PTSystematic ReviewArchives of physiotherapy2024

Adverse events related to physiotherapy practice: a scoping review.

Yiran Wang, Narelle Dalwood, Melanie Farlie and 1 others

PMID 39734425

WHAT IT FOUND

Across 58 studies, physiotherapy interventions were associated with adverse events including increased pain, falls, and haemodynamic instability.

Musculoskeletal care most frequently reported pain and stiffness, while cardiorespiratory and neurological settings saw falls and vital sign changes. These events were attributed to the physiotherapy intervention.

Key findings

01In musculoskeletal physiotherapy, commonly reported adverse events were increased pain, stiffness, swelling, headaches, worsening of symptoms, musculoskeletal tissue disorders, and falls.

02In cardiorespiratory physiotherapy for critically ill patients, adverse events included haemodynamic instability, angina, oxygen desaturation, elevated respiratory rate, vertigo, falls, line dislodgement, and airway obstruction.

03In neurological physiotherapy, adverse events reported during gait and balance training for conditions like stroke, Parkinson's, and multiple sclerosis included pain, falls, and haemodynamic intolerance.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

The review only included adverse events explicitly defined and attributed to physiotherapy by the original study authors, which may vary between studies. The search strategy relied on specific terms like 'adverse events', which may not have been used consistently across all studies, potentially leading to missed reports. Systematic reviews were excluded, which might have omitted aggregated data on adverse events. The review focused on the last 10 years, which may miss historical patterns or long-term safety data. It is possible that adverse events occurring after the intervention period were not captured in the included studies.

Declared interests

The authors have no conflicts of interest and no funding or financial support to disclose.

The easy way to misread this

Do not interpret the occurrence of adverse events in these studies as proof that physiotherapy is unsafe. The review reports events attributed to physiotherapy by the original study authors, but it does not compare these rates to control groups or natural history. The presence of adverse events does not negate the potential benefits of the interventions studied.

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