. 2025 Mar 12;15(3):e096044.

doi: 10.1136/bmjopen-2024-096044.

Effectiveness of primary-contact physiotherapy in managing musculoskeletal conditions in emergency departments: protocol for the RESHAP-ED randomised controlled trial

Tarcisio F de Campos^#^{1

2}, Danielle Coombs^#^{3

2}, Chathurani Sigera^{3

2}, Christopher Williams^{4

5}, Eileen Rogan⁶, James Edwards⁷, Kirsten McCaffery⁸, Kirsten Howard³, Laurent Billot⁹, Chris Maher^{3

2}, Gustavo C Machado^{3

2}; RESHAP-ED Investigators

Collaborators, Affiliations

Collaborators

RESHAP-ED Investigators:
Rachelle Buchbinder, Ian Harris, Vasi Naganathan, John Wiggers, Lisa Harvey, Leigh Kinsman, Narcyz Ghinea, Owen Hutchings, Michael Dinh, Hatem Alkhouri, Helen Goldsmith, Teresa Anderson, John-Paul Smiles, Gabriel Lau, Andrew Bailey, Bethan Richards, Thomas Lung, Peter Youseff, Ian Liang, Alla Melman, Qiuzhe Chen, Chantay Lenord, Ruth Perrott, Julie Penn, Stephen Spennati, Andrew Wong, Allison Moore, Andrew Lawson, Rebecca Ormerod, Samuel Folbigg, Katherine Maka, Laura Butterworth, Frederico Estermann, Chelsea Hall, Sarah Attree, Samuel Boughton, Prue Neely, Amy Wigham, Angelo Efthimiou, Hui-Te Ku, Sarah Kammoun, Breanna Frendo, Patrick Law, Sharon Xu

Affiliations

¹ School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia tarcisio.decampos@sydney.edu.au.
² Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, New South Wales, Australia.
³ School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
⁴ University Centre for Rural Health, School of Health Sciences, The University of Sydney, Lismore, New South Wales, Australia.
⁵ Research and Knowledge Translation Directorate, Mid North Coast Local Health District, Port Macquarie, New South Wales, Australia.
⁶ Emergency Department, Canterbury Hospital, Sydney Local Health District, Sydney, New South Wales, Australia.
⁷ Emergency Department, Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown, New South Wales, Australia.
⁸ Wiser Healthcare, School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
⁹ The George Institute for Global Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia.

^# Contributed equally.

PMID: 40074281
PMCID: PMC11904353
DOI: 10.1136/bmjopen-2024-096044

Effectiveness of primary-contact physiotherapy in managing musculoskeletal conditions in emergency departments: protocol for the RESHAP-ED randomised controlled trial

Tarcisio F de Campos et al. BMJ Open. 2025.

. 2025 Mar 12;15(3):e096044.

doi: 10.1136/bmjopen-2024-096044.

Authors

Collaborators

RESHAP-ED Investigators:
Rachelle Buchbinder, Ian Harris, Vasi Naganathan, John Wiggers, Lisa Harvey, Leigh Kinsman, Narcyz Ghinea, Owen Hutchings, Michael Dinh, Hatem Alkhouri, Helen Goldsmith, Teresa Anderson, John-Paul Smiles, Gabriel Lau, Andrew Bailey, Bethan Richards, Thomas Lung, Peter Youseff, Ian Liang, Alla Melman, Qiuzhe Chen, Chantay Lenord, Ruth Perrott, Julie Penn, Stephen Spennati, Andrew Wong, Allison Moore, Andrew Lawson, Rebecca Ormerod, Samuel Folbigg, Katherine Maka, Laura Butterworth, Frederico Estermann, Chelsea Hall, Sarah Attree, Samuel Boughton, Prue Neely, Amy Wigham, Angelo Efthimiou, Hui-Te Ku, Sarah Kammoun, Breanna Frendo, Patrick Law, Sharon Xu

Affiliations

¹ School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia tarcisio.decampos@sydney.edu.au.
² Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, New South Wales, Australia.
³ School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
⁴ University Centre for Rural Health, School of Health Sciences, The University of Sydney, Lismore, New South Wales, Australia.
⁵ Research and Knowledge Translation Directorate, Mid North Coast Local Health District, Port Macquarie, New South Wales, Australia.
⁶ Emergency Department, Canterbury Hospital, Sydney Local Health District, Sydney, New South Wales, Australia.
⁷ Emergency Department, Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown, New South Wales, Australia.
⁸ Wiser Healthcare, School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
⁹ The George Institute for Global Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia.

