Physical activity promotion is lacking in local treatment protocols for patients hospitalized with myocardial infarction: A cross-sectional study

Objectives: To describe the content and methodological quality of local physiotherapy and nursing treatment protocols specifically regarding physical activity promotion in patients hospitalised with myocardial infarction. Design: Cross-sectional study comprising the analysis of 18 physiotherapy and 14 nursing protocols. Setting: Protocols from twenty Dutch hospitals were used. Main outcome measures: Data were extracted from protocols for patients hospitalised with myocardial infarction according to a standardized data-extraction procedure. Descriptive statistics were used to describe the content of protocols, in specific, treatment goals, interventions, clinimetrics and discharge criteria. Methodological quality of the protocols was examined using the AGREE-II tool. Results: Therapeutic goals concerning physical activity were described in 83% of the physiotherapy protocols and in 7% of the nursing protocols. Therapeutic interventions concerning physical activity were described in 100% of the physiotherapy protocols and in 57% of the nursing protocols. Two (14%) of the fourteen interventions described in the physiotherapy protocols and none in the nursing protocols, were interpreted as physical activity promotion. All protocols were rated as having low methodological quality, mainly due to a lack of supporting scientific evidence. The overall quality was rated with an average score of 3 out of 7 (range: 1-5). Conclusions: Physiotherapy and nursing protocols for hospitalized patients with myocardial infarction are primarily aimed at physical activity under supervision, rather than physical activity promotion. Our work provides physiotherapists and nurses insights in how to further improve the content and methodological quality of their local treatment protocols for patients hospitalised with myocardial infarction.