Perspectives on an Advanced Practice Physiotherapy-Led Model for Musculoskeletal Care in Canada: A Qualitative Study of Patients and Multidisciplinary Clinicians

Background Musculoskeletal (MSK) conditions are the leading cause of global disability, placing a substantial burden on healthcare systems. Internationally, Advanced Practice Physiotherapy (APP) has shown promise in alleviating this burden; yet systemic barriers limit its integration in Canada. Understanding the perspectives of patients and multidisciplinary clinicians with direct experience in an APP-led MSK model can inform strategies for sustainable implementation. Aim To understand and integrate the perspectives of multidisciplinary clinicians and patients on an APP-led MSK model in Canada. Design A qualitative descriptive study conducted within a pragmatic paradigm and reported in accordance with the Consolidated Criteria for Reporting Qualitative Research. Methods All clinicians involved in the APP-led model were invited to participate. Patients seen within the model during recruitment were consecutively invited verbally or through advertisement. Focus groups were used for data collection. 2 researchers conducted content analysis to generate descriptive themes, followed by thematic synthesis to integrate findings. Findings 4 key themes were identified from 2 patient (n=8) and 2 clinician focus groups (n=12): 1) collaboration is a pathway to acceptance, optimal patient care and professional growth, 2) broad agreement on the positive impact for patients and the healthcare system, 3) challenges remain to be addressed and 4) potential opportunities exist to improve the model. Conclusion APP-led MSK care was supported by patients and clinicians, but broader implementation is constrained by gaps in standardized education and enabling policy structures. Addressing these system-level barriers may support sustainability and maximize the impact of APP in MSK care in Canada.