^# Contributed equally.

PMID: 40074281
PMCID: PMC11904353
DOI: 10.1136/bmjopen-2024-096044

Abstract

Introduction: Patients with musculoskeletal conditions often seek care in an emergency department (ED). The problem is that the time required to manage these patients places an additional pressure on ED physician and nursing staff, who are primarily trained and resourced to manage high-acuity patients. Primary-contact physiotherapists could play a greater role in supporting ED physician and nursing staff in the management of patients presenting to the ED with musculoskeletal conditions.

Methods and analysis: The RESHAP-ED trial is a multicentre, pragmatic, open-label, two-arm, parallel randomised controlled trial with nested process and economic evaluations. The trial will investigate whether a primary-contact physiotherapy pathway compared with usual care (primary-contact by physician and/or nursing staff pathway) reduces time spent in ED. Patients with simple musculoskeletal conditions will be recruited from EDs in New South Wales, Australia. The primary outcome is ED length of stay (LOS). Secondary outcomes will include acceptability, feasibility and cost-effectiveness of primary-contact physiotherapy, and explore patients' and clinicians' experience. To detect a 30 min between-group difference in ED LOS, 1370 patients will be required. Analyses of the primary and secondary outcomes will be conducted following the intention-to-treat principle. The adjusted mean difference in ED LOS and 95% CI will be calculated using linear regression adjusted for hospital using a random effect model.

Ethics and dissemination: The study received ethical approval from the Sydney Local Health District (RPAH zone) Human Research Ethics Committee (X23-0143). Findings from this study will be disseminated through publication in peer-reviewed journals and conference presentations.

Trial registration number: Australia New Zealand Clinical Trials Registry: ACTRN 12623000782639; Universal Trial Number (UTN): U1111-1292-2883.

Keywords: Emergency Departments; Health Services; Musculoskeletal disorders; Randomised Controlled Trial.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

**Figure 1. Flow of participants through the study. ED, emergency department; REDCap, Research Electronic Data Capture.**

See this image and copyright information in PMC

References

1. Australian Institute of Health and Welfare . Emergency department care 2022–23: Australian hospital statistics. Canberra: AIHW; 2023.
1. Ferreira GE, Traeger AC, Maher CG. Review article: A scoping review of physiotherapists in the adult emergency department. Emerg Med Australas. 2019;31:43–57. doi: 10.1111/1742-6723.12987. - DOI - PubMed
1. Ferreira GE, Traeger AC, O’Keeffe M, et al. Staff and patients have mostly positive perceptions of physiotherapists working in emergency departments: a systematic review. J Physiother. 2018;64:229–36. doi: 10.1016/j.jphys.2018.08.001. - DOI - PubMed
1. Bird S, Thompson C, Williams KE. Primary contact physiotherapy services reduce waiting and treatment times for patients presenting with musculoskeletal conditions in Australian emergency departments: an observational study. J Physiother. 2016;62:209–14. doi: 10.1016/j.jphys.2016.08.005. - DOI - PubMed
1. Guengerich M, Brock K, Cotton S, et al. Emergency department primary contact physiotherapists improve patient flow for musculoskeletal patients. Int J Ther Rehabil. 2013;20:396–402. doi: 10.12968/ijtr.2013.20.8.396. - DOI

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Effectiveness of primary-contact physiotherapy in managing musculoskeletal conditions in emergency departments: protocol for the RESHAP-ED randomised controlled trial

Collaborators

Affiliations

Effectiveness of primary-contact physiotherapy in managing musculoskeletal conditions in emergency departments: protocol for the RESHAP-ED randomised controlled trial

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources