Direct-access physiotherapy to help manage patients with musculoskeletal disorders in an emergency department: Results of a randomized controlled trial

Methodology: 2/5
Usefulness: 2.5/5

Gagnon R, et al. Acad Emerg Med. 2021 Aug;28(8):848-858. doi: 10.1111/acem.14237.

Question and Methods: RCT to assess if direct access to Physiotherapy (PT) in the ED could reduce pain interference on function, pain intensity as well as decreasing resource use for patients presenting with MSKD to the ED.
Findings: The group with direct access to PT within the ED showed greater improvement in pain with less return to ED at 1 month follow-up. There was no significant difference between resource utilization at the 3 month follow-up.
Limitations: The main limitation of this study was their use of continuous variables for primary and secondary outcomes as well as their small sample size and large amount lost to follow-up.

Interpretation: This trial shows weak evidence that direct access to PT in the ED could be useful to patient care but further studies are needed to determine effect and cost analysis.

By: Dr. Julie Ingratta

Authors

Julie Ingratta

Dr. Ingratta (she/her) is a senior Emergency Medicine Resident at the University of Ottawa.

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Jeff Perry

Dr. Perry is an Emergency Physician and full Professor in the department of Epidemiology and Community Medicine. He has a special research interest in subarachnoid hemorrhage, TIA and stroke.

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Hans Rosenberg

Dr. Rosenberg is an emergency physician at the Ottawa Hospital, associate professor at the University of Ottawa, and Director of the Digital Scholarship and Knowledge Dissemination Program.

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