The Impact of Physical Therapy Assistants on Rehabilitation Clinical Outcomes: A Systematic Review

Objective(s): To examine the impact of physical therapy assistant (PTA) utilization on clinical rehabilitation outcomes in multiple physical therapy settings.

Data Sources: Four databases were searched – PubMed, SPORTDiscus, MEDLINE, and Web of Science – from inception until September 4th, 2023.

Study Selection: Inclusion criteria were articles examining any clinical outcome in relation to PTAs, retrospective or prospective study designs, randomized controlled trials, case series, and full-text articles in English. Exclusion criteria were articles focusing on non-clinical outcomes, articles not mentioning PTAs, case reports, systematic reviews, meta-analyses, books, clinical commentaries, expert opinions, missing full-text, and articles not in English. Eight articles met inclusion criteria from 1,105 initially retrieved.

Data Extraction: Data extraction was performed by multiple authors and included study type, physical therapy setting, number of patients treated, number of facilities examined, number of patients treated by PTAs, and relevant clinical outcomes with corresponding p-values.

Data Synthesis: This study examined 82,195 patients and 25,765 nursing facilities across subacute (n=2 articles), home health (n=1 article), and outpatient settings (n=4 articles). In outpatient settings, PTA utilization was associated with increased physical therapy utilization and mixed clinical outcome results. For home health, one article indicated increased physical therapy services with good outcomes, although sample size was limited. For inpatient rehabilitation, three articles indicated mixed results with some concluding no difference in clinical outcomes while others reported increased patient fall risk. No articles examined PTAs impact in acute care.

Conclusions: This systematic review of moderate quality observational studies found increased therapy utilization and mixed clinical outcomes with PTA utilization across multiple different settings. Additional research is needed to improve both quality and quantity of literature on this topic

Author(s) Disclosures: The authors have no relevant disclosures to make known at this time.