Advanced Physiotherapy Practice

Original Editor - Angeliki Chorti

Top Contributors - Angeliki Chorti and Cindy John-Chu  

Introduction[edit | edit source]

Patient doing exercise using equipment with therapist

Advanced Physiotherapy Practice (APP) refers to a higher level of physiotherapy practice, with specific competencies, responsibilities, functions, activities and standards.

In some cases, Advanced Physiotherapy Practitionners (APPs) are also referred to as Extended Scope Practitioners (ESPs). [1][2]

Drivers to APP[edit | edit source]

One of the main drivers behind APP is the steady rise of healthcare utilisation and demand over the years, [3] which is expected to increase even further over the next decades. This places an additional burden to doctors, whose workload not only increases considerably but also witness a decline in the number of their colleagues.

Barriers to APP[edit | edit source]

Despite the potential for increased deployment and value of APP, APP is not yet widely accepted. [4] Barriers in the implementation of APP may involve different values between doctors and APPs and reluctance to hand over control of elements of patient care to APPs. In addition, APPs do not appear to influence the implementation, because of their strong dependence on GPs. [4]

You can learn more on different models of advanced practice across countries, as well as their drivers, barriers and successful stories in the following video: [5]

Resources[edit | edit source]

World Physiotherapy Policy Statement: Advanced Physical Therapy Practice

WP Position Paper on Advanced Clinical Practice in Physiotherapy in the European Region

References[edit | edit source]

  1. Tawiah AK, Desmeules F, Wieler M, Finucane L, Lewis J, Woodhouse LJ, et al. Advanced practice in physiotherapy: a global survey. Physiotherapy. 2021;113:168–76.
  2. Vedanayagam M, Buzak M, Reid D, Saywell N. Advanced practice physiotherapists are effective in the management of musculoskeletal disorders: a systematic review of systematic reviews. Physiotherapy. 2021.
  3. Garson A Jr, Levin SA. Ten 10-year trends for the future of healthcare: implications for academic health centers. Ochsner J. 2001;3:10–5.
  4. 4.0 4.1 Pellekooren S, Donker M, Reijnders E, Boutalab L, Ostelo R, van Tulder M, Pool-Goudzwaard A. The introduction of advanced practice physiotherapy within Dutch primary care is a quest for possibilities, added value, and mutual trust: a qualitative study amongst advanced practice physiotherapists and general practitioners. BMC Health Services Research 2022 April 21; 22:529.
  5. Europe Region World Physiotherapy. Webinar 15/5/2023 Advanced Physiotherapy: Models, Successes and Challenges. Available from: [accessed 3/7/2023]