Next generation physiotherapy and POCUS: What does it mean for you?

Using ultrasound imaging, a wide range of anatomical tissues and structures can be viewed in real-time and rapid development in portable technology makes it easier than ever to perform this ‘at the bed-side’. 

How can physiotherapy POCUS support patient care?

Key to the value of POCUS is the combining of clinical reasoning with patient-centred imaging, thereby opening up new opportunities to enhance patient care. As such, POCUS can provide physiotherapists with new levels of diagnostic, monitoring and patient education capabilities across almost all physiotherapy specialisms: for example cardiovascular respiratory, pelvic health, neurology, musculoskeletal, and rheumatology. 

Is physiotherapy POCUS new? 

POCUS use is rapidly expanding across almost all medical and non-medical healthcare professions; and physiotherapists in the UK and internationally have been trailblazing its use for some time. 

However, POCUS expansion has been stilted by a persistent lack of clarity about what physiotherapists are allowed to do when using POCUS, what their remit is and how they can evidence their competency.

So what is the new guidance?

Dr Mike Smith has worked with experts across a range of physiotherapy POCUS specialisms to support the CSP with providing the world’s first, cross-specialism, physiotherapy POCUS guidance. 

In parallel, ‘first of their kind’, peer-reviewed framework publications (written by each physiotherapy POCUS specialism) are being published, covering the scope of practice, governance and education domains that will support each area of clinical practice.

I’ve not thought of using physiotherapy POCUS before. Should I be using it and if so, what does the guidance mean for me?

Physiotherapy POCUS is about treating the patient, not the scan! So POCUS should only be an adjunct to clinical practice and certainly not the primary focus. Nonetheless, physiotherapy POCUS can open up new ways to assess and treat your patients, to structure care pathways, to monitor your treatment interventions and support your decision making. 

As a first step, we invite you to read the peer-reviewed framework publications which include descriptions of how POCUS can inform and support your physiotherapy practice. The lung/critical care and pelvic floor framework publications are in print; with (i) image-guided botulinum toxin injections for spasticity and (ii) musculoskeletal (including image-guided interventions) soon to join them. 

Combined with the CSP’s over-arching guidance, these should equip you with all you need to know about how to step into this exciting new area of practice. Find out more from our information papers here.  

I already use physiotherapy POCUS, so what does the guidance mean to me?

We invite you to read the CSP information papers which provide overarching guidance about how physiotherapy POCUS sits within wider physiotherapy practice and governance. Use the 16 Practice Principles to assess your own practice, education and governance arrangements and identify areas for improvement or development.

Also see the peer-reviewed framework publications for granular level detail for different clinical specialisms. If these relate to your clinical area, consider how your service compares to these published frameworks and identify areas for local practice or service improvement. We will update the membership when additional clinical specialism framework publications are available. 

POCUS expansion has been stilted by a persistent lack of clarity about what physiotherapists are allowed to do when using POCUS, what their remit is and how they can evidence their competency.

Can physiotherapy POCUS really transform patient care?

Yes it can! The peer-reviewed frameworks are not intended to stifle innovation or development of physiotherapy clinical practice or roles. Instead they present a clear structure for the contextual considerations that will guide both safe and effective practice, and for you to explore opportunities to improve the quality of the physiotherapy management of patients.

I still have some questions; who can I ask?

If, after reading the linked resources you have further questions send them to professionaladvicese@csp.org.uk