There is broad support for the physiotherapy ESP role and evidence of favourable outcomes from ESP intervention. Clinical decisions made by ESPs correlate well with those of medical colleagues, although there is a lack of detail explaining the ESP decision-making process itself and the influences and mechanisms by which this occurs. Copyright © 2016 John Wiley & Sons, Ltd.

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Background/Aims In the UK, two-thirds of people with dementia are community-dwelling. Guidelines recommend exercise to promote independence among this population, however evidence to support this is scarce. This study aimed to evaluate the effectiveness of home-based exercise programmes on mobility and functional independence in people with Alzheimer's disease living in the community. Methods The following electronic databases were searched: AMED, CINAHL, EMBASE, Medline, SPORTsDiscus, The Cochrane Library, PEDro, OpenGrey and Online Thesis. All included trials were assessed for methodological quality using PEDro bias scores and McMaster's Critical Appraisal Tool and Guideline. English language restrictions were applied. Results A total of seven trials were included within the review. Trial quality was mixed. All trials reported measures for mobility, while five trials included measures of functional independence. Results for the effectiveness of home-based exercise on mobility were mixed, with only two studies reporting significant improvements. Functional independence significantly improved in all trials. Conclusions The effectiveness of home-based exercise programmes on mobility in community-dwelling people with Alzheimer's disease remains inconclusive, while a growing body of evidence indicates its effectiveness in improving functional independence. However, high quality trials are scarce. Larger, randomised, controlled trials specific to this population are thus warranted.

Introduction Advanced practice roles for allied health professionals continue to expand and provide key services within pathways of care for patients with musculoskeletal conditions. Despite the extensive utilisation of these roles and previously reported high patient satisfaction, little is understood about how these practitioners interact with their patients and the factors that influence decision‐making conversations. Study A qualitative study utilised Interpretive Phenomenological Analysis (IPA) to explore the decision‐making process occurring between Advanced Practitioners (APs) and their patients in a musculoskeletal service. AP data were collected through focus groups and analysed using IPA methodology. Conclusions Advanced practice decision‐making is a complex process and APs exhibit a range of styles, from paternalistic to shared decision‐making. APs may have a personal preference, but exhibit the ability to flex between styles in consultations. Multiple themes emerged from the data that influenced the decision‐making process, including AP staff understanding the importance of patient expectations and the complex factors that influence patient interactions. It is important that clinicians have an awareness of the multiple factors that contribute to the decision‐making process.