ArticleBMJ open2026
What are healthcare practitioners' perspectives and experiences of strength assessment and strength training practices in community pulmonary rehabilitation? A qualitative study from the UK.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo explore healthcare practitioner perspectives and experiences of using strength assessment and strength training within pulmonary rehabilitation, focusing on perceived utility, barriers and impact on service delivery and patient care.
designQualitative study using semi-structured one-to-one interviews analysed through reflexive thematic analysis.
settingA pulmonary rehabilitation service in the South East of England, operating across three community sites.
participants11 female healthcare practitioners (including physiotherapists, nurses, and associate practitioners) involved in managing, delivering, or assisting in pulmonary rehabilitation programmes.
resultsFour themes were constructed: (1) beyond lung fit: valuing strength training for functional independence; (2) mixed attitudes towards strength assessment utility in practice; (3) navigating the implementation gap: perceived challenges for pulmonary rehabilitation and strength assessment; and (4) the professional training divide: a call for further training. These findings show practitioners have positive views of strength assessment and strength training in pulmonary rehabilitation and recognise the benefits they offer services and patients. However, a number of barriers were identified, including uncertainty of strength assessment practicality in current practices, the need for staff training and education, and service-related challenges (time constraints, limited equipment and high workloads).
conclusionHealthcare practitioners perceive strength training as essential to pulmonary rehabilitation and recognise the potential benefits of assessing patient strength. However, organisational constraints, limited equipment, and insufficient staff training limit its routine implementation. Addressing these barriers through resource investment, clearer guidance, and structured training could bridge the implementation gap between evidence and everyday clinical practice, enhancing patient outcomes and the quality and consistency of pulmonary rehabilitation services across the UK.
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