Exploration of rehabilitation models addressing coexisting conditions such as T2DM, COPD, and cardiovascular disease.

About the Project

The growing prevalence of multimorbidity presents a major challenge for contemporary healthcare systems, particularly within the United Kingdom. Individuals increasingly live with coexisting long-term conditions such as Type 2 Diabetes Mellitus (T2DM), Chronic Obstructive Pulmonary Disease (COPD), and cardiovascular disease (CVD), which collectively contribute to reduced functional capacity, diminished quality of life, and increased healthcare utilisation. Despite this, current rehabilitation services are largely organised around single-disease models, such as cardiac or pulmonary rehabilitation, which may not adequately address the complex and overlapping needs of individuals with multimorbidity.

This PhD project aims to explore and develop integrated rehabilitation models tailored for individuals with coexisting T2DM, COPD, and CVD, with a particular focus on physiotherapy-led, exercise-based interventions. The research will examine how existing rehabilitation frameworks can be adapted or reconfigured to deliver holistic, patient-centred care that targets shared impairments, including exercise intolerance, breathlessness, fatigue, and physical deconditioning. In doing so, the project will address a critical evidence gap in the design and delivery of rehabilitation for cardiometabolic and cardiorespiratory multimorbidity.

A mixed-methods approach will be employed. The initial phase will involve a systematic or scoping review to synthesise existing evidence on integrated or multimorbidity-focused rehabilitation models. This will be followed by qualitative research exploring patient, clinician, and service-level perspectives on barriers and facilitators to engagement in rehabilitation, with particular attention to issues of accessibility, adherence, and health inequalities. Building on these findings, the project will co-develop an integrated rehabilitation model, potentially incorporating exercise prescription, self-management education, and behaviour change strategies, aligned with contemporary clinical guidelines.

Subsequently, a feasibility or pilot study will be conducted to evaluate the acceptability, implementation, and preliminary effectiveness of the developed model within a clinical or community setting. Outcomes of interest may include functional capacity (e.g., 6-minute walk distance), glycaemic control (e.g., HbA1c), symptom burden (e.g., dyspnoea), and patient-reported outcomes such as quality of life and self-efficacy. Consideration will also be given to the role of digital or hybrid delivery methods to enhance access and long-term adherence.

This project aligns with key priorities identified by the National Health Service Long Term Plan, which emphasises integrated care, prevention, and the management of long-term conditions, as well as funding priorities of the National Institute for Health and Care Research in applied health and implementation research. The findings are expected to inform the development of scalable, cost-effective rehabilitation pathways that better reflect the realities of multimorbidity in clinical practice.

Overall, this PhD will contribute to advancing physiotherapy practice by generating evidence to support integrated, patient-centred rehabilitation models, with the potential to improve health outcomes and service delivery for individuals living with complex long-term conditions.

This project is not associated with funding from the University of Birmingham. Applicants will need to obtain their own scholarship or other financial support to cover tuition fees and living costs. All interested candidates MUST contact the lead supervisor of this project by email, including a current CV and statement of interest BEFORE submitting a formal application.

Please note this research topic is also available for students applying for a research masters course: https://www.birmingham.ac.uk/study/postgraduate/subjects/sport-and-exercise-sciences-courses/sport-exercise-and-rehabilitation-sciences-phd