OBJECTIVES: To conduct a systematic review investigating the effects of physiotherapy in emergency departments (EDs) on health care use and patient-reported outcomes for patients referred to EDs due to low back pain (LBP), compared with usual care. METHODS: A search was conducted in PubMed, Cinahl and Embase in April 2023, and rerun in September 2024. Randomised and quasi-randomised trials and observational studies including adult patients referred to an ED due to LBP were eligible. Study quality was assessed using ROBINS-I and PEDro, and the strength of the evidence was assessed using GRADE. RESULTS: Included studies were three retrospective cohorts, two prospective cohorts and two randomised controlled trials, totalling 4,057 patients. Four of six studies were rated as serious risk of bias, primarily due to limitations in the study design, two studies were rated as moderate risk, and one as low risk. Overall, the studies indicated a positive effect of ED physiotherapy in comparison with usual care in relation to length of stay, imaging and patient satisfaction. For the remaining outcomes on health-care use and patient-reported outcomes, findings were inconclusive. For all outcomes, the certainty of the evidence was considered very low or low. CONCLUSIONS: The present review indicates that there may be beneficial effects of involving PTs in the management of patients with LBP in EDs. However, given the very low certainty of evidence the findings should be interpreted with great caution. Future high level evidence studies in the field should therefore be a priority. REGISTRATION NUMBER PROSPERO: CRD42023420107.

Full text (sometimes free) may be available at these link(s):      help

• DOI
• PubMed
• PDF locator
• publisher