A challenge to improve the Quality of Care.Rehabilitation outcome measures in the Emergency Department: a scoping review.

Abstract

Background: The integration of physiotherapists within Emergency Departments (EDs) is increasing internationally; however, the outcome measures employed in this setting remain heterogeneous and largely non-standardized.

Objective: To map and describe clinical, functional, psychological, prognostic, and patient experience outcome measures currently used by physiotherapists working in EDs.

Methods: A scoping review was conducted following PRISMA-ScR guidelines. PubMed and Google Scholar were searched from their inception to November 2025. Studies were included if they involved patients of any age presenting to the ED with musculoskeletal, traumatic, vestibular conditions or concussion, where physiotherapists applied or reported at least one standardized outcome measure. Two reviewers independently screened titles, abstracts, and full texts.

Results: Of 9,790 records identified, 27 met eligibility criteria. Most research originated from Australia, Canada, the United Kingdom, Ireland, and the United States, primarily involving low-complexity musculoskeletal conditions, vestibular disorders, and concussion, including pediatric pathways. Pain intensity scales (NPRS, VAS) and pain interference (BPI-PI) were the most commonly used measures. Functional and disability outcomes (NDI, ODI/mODI, LEFS, QuickDASH, PROMIS Physical Function, PSFS) were predominantly applied during post-ED follow-up. Psychological and prognostic instruments (PCS, STarT Back, 5P Rule) supported risk stratification, while PREMs such as PedsQL Healthcare Satisfaction, SAPS, and VSQ-9 assessed patient experience. Considerable heterogeneity in outcome measurement remains, with few randomized trials, limited long-term follow-up, and scarce economic evaluations. No studies were identified from Italy or Southern Europe.

Conclusions: The use of validated outcome measures by physiotherapists in EDs is feasible and clinically valuable; however, a lack of standardization and limited high-quality evidence particularly within the Italian healthcare context highlight the need for further research to establish shared outcome sets and transferable models of care.