Physiotherapy Practice in Flemish Nursing Homes

May 4, 2026 updated by: Joke Spildooren, Hasselt University

Physiotherapy in Flemish Nursing Homes: Insights Into Practice, Barriers, and Facilitators

The goal of this observational study is to evaluate the extent to which physiotherapy sessions in Flemish nursing homes adhere to the IAGG-GARN guidelines and to explore factors influencing clinical practice among physiotherapists.

The study targets multiple nursing homes across Flanders, with 3 to 5 centers in each of the provinces of Limburg, Antwerp, and Flemish Brabant. This selection ensures variation in geographic location and organizational context. The participants in this study are physiotherapists working in the participating nursing homes.

The main questions it aims to answer are:

  • To what extent do the physiotherapy sessions align with the IAGG-GARN guidelines?
  • Are there differences in physiotherapy session content and volume according to physiotherapist characteristics and resident characteristics?
  • What barriers and facilitators do physiotherapists experience when implementing guideline-based practice in Flemish nursing homes?

Researchers will observe physiotherapy sessions delivered as part of routine care and document session content and duration using structured observation diaries. Participating physiotherapists will also take part in focus groups discussing experiences with guideline implementation, barriers, facilitators, and clinical decision-making.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
40

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Contact Backup

Study Locations

  • Belgium
    • Antwerpen
      • Deurne, Antwerpen, Belgium
        • Not yet recruiting
        • Nursing home
      • Zoersel, Antwerpen, Belgium
        • Recruiting
        • Nursing home
    • Limburg
      • Tongeren, Limburg, Belgium
        • Recruiting
        • Nursing home

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

The study population consists of licensed physiotherapists working in Flemish nursing homes who provide physiotherapy to older residents

Description

Inclusion Criteria:

  • None beyond being a licensed physiotherapist working in a Flemish nursing home and willing to participate.

Exclusion Criteria:

  • None

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Guideline Adherence to IAGG-GARN Recommendations
Time Frame: 2 weeks
Overall adherence of physiotherapy sessions in Flemish nursing homes to IAGG-GARN recommendations. Adherence is assessed through structured direct observation of the routine physiotherapy sessions. The secondary outcomes are operationalize adherence to the guideline (frequency, exercise intensity, exercise duration, exercise type and personalization)
2 weeks

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Exercise Description
Time Frame: 2 weeks
Narrative description of each exercise performed during a physiotherapy sessions.
2 weeks
Use of Equipment, Aids or Materials
Time Frame: 2 weeks
Type of equipment, aids or materials used during each exercise.
2 weeks
Exercise format
Time Frame: 2 weeks
Whether the exercise is performed individually or in a group setting.
2 weeks
Group Size
Time Frame: 2 weeks
Number of participants involved in group-based exercises.
2 weeks
Level of supervision
Time Frame: 2 weeks
Level of supervision provided by the physiotherapist during exercises (none, intermittent, continuous)
2 weeks
Exercise Start and End Time
Time Frame: 2 weeks
Start and end time of each exercise performed during physiotherapy sessions
2 weeks
Rest Periods During Exercises
Time Frame: 2 weeks
Rest periods during physiotherapy exercises, recorded separately as (1) rest periods instructed or allowed by the physiotherapist and (2) rest periods actually taken by the resident during exercise.
2 weeks
Exercise Category
Time Frame: 2 weeks
Category of each exercise performed during physiotherapy sessions (strength, endurance, mobility/flexibility, balance/coordination, or other)
2 weeks
Exercise Volume - Repetitions
Time Frame: 2 weeks
Number of repetitions per exercise, recorded separately as (1) repetitions prescribed by the physiotherapist and (2) repetitions actually performed by the resident during the exercise.
2 weeks
Exercise Intensity
Time Frame: 2 weeks
Intensity of each exercise performed during physiotherapy sessions, including whether intensity was explicitly determined during the exercise, the method used to determine intensity, the recorded intensity value, and the observer's interpretation (high, medium or low intensity).
2 weeks
Walking or Treadmill parameters
Time Frame: 2 weeks
Parameters during walking or treadmill exercises (incline and speed).
2 weeks
Cycling Parameters
Time Frame: 2 weeks
Parameters recorded during cycling exercises (rounds per minute, resistance and distance)
2 weeks
Speed of movement
Time Frame: 2 weeks
Speed of movement during exercises, classified according to the observed execution pace (slow, controlled or fast).
2 weeks
External Load (Resistance)
Time Frame: 2 weeks
External load applied during exercises (kg).
2 weeks
Contextual Factors
Time Frame: 2 weeks
Contextual elements influencing physiotherapy sessions, such as disturbances (e.g., noise, interruptions) and other relevant observations.
2 weeks

Other Outcome Measures

Other Outcome Measures

For clinical trials, a planned measurement described in the protocol that is used to determine the effect of an intervention/treatment on participants. For observational studies, a measurement or observation that is used to describe patterns of diseases or traits, or associations with exposures, risk factors, or treatment. Types of outcome measures include primary outcome measure and secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Background information physiotherapists
Time Frame: baseline

Age, gender, year of graduation, specialization, number of years of experience as a physiotherapist, educational level (e.g., bachelor, master…), employment regime (full-time, part-time, other appointment), number of years working within the nursing home and continuing education participation

This information is pseudonymously linked to the observation data with the aim of identifying interpersonal differences in therapy approach.
baseline
Background information residents
Time Frame: baseline

In addition, the physiotherapeutic interventions will be linked to residents' background information to determine the extent to which the physiotherapists adapt their therapy to the specific needs of the patient. The following information will be used:

  • Age category: 65-70, 71-75, 76-80, 81-85, 86-90, 91-95, 96-100 and 100+
  • Gender: male / female / other
  • Stable medical status: yes/no
  • Cognitive status (MMSE score): 25-30 (normal), 21-24 (mild cognitive impairment), 10-20 (moderate cognitive impairment), 0-9 (severe cognitive impairment)
  • Ability to walk (maximum achievable level for resident): independent, independent with walking aid, with assistance from caregiver, wheelchair-bound, bedridden
  • Ability to transfer (maximum achievable level for resident): independent, with aid, with assistance from caregiver, with hoist
  • Following physiotherapy: yes/no
  • With which (main) physiotherapist: physiotherapist ID
baseline
Focus groups with physiotherapists
Time Frame: 2 days

Step 1: Center-specific After completion of the observations, a center-specific feedback session will be held at each nursing home. These sessions (60-90 minutes, 2-8 therapists) present and discuss the results with physiotherapists, focusing on their work context, its influence on care delivery, and the reasoning behind their choices.

Step 2: Validation Following the feedback sessions, a validation focus group will be organized at a neutral location (UHasselt), including 1-2 representatives per center and additional physiotherapists (10 participants, 60-90 minutes). Results from the observations and all feedback sessions will be presented anonymously. The discussion will focus on validating and deepening findings, identifying key themes and patterns, and determining priorities for further development

Digital recordings of the focus groups will be made during the session. At the end of the focus groups, the recordings will be transcribed and anonymized for analysis.
2 days

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Hasselt University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Joke Spildooren, Prof.dr, UHasselt

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
March 23, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
January 1, 2028

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 1, 2028

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
April 2, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
May 4, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
May 8, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
May 8, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
May 4, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
May 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • B1152025000037
  • BOF25OWB11 (Other Grant/Funding Number: Bijzonder Onderzoekfonds (BOF))

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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