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Related Experiment Video

Updated: Feb 3, 2026

The Combined Use of Transcranial Direct Current Stimulation and Robotic Therapy for the Upper Limb
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Direct access in physical therapy: a systematic review.

D Piscitelli1, M P Furmanek2, R Meroni3

  • 1School of Physical and Occupational Therapy, McGill University, Montreal, Canada - School of Medicine and Surgery, PhD Program in Neuroscience, University of Milan-Bicocca, Milan, Italy.

La Clinica Terapeutica
|November 6, 2018
PubMed
Summary
This summary is machine-generated.

Direct Access (DA) to physiotherapy is feasible, reducing treatments, physician visits, and costs while increasing patient satisfaction. Further research is needed to fully explore its clinical safety.

Keywords:
Physical Therapy ModalitiesPrimary Health CareReferral and Consultation

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Area of Science:

  • Physiotherapy
  • Health Services Research
  • Health Economics

Background:

  • Growing evidence supports Direct Access (DA) to physiotherapy as a novel care model.
  • DA may improve patient health status and reduce healthcare costs compared to traditional referral pathways.

Purpose of the Study:

  • To systematically review the evidence on the feasibility, effectiveness, costs, safety, and patient satisfaction of DA physiotherapy compared to other models.

Main Methods:

  • A systematic review of MEDLINE, CINAHL, and EMBASE databases was conducted.
  • Included studies compared DA physiotherapy with alternative organizational models.
  • Methodological quality was assessed using the Newcastle-Ottawa Scale.

Main Results:

  • Thirteen studies met inclusion criteria; average quality score was 6.4/9.
  • DA resulted in fewer physiotherapy treatments, physician visits, imaging, and NSAID use.
  • Patients reported higher satisfaction with DA, with lower per-subject costs. No harms were reported.

Conclusions:

  • Direct Access to physiotherapy appears feasible clinically and economically.
  • Further research is necessary due to limited evidence and to investigate clinical safety.