• Eveline Matifat, Marianne Méquignon, Caitriona Cunningham, Catherine Blake, Oma Fennelly, and François Desmeules.
• Maisonneuve-Rosemont Hospital Research Center, University of Montréal Affiliated Research Center, Montréal, Québec, Canada.
• Phys Ther. 2019 Sep 1; 99 (9): 1150-1166.

BackgroundOver the past few decades, physical therapists have emerged as key health care providers in emergency departments (EDs), especially for patients with musculoskeletal disorders (MSKD).PurposeThe purpose of this review was to update the current evidence regarding physical therapist care for patients with MSKD in EDs and to update current recommendations for these models of care.Data SourcesSystematic searches were conducted in 5 bibliographic databases.Study SelectionThe studies selected presented quantitative data related to the care of patients with MSKD by physical therapists in an ED setting.Data ExtractionRaters reviewed studies and used the Effective Public Health Practice Project Quality Assessment Tool to assess their methodological quality.Data SynthesisFifteen studies were included. Two studies, 1 of weak and 1 of strong quality, demonstrated that physical therapist care in EDs was as effective as or more effective than usual medical care for pain reduction, and 6 studies of varying quality reported that physical therapist care in EDs was as effective as usual care in EDs in reducing disability. Eight studies of varying quality reported that physical therapist care could significantly reduce waiting time in EDs. Four studies of varying quality reported that physical therapists ordered no more, or even fewer, medical images than physicians. In terms of health care costs, 2 studies of moderate to high quality found no significant differences in costs between physical therapist care and usual care in EDs. Finally, 6 studies of varying quality reported that patients were as satisfied or more satisfied with physical therapist care as with usual medical care in EDs.LimitationsThe roles of physical therapists in EDs vary depending on the setting, legislation, and training of providers. Only a limited number of high-quality studies were identified.ConclusionsAlthough the quality of the evidence is heterogeneous, physical therapist care for patients with MSKD in EDs may be beneficial.© 2019 American Physical Therapy Association.

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