Trial reportEmergency medicine journal : EMJ2005
Randomised controlled trial and cost consequences study comparing initial physiotherapy assessment and management with routine practice for selected patients in an accident and emergency department of an acute hospital.
Trial report in Emergency medicine journal : EMJ, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- The effectiveness of allied health and nurse practitioner models-of-care in managing musculoskeletal conditions in the emergency department: a systematic review and meta-analysis.BMC emergency medicine · 2024Pooled it
- Economic evaluation of advanced practice physiotherapy models of care: a systematic review with meta-analyses.BMC health services research · 2021Pooled it
- Advanced practice physiotherapy in patients with musculoskeletal disorders: a systematic review.BMC musculoskeletal disorders · 2012Pooled it
- Trial
- No major difference in perceived quality of care in patients with hip or knee osteoarthritis assessed in a physical therapy-led triage compared with standard care: a randomized controlled trial.BMC musculoskeletal disorders · 2023Trial
- Trial
- Physiotherapist as primary assessor for patients with suspected knee osteoarthritis in primary care-a randomised controlled pragmatic study.BMC musculoskeletal disorders · 2019Trial
- Perceived quality of physiotherapist-led orthopaedic triage compared with standard practice in primary care: a randomised controlled trial.BMC musculoskeletal disorders · 2016Trial
- Do we need internal medicine specialists in physical therapy? Recognizing the need for updating the clinical practice paradigm.Frontiers in rehabilitation sciences · 2025Article
- Demographics and scope of Australian emergency department physiotherapists.International journal of emergency medicine · 2024Article
- On-Site Physiotherapy in Emergency Department Patients Presenting with Nonspecific Low Back Pain: A Randomized Controlled Trial.Journal of clinical medicine · 2024Article
- Article
- Concordance between physiotherapists and physicians for care of patients with musculoskeletal disorders presenting to the emergency department.BMC emergency medicine · 2019Article
- Rehabilitation and management outcomes of musculoskeletal injuries in a major referral hospital in Ghana.BMC musculoskeletal disorders · 2019Article
- Association Between the Type of First Healthcare Provider and the Duration of Financial Compensation for Occupational Back Pain.Journal of occupational rehabilitation · 2017Article
- Potential impact of early physiotherapy in the emergency department for non-traumatic neck and back pain.World journal of emergency medicine · 2017Article
- The patient perspective: arthritis care provided by Advanced Clinician Practitioner in Arthritis Care program-trained clinicians.Open access rheumatology : research and reviews · 2015Article
- Evaluation of performance quality of an advanced scope physiotherapy role in a hospital emergency department.Patient related outcome measures · 2015Article
- Can physiotherapists contribute to care in the emergency department?The Australasian medical journal · 2014Article
- The role of clinical specialist physiotherapists in the management of low back pain in a spinal triage clinic.Irish journal of medical science · 2013Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe Department of Health is reviewing the effectiveness of accident and emergency (A&E) departments. This study aimed to compare health and economic effects of physiotherapy initial assessment and management with routine practice in an A&E department.
methodsRandomised controlled trial and cost and consequences study. Patients presenting at A&E were eligible if suspected at triage to have soft tissue injury without fracture. The efficacy end point was "days to return to usual activities". Secondary end points included patient satisfaction with their care and further health outcomes and cost data.
results766 of 844 (915) patients were randomised. The median days before return to usual activities (available for 73% of those randomised) was greater in the physiotherapist group (41 days compared with 28.5 days; hazard ratio 0.85 p = 0.071). The physiotherapy group expressed greater satisfaction with their A&E care (on a scale of 1 to 5, median was 4.2 compared with 4.0, p<0.001), were more likely to be given advice and reassurance, and more likely to be provided with aids and appliances. Costs were the same between the two arms.
conclusionThere is evidence that physiotherapy leads to a prolonged time before patients return to usual activities. This study shows no clear danger from physiotherapy intervention and long term outcomes may be different but given these findings, a best estimate is that introducing physiotherapist assessment will increase costs to the health service and society. Routine care should continue be provided unless there is some reason why it is not feasible to do so and an alternative must be found.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.