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|Title:||Extended scope physiotherapy roles for orthopedic outpatients: an update systematic review of the literature|
|Citation:||Journal of Multidisciplinary Healthcare, 2012; 5:37-45|
|Publisher:||Dove Medical Press|
|Jessica Stanhope, Karen Grimmer-Somers, Steve Milanese, Saravana Kumar, Joanne Morris|
|Abstract:||Purpose: This systematic review updates one conducted in 2008 into extended scope practice (ESP) in physiotherapy in orthopedics. Methods: A comprehensive open-ended search was conducted using electronic library databases and Google Scholar to identify any primary study design reporting on physiotherapists working in ESP roles within orthopedic settings. Studies were allocated to the National Health and Medical Research Council hierarchy of evidence, although only studies in levels I, II, or III_1 were critically appraised using a purpose-built critical appraisal tool. Information was extracted on the country of origin, ESP tasks, relevant training, patient types, health, process, and cost measures. Results: 1071 studies were identified, and twelve were included in the review (including diagnostic and evaluative research). The hierarchy of evidence ranged from II to IV, from which only two diagnostic studies met the criteria for critical appraisal. ESP tasks included injection therapy, removing k-wires, and requesting investigations. The education of ESP physiotherapists varied widely, and included formal and informal training. The positive outcomes of ESP initiatives were reported, in diagnostic ability, reduced costs and waiting times, and improved health outcomes. Conclusion: Despite the positive results, the generally low level of evidence and the range of outcome measures reported, constrained clear conclusions regarding the health, process, and cost implications of ESP physiotherapy roles in orthopedic settings. The need for formalized, widely recognized training was highlighted, to give ESP physiotherapy roles credibility.|
|Keywords:||extended scope practice; physiotherapy; orthopedics|
|Rights:||© 2012 Stanhope et al, publisher and licensee Dove Medical Press Ltd. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.|
|Appears in Collections:||Public Health publications|
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