Clinical decision-making of physiotherapists regarding ambulation in people with neurological conditions: A systematic review

Eloise Holland; Jill Garner

Abstract

Aims: To (1) describe how physiotherapists make decisions regarding progression of ambulation in people with neurological conditions, (2) identify the choices made by physiotherapists when progressing ambulation in neurological patients, and (3) explore factors that may influence clinical decision-making, including outcome measures.

Design: Mixed-methods systematic review

Methods: Five databases were searched from 1946 to February 25, 2024. Independent reviewers evaluated study eligibility. Data were extracted and synthesised according to the Joanna Briggs Institute approach for mixed-methods reviews and PRISMA guidelines. Qualitative data were analysed using NVivo with thematic analysis, while quantitative data were synthesised narratively, using codes from the qualitative data to interpret questionnaire responses and textual data in quantitative studies.

Results: Ten studies (eight qualitative, one quantitative, one mixed methods) met inclusion criteria The studies were rated as high quality (n=7), medium quality (n=3), low quality (n=1). Five key themes emerged from the qualitative studies: clinician assessment procedure, individualised treatment planning, patient’s assessed abilities, integrated decision-making in patient care and patient cognitive capacity.

Conclusion: This review highlights factors influencing decision-making for ambulation progression across varied settings, with clinician experience identified as essential in assessing patient outcomes. Further research should explore ambulation progression in paediatric populations and investigate specific clinical contexts in greater depth.

Key practice points:
• Clinical decision making can be influenced by assessment procedures, treatment planning, the patient’s abilities, and patient cognitive capacity.

Original language	English
Pages	293
Number of pages	1
Publication status	Published - 23 Oct 2025
Event	Australian Physiotherapy Association Scientific Conference: Lead the Physiotherapy Evolution - Adelaide Convention Centre, Adelaide, Australia Duration: 23 Oct 2025 → 25 Oct 2025 Conference number: 25 https://physiotherapy.eventsair.com/apasc25/

Conference

Conference	Australian Physiotherapy Association Scientific Conference
Abbreviated title	APASC
Country/Territory	Australia
City	Adelaide
Period	23/10/25 → 25/10/25
Internet address	https://physiotherapy.eventsair.com/apasc25/

Keywords

physiotherapists
ambulation
decision making
neurological patients

Access to Document

https://physiotherapy.eventsair.com/apasc25/abstractsLicence: In Copyright

Cite this

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title = "Clinical decision-making of physiotherapists regarding ambulation in people with neurological conditions: A systematic review",

abstract = "Aims: To (1) describe how physiotherapists make decisions regarding progression of ambulation in people with neurological conditions, (2) identify the choices made by physiotherapists when progressing ambulation in neurological patients, and (3) explore factors that may influence clinical decision-making, including outcome measures. Design: Mixed-methods systematic review Methods: Five databases were searched from 1946 to February 25, 2024. Independent reviewers evaluated study eligibility. Data were extracted and synthesised according to the Joanna Briggs Institute approach for mixed-methods reviews and PRISMA guidelines. Qualitative data were analysed using NVivo with thematic analysis, while quantitative data were synthesised narratively, using codes from the qualitative data to interpret questionnaire responses and textual data in quantitative studies. Results: Ten studies (eight qualitative, one quantitative, one mixed methods) met inclusion criteria The studies were rated as high quality (n=7), medium quality (n=3), low quality (n=1). Five key themes emerged from the qualitative studies: clinician assessment procedure, individualised treatment planning, patient{\textquoteright}s assessed abilities, integrated decision-making in patient care and patient cognitive capacity. Conclusion: This review highlights factors influencing decision-making for ambulation progression across varied settings, with clinician experience identified as essential in assessing patient outcomes. Further research should explore ambulation progression in paediatric populations and investigate specific clinical contexts in greater depth. Key practice points: • Clinical decision making can be influenced by assessment procedures, treatment planning, the patient{\textquoteright}s abilities, and patient cognitive capacity.",

keywords = "physiotherapists, ambulation, decision making, neurological patients",

author = "Eloise Holland and Jill Garner",

year = "2025",

month = oct,

day = "23",

language = "English",

pages = "293",

note = "Australian Physiotherapy Association Scientific Conference : Lead the Physiotherapy Evolution, APASC ; Conference date: 23-10-2025 Through 25-10-2025",

url = "https://physiotherapy.eventsair.com/apasc25/",

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TY - CONF

T1 - Clinical decision-making of physiotherapists regarding ambulation in people with neurological conditions

T2 - Australian Physiotherapy Association Scientific Conference

AU - Holland, Eloise

AU - Garner, Jill

N1 - Conference code: 25

PY - 2025/10/23

Y1 - 2025/10/23

N2 - Aims: To (1) describe how physiotherapists make decisions regarding progression of ambulation in people with neurological conditions, (2) identify the choices made by physiotherapists when progressing ambulation in neurological patients, and (3) explore factors that may influence clinical decision-making, including outcome measures. Design: Mixed-methods systematic review Methods: Five databases were searched from 1946 to February 25, 2024. Independent reviewers evaluated study eligibility. Data were extracted and synthesised according to the Joanna Briggs Institute approach for mixed-methods reviews and PRISMA guidelines. Qualitative data were analysed using NVivo with thematic analysis, while quantitative data were synthesised narratively, using codes from the qualitative data to interpret questionnaire responses and textual data in quantitative studies. Results: Ten studies (eight qualitative, one quantitative, one mixed methods) met inclusion criteria The studies were rated as high quality (n=7), medium quality (n=3), low quality (n=1). Five key themes emerged from the qualitative studies: clinician assessment procedure, individualised treatment planning, patient’s assessed abilities, integrated decision-making in patient care and patient cognitive capacity. Conclusion: This review highlights factors influencing decision-making for ambulation progression across varied settings, with clinician experience identified as essential in assessing patient outcomes. Further research should explore ambulation progression in paediatric populations and investigate specific clinical contexts in greater depth. Key practice points: • Clinical decision making can be influenced by assessment procedures, treatment planning, the patient’s abilities, and patient cognitive capacity.

AB - Aims: To (1) describe how physiotherapists make decisions regarding progression of ambulation in people with neurological conditions, (2) identify the choices made by physiotherapists when progressing ambulation in neurological patients, and (3) explore factors that may influence clinical decision-making, including outcome measures. Design: Mixed-methods systematic review Methods: Five databases were searched from 1946 to February 25, 2024. Independent reviewers evaluated study eligibility. Data were extracted and synthesised according to the Joanna Briggs Institute approach for mixed-methods reviews and PRISMA guidelines. Qualitative data were analysed using NVivo with thematic analysis, while quantitative data were synthesised narratively, using codes from the qualitative data to interpret questionnaire responses and textual data in quantitative studies. Results: Ten studies (eight qualitative, one quantitative, one mixed methods) met inclusion criteria The studies were rated as high quality (n=7), medium quality (n=3), low quality (n=1). Five key themes emerged from the qualitative studies: clinician assessment procedure, individualised treatment planning, patient’s assessed abilities, integrated decision-making in patient care and patient cognitive capacity. Conclusion: This review highlights factors influencing decision-making for ambulation progression across varied settings, with clinician experience identified as essential in assessing patient outcomes. Further research should explore ambulation progression in paediatric populations and investigate specific clinical contexts in greater depth. Key practice points: • Clinical decision making can be influenced by assessment procedures, treatment planning, the patient’s abilities, and patient cognitive capacity.

KW - physiotherapists

KW - ambulation

KW - decision making

KW - neurological patients

M3 - Abstract

SP - 293

Y2 - 23 October 2025 through 25 October 2025