TITLE: Performance enhancement in athletes: a survey to investigate the current clinical practice of Italian sport physiotherapists
AUTHORS: Pasquale Alessio  Sauchelli, Greta Botti, Marco Gesi, Miriam Rosa

[DESCRIPTION]
Background and rationale
Professional sport physiotherapist profile is characterised by eleven specific competences, defined by standards which are described by the Sports Physiotherapy for All (SPA) project [1].
Among these, performance evaluation and enhancement are fundamental in order to let athletes achieve their specific sport gestures best execution with a relevant impact on functional outcome. They alsoinfluencepositively on the decrease of injury risk [2-4].
Based on this cultural background, it is necessary that professionals evaluate their own clinicalpractice in order to match international standards, increase their work quality satisfying the functional requests of the sport environment, matching the perspective changes driven by the scientific community [2].

Study aim
This survey aims to:
•assess how Italian sport physiotherapists perform education and enhancement of the athlete performance in their clinical practice.
•evaluate confidence of Italian professionals in performing such competence while managing the athlete performance.
The average competencies of the analysed sample will be quantified and compared with what is set by the current scientific evidences regarding performance enhancement in athletes.

Study design
This observational cross-sectional study will be conducted in Italy through a digital questionnaire administration to a sample of 1093 sport physiotherapists [5].
Considering around 65000 Italian physiotherapists as a reference population, a confidence interval of 95% and a relative standard error of 3%, the necessary sample in order to have relevant results for the whole selected population is 1093 professionals [6-7].
This sample composed of Italian professionals will be recruited through social channels and/or newsletters sent by e-mail.
The questionnaire will be filled in only after privacy law requirements acceptance and meeting inclusion criteria by the recruited sample.
Results from this survey will be reported according to criteria set by STROBE guidelines and will be quantified and interpreted following the above-mentioned study aim.
This study will be performed in accordance with the Checklist for Reporting Results of Internet E-survey criteria (CHERRIES) and with ethical principles contained in the Helsinki Declaration [8-10].
Committee on Bioethics of University of Pisa approved the present study.



[GUIDELINES]
[1] Bulley, C., Donaghy, M., Coppoolse, R., Bizzini, M., van Cingel, R., DeCarlo, M., Dekker, L., Grant, M., Meeusen, R., Phillips, N., & Risberg, M. (2004) Sports Physiotherapy Competencies and Standards. Sports Physiotherapy For All Project. [online] Available at: www.SportsPhysiotherapyForAll.org/publications/

[2] Reinold MM. Performance Physical Therapy is Sports Physical Therapy: Why our profession needs to progress. Int J Sports Phys Ther. 2021 Apr 1;16(2):21556. doi: 10.26603/001c.21556. PMID: 33842056; PMCID: PMC8016433.

[3] Schwellnus M, Soligard T, Alonso JM, Bahr R, Clarsen B, Dijkstra HP, Gabbett TJ, Gleeson M, Hägglund M, Hutchinson MR, Janse Van Rensburg C, Meeusen R, Orchard JW, Pluim BM, Raftery M, Budgett R, Engebretsen L. How much is too much? (Part 2) International Olympic Committee consensus statement on load in sport and risk of illness. Br J Sports Med. 2016 Sep;50(17):1043-52. doi: 10.1136/bjsports-2016-096572. PMID: 27535991; PMCID: PMC5013087.

[4] Wilk KE, Arrigo CA, Andrews JR. Teamwork is Essential to Success: Sports Physical Therapy is No Exception. Int J Sports Phys Ther. 2021 Feb 1;16(1):19041. doi: 10.26603/001c.19041. PMID: 33604157; PMCID: PMC7872455.

[5] Maselli F, Rossettini G, Storari L, Barbari V, Viceconti A, Geri T, Testa M. Knowledge and management of low back pain as running-related injuries among Italian physical therapists: findings from a national survey.Phys Sportsmed. 2021 Sep;49(3):278-288. doi:
10.1080/00913847.2020.1816124. Epub 2020 Sep 30. PMID: 32997551.

[6] Associazione Italiana di Fisioterapia (A.I.F.I.) - https://aifi.net/regioni-it-aifi-censimento-fisioterapisti-cifre/

[7] Service National Statistical. 2018 Dec 29. https://www.abs.gov.au/websitedbs/D3310114.nsf/home/Sample+Size+Calculator

[8] Altman DG, Egger M, et al.The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Int J Surg. 2014;12(12):1495–1499.

[9] Eysenbach G. Improving the quality of web surveys: the checklist for reporting results of internet E-surveys (CHERRIES) | Eysenbach | journal of medical internet research. J Med Internet Res. 2004;6:e34+.

[10] Kong H, West S. WMA declaration of HELSINKI–ethical principles for scientific requirements and research protocols. Ferney-Voltaire, France: World Medical Association; 2013. p. 29–32.

[STEPS]