Journal of Novel Physiotherapies
Open Access

Physical therapy speciality; Musculoskeletal diseases; Clinical competence

Introduction

Back discomfort, hip and knee osteoarthritis, whiplash-associated diseases, and ankle sprains are a few of the frequent musculoskeletal ailments. Together, musculoskeletal diseases account for 21% of all years spent living with a handicap (behind only mental illness), having a significant negative impact on global health. In Australia in 2015, it was thought that 30% of the population had at least one musculoskeletal disorder. According to reports, this percentage might go up to 72 percent for persons over 75. An estimated $5.7 billion in expenses were related to musculoskeletal problems in 2008-2009 [1,2].

Many musculoskeletal disorders are managed with the help of exercise, support, and counsel. Physiotherapists often give exercise, support, and guidance during routine in-person visits. However, as part of a home fitness programme, exercise may be performed remotely, and assistance and guidance can be given over the phone. There is preliminary evidence from studies and systematic reviews that various types of remotely supplied physiotherapy can be used to safely and efficiently address a variety of musculoskeletal problems. There are several potential advantages of moving away from physiotherapy sessions in person. People who reside in remote or rural areas or who have serious mobility problems will be able to receive timely and accessible care if new technology and management techniques are included into physiotherapy. The cheap cost of this form of physical treatment is an additional advantage, which may increase its costeffectiveness from the viewpoints of funders and patients. By reducing waiting times for publicly funded outpatient physiotherapy, increasing remote access and lowering physiotherapy costs may also lessen the strain on the public health system.

Musculoskeletal (MSK) diseases have negative effects on quality of life connected to health, healthcare use as a whole, time away from work due to illness, and productivity [3,4]. In order for physiotherapists to adapt to the expanding MSK load and meet patient requirements, jobs and educational trajectories in the field of physiotherapy are changing [5]. These expanded roles frequently demand for physiotherapists to practice at a high level rather than in a defined capacity [6] and carry out formerly medically-restricted duties including ordering imaging, prescribing medicine, and giving injections [7]. Advanced practice physiotherapists (APPs) frequently oversee the care of patients who are thought not to need medical or surgical procedures [8,9] in an effort to shorten wait times and give these patients better appropriate care [10]. The United Kingdom (UK), Australia, Canada, and Ireland are among the nations where advanced practice physiotherapy services are now available. These services are frequently found in orthopedics, rheumatology, emergency rooms, primary care, neurology, cardiorespiratory, and women's health services for MSK patients. These APP services were often created on an as-needed basis, enabling them to be customized to the unique requirements of the local service with the availability of in-house training. This happened in Ireland, where clinical expert physiotherapists originally started working at an advanced practice level in fracture and low back pain clinics at different hospitals. Since 2011, 24 APP roles have been created throughout orthopaedic and rheumatology departments at 18 acute hospitals as part of a national MSK Physiotherapy Triage Initiative. But service obstacles and professional concerns arise due to a lack of national certification, APPs' clearly defined area of activity, and standardized training, both in Ireland and worldwide. These include ambiguous job names and descriptions, a lack of professional recognition, inadequate pay and governance, difficulties proving the transferability of skills, and difficulty generalizing the overall advantages of such care models.

Furthermore, internal training may not always have the rigour and resources needed to guarantee standardised certification. The following steps should be taken in order to construct competency-based education, which is increasingly being utilised to educate advanced practitioners: Identifying the necessary APP competencies, organising competencies into themes, organising themes into courses, and organising courses into curricula are the first three steps. Reviewing clinical priorities, clinician learning requirements, and the entire health system within which the service will be located all require involvement from stakeholders. Since APPs have been used in MSK services for more than 30 years, several competence frameworks and educational programmes have probably been implemented on a global scale. In order to guide the creation and improvement of MSK APP education curricula, this study set out to analyse the existing worldwide APP competence frameworks and education curricula as well as investigate the local learning needs of physiotherapists.

Conclusion

In order to improve and harmonise MSK APP education, this page offers a summary of worldwide MSK APP competence frameworks and educational curricula. In the long run, this should improve APP practice, offer better recognition for advanced practice, and assist develop clearer career advancement routes for physiotherapists while facilitating worker mobility.

Acknowledgement

Not applicable.

Conflict of Interest

Not declared.

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