Physiotherapists' Use of Attentional Focus Instructions and Feedback in the Philippines: A Survey Study

Background and Purpose: Verbal instructions and feedback are critical motor learning elements within physiotherapy practice. With evident advantages associated with instructions and feedback that direct learner attention externally, it has been recommended that knowledge about the focus of attention (FOA) be translated into physiotherapy practice. However, most existing information on this topic comes from non-Asian and high-resourced settings. This study aims to fill the knowledge gap regarding context-specific practice patterns by examining the preferences of physiotherapists in the Philippines for external or internal FOA when delivering instructions and feedback across various practice areas. We also explored how professional characteristics relate to these preferences and considerations for delivering instructions and feedback. Methods: This study employed a cross-sectional survey design. A total of 223 physiotherapists completed an online survey, of which 182 answered questions on their preferences for external or internal FOA based on clinical scenarios. The survey also collected information on participants' professional and practice backgrounds, conscious planning in delivering instructions and feedback, and considerations for varying instructions and feedback. Results: The participants tended to prefer internal FOA for delivering instructions and feedback, which was not associated with educational background, years of experience, specialisation, geographic region, practice setting, or FOA familiarity. While only approximately half of the respondents were familiar with the concept of FOA, the majority tended to consciously plan the delivery of instructions and feedback based on clients' cognitive and impairment levels. Discussion: There is an overall preference for internal FOA for delivering instructions and feedback among physiotherapists in the Philippines. Work is needed to enhance practitioners' knowledge of the evidence related to FOA and to facilitate knowledge translation that enables the utilisation of research in physiotherapy practice.