of tailoring interventions to each patient's individual condition, abilities, and goals.