Chinese rehabilitation students show low knowledge of physical activity guidelines; learning linked to practice

BackgroundPhysical inactivity is a major global health risk. Physical therapists, as key health promoters, are well-positioned to counsel patients on physical activity (PA) using evidence-based guidelines. However, studies globally indicate physiotherapists' knowledge of PA guidelines (e.g., WHO recommendations) is often insufficient. In China, the state of PA guideline education and knowledge among rehabilitation students—future physiotherapists—remains unexplored.ObjectivesThis mixed-methods study aimed to: (1) assess the level of teaching and knowledge of PA guidelines among Chinese rehabilitation students, and (2) discuss ways to better incorporate PA guideline teaching at the undergraduate level.MethodsAn explanatory sequential design was employed. Phase 1 involved an online questionnaire distributed to 105 recent graduates (post-2020) from Chinese rehabilitation programs, assessing their knowledge, educational exposure, and self-reported clinical practices related to PA guidelines. Phase 2 consisted of 10 online, semi-structured interviews with experienced rehabilitation therapists to gain in-depth insights into guideline application and promotion in practice. Quantitative data were analyzed using descriptive statistics, chi-square tests, and ordinal logistic regression. Qualitative data were analyzed thematically.ResultsQuantitative findings revealed that 66.7% of surveyed students reported not being taught PA guidelines during their undergraduate studies. Only 10.4% could correctly answer all three core knowledge questions about the WHO PA guidelines. A significant association was found between learning PA guidelines at university and a higher self-reported frequency of initiating discussions about physical inactivity with patients during internships [adjusted OR = 4.73, 95% CI (2.10, 10.67), p < 0.001]. Interview data identified three main themes: (1) the recognized benefits of appropriate PA for patient recovery and adherence, (2) the current inadequacy of PA guideline teaching in undergraduate curricula, with a strong recommendation for integrating theory with clinical practice, and (3) the need for selective promotion of PA guidelines in clinical settings, with outpatient departments highlighted as particularly suitable contexts.ConclusionThere is a significant gap in PA guideline education and knowledge among rehabilitation students in China. Integrating PA guideline instruction into undergraduate curricula, particularly in conjunction with clinical practice, is crucial. Furthermore, promoting PA guidelines may be most feasible and effective in outpatient clinical settings.