Exploring the experiences of physiotherapists working in specialist roles for the management of spasticity: a pilot study

Background/Aims Physiotherapists in the UK are now established in specialist roles for the management of spasticity. Insights into their experiences could help shape the future of the role by highlighting successes alongside areas for development. The study aimed to explore the experiences of physiotherapists working in specialist roles within outpatient spasticity management services, with a focus on responsibilities, support, development and job satisfaction. Methods A total of 15 physiotherapists from adult and paediatric services were recruited from Scotland, England and Northern Ireland via purposive and snowball sampling. An interpretive qualitative approach using online focus groups was undertaken to explore the experiences of the physiotherapists. Reflexive thematic analysis was conducted to analyse the data. Results Four themes were identified: expert in spasticity management; personal and professional development; wider awareness and understanding; and sustainability of the role. Sub-themes were also identified within each theme. Participants were found to be extremely skilled and knowledgeable, with many using advanced skills such as injection therapy and non-medical prescribing. They perceived themselves to have a high level of job satisfaction and were motivated to develop themselves and their services. A lack of structured clinical supervision was identified and most relied on peer networks for clinical support. Participants felt a greater awareness and understanding of spasticity and its consequences is required from stakeholders to encourage investment into spasticity services. Conclusions The development of a national competency framework to standardise education and training for such roles is needed to promote service equity and efficacy across the UK. Implications for practice This study highlights the need for a standardised UK-wide competency framework, clear role definitions, and structured peer support for specialist neurological physiotherapists. Additionally, updated guidance from the Chartered Society of Physiotherapy on injection therapy and non-medical prescribing is essential to ensure safe, advanced practice.