Direct access to physical therapy for the patient with musculoskeletal disorders, a literature review

Leonardo Piano, Filippo Maselli, Antonello Viceconti, Silvia Gianola, Aldo Ciuro

Research output: Contribution to journalReview articlepeer-review


[Purpose] To present legislation comparing direct and referred access—or other measures—to physical therapy. The focus is on the management of the most burdensome musculoskeletal disorders in terms of regulations, costs, effectiveness, safety and cost-effectiveness. [Methods] Main biomedical databases and gray literature were searched ranging from a global scenario to the analysis of targeted geographical areas and specifically Italy and the Region Piedmont. [Results] legislation on Direct Access highlights inconsistencies among the countries belonging to World Confederation for Physical Therapy. Direct Access could be an effective, safe and efficient organization model for the management of patients with musculoskeletal diseases and seems to be more effective safer and cost effective. [Conclusion] Direct Access is a virtuous model which can help improve the global quality of physical therapy services. Further studies are required to confirm this approach and determine whether the findings of the present overview can be replicated in different countries and healthcare systems.

Original languageEnglish
Pages (from-to)1463-1471
Number of pages9
JournalJournal of Physical Therapy Science
Issue number8
Publication statusPublished - Jan 1 2017


  • Musculoskeletal diseases
  • Physical therapy specialty
  • Referral and consultation

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation


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