Abstract
Physiotherapists are in a prime position to take on the role of health promotion advocates. This is highlighted in the recent article by Holm et al. in which physiotherapy promoting physical fitness increased activity levels of patients with chronic musculoskeletal conditions [1. Whilst exercise programs were individually tailored in this study, the setting in which they were carried out and environmental impacts were not considered. Such factors are relevant as patients often report a link between symptoms and weather. A key role of physiotherapists is to enable safe exercise in vulnerable populations and the impact of environmental factors including climate change therefore cannot be ignored.
There are often changes in patients’ musculoskeletal symptoms with weather fluctuations, and studies report increased pain during higher temperature and humidity [2. As modest reductions in activity of vulnerable patients can have significant consequences [3, the impact of weather on physical activity is worthy of investigation. Reduced physical activity in people with arthritis during extreme weather has been suggested [3, potentially contributing to pain. Such extreme weather is predicted to occur with increased frequency and intensity due to climate change [4. This highlights the importance for physiotherapists to consider the impact that climate change can have on physical wellbeing.
The Intergovernmental Panel on Climate Change predicts average temperatures to rise up to 5.8 degrees by 2100, considerably impacting public health [4. Consequences will be most notable during extreme weather events such as heatwaves [4, which are likely to have the greatest impact on elderly people [[4], [5]]. Those with chronic disease, living alone or in low socioeconomic settings are most vulnerable [5. Public hospital patients commonly fulfil all of these descriptors, and we as physiotherapists can be mindful of those at risk during warmer months.
Public health preparedness reduces heatwave morbidity and mortality [4, and physiotherapists can assist by providing mitigation strategies directly to patients alongside raising awareness on a larger scale [3. Heatwave warning systems can reduce the impacts of extreme weather and health professional awareness of such frameworks in their local area is valuable.
Physiotherapists, as promoters of physical activity, are in a unique position to advocate for vulnerable groups during extreme weather conditions. We can contribute to improving public health by raising awareness of the potential impacts of climate change.