The Physio Assistant-physiotherapy evidence assistant

Example

Sciatica with leg-dominant pain in primary care: Produces a concise evidence brief comparing exercise, education, manual therapy as adjuncts, and epidural steroid injections; labels each by study type (e.g., SR/RCT), effect direction, and evidence strength (e.g., Moderate by GRADE); aligns with a requested guideline set (e.g., NICE NG59 for LBP/sciatica, APTA CPG). It explicitly marks outdated/low-value options (e.g., routine imaging without red flags, passive modalities with minimal effect) and notes when evidence is contested.

Scenario

A First Contact Practitioner builds a pathway update: The Assistant auto-lists key recommendations (e.g., keep active, screen red flags, safety-netting), contraindications, and referral thresholds; provides a one-page summary with PubMed-style links for the MDT governance pack and highlights where local policy should mirror national guidance.

Example

Dizziness triage: The Assistant runs a vestibular logic tree differentiating peripheral (e.g., BPPV: brief positional vertigo, fatigable horizontal/rotatory nystagmus) from central features (e.g., direction-changing nystagmus, severe ataxia, focal neuro signs). It proposes appropriate bedside tests (e.g., Dix–Hallpike, HINTS+ overview), flags red flags (neurologic deficits, new severe headache), and outlines urgent referral triggers.

Scenario

Same-day access MSK clinic receives a whiplash case: The Assistant applies the Canadian C-Spine Rule (age, dangerous mechanism, paresthesias; low-risk factors; active rotation) to determine if imaging is indicated, documents the reasoning, and drafts safety-net advice. In an ankle sprain, it applies the Ottawa Ankle/Foot Rules to reduce unnecessary radiographs and standardise triage across clinicians.

Example

ACL reconstruction: Generates a week-by-week clinical timeline with criteria-based progression (e.g., effusion control → ROM restoration → strength symmetry benchmarks → running/readiness testing), load management cues, and red flags (e.g., calf pain/swelling → DVT rule-out). It pairs this with an EMR-ready SOIER or SOAP note and an outcomes tracker (e.g., KOOS subscales, hop tests). For shoulder rehab, it interprets SPADI improvement (e.g., +15 points exceeds a commonly cited MCID ~13) and for LBP interprets ODI change (e.g., −12 points exceeds a typical MCID ~10), noting population/context caveats.

Scenario

On a surgical ward (day 2 post–rotator cuff repair), the Assistant drafts: (1) SOIER assessment with precautions and mobility status; (2) an MDT handover highlighting sling use, sleeping position, and opioid weaning plan; (3) a patient-friendly exercise sheet with stage-appropriate dosing; (4) an outcome plan with review intervals and MCID targets to guide discharge planning.