PHYSIOTHERAPIST-LED CARE FOR MUSCULOSKELETAL CONDITIONS IN THE EMERGENCY DEPARTMENT Model of care study reduces time in ED when receiving standard care, earlier treatment and other outcomes
With
Associate Professor Gustavo Machado
University of Sydney &
NHMRC Principal Research Fellow,
Institute for Musculoskeletal Health
SEGMENT
Filmed in Sydney | October 2026
Associate Professor Gustavo Machado is a leading physiotherapist, health services researcher, and advocate for evidence-based reform in musculoskeletal and emergency care. He holds prestigious fellowships from the National Health and Medical Research Council (NHMRC EL2 Investigator) and The University of Sydney (Robinson Fellow). Based at the Institute for Musculoskeletal Health, he leads an innovative research program transforming how back pain and musculoskeletal conditions are managed across emergency, hospital and virtual care settings.
RESHAP-ED trialled new ways to reduce crowding across busy emergency departments (EDs), by testing whether physiotherapists could provide care for people with muscle, joint and bone conditions in the ED, while also ensuring safe and effective treatment.
RESHAP-ED included 1,475 patients across five EDs in NSW. Patients received care from a physiotherapist or conventional doctor- or nurse-led care. Patients treated by physiotherapists spent an average of 2.4 hours in the ED compared with 3.4 hours for those receiving standard care. They were seen and treated sooner, were three times more likely to receive care within recommended triage timeframes, and 90% went home within four hours. Patients were more satisfied with their care, while pain levels, quality of life and safety outcomes were similar between both groups. The model also reduced healthcare costs by $35 per patient.
Study collaboration partners included Australasian College for Emergency Medicine, Sydney Local Health District, Northern Sydney Local Health District, Sydney Health Partners and Australian Physiotherapy Association
If scaled across NSW, this approach could save an estimated $19 million each year and free up more than 540,000 hours in EDs, while maintaining safe, high-quality patient care.
The study has been published in Lancet https://doi.org/10.1016/ S0140-6736(26)01327-9,
Sigera C, Campos T, Coombs D et al.
Physiotherapist-led care for musculoskeletal conditions in the emergency department (RESHAP-ED): a randomised controlled trial with economic evaluation
The Lancet, 2026; 408, 1326-1336
Source: From University of Sydney biography & 2026 NSW Health Awards Finalist description for Health Research Award
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