A range of extended practice roles for allied health professionals have been promoted and are being undertaken, but their health outcomes have rarely been evaluated. There is also little evidence as to how best to introduce such roles, or how best to educate, support and mentor these practitioners.

Objectives: To explore the range, drivers and perspectives of extended or enhanced practitioner roles within physiotherapy.Data sources: Nineteen electronic databases, hand searches, bibliography scanning and personal contact were used to identify published and unpublished resources. Review methods:A systematic review using an expanded approach. Resources were included if they discussed extended scope of practice (ESP, intervention) in physiotherapy (profession) and outcome (for patients, other health professionals, and health services delivery) irrespective of patient group, language, year of publication (up to 2005), study design, or health care systems evaluated. All resources were screened against formal inclusion criteria for relevance. Information from relevant resources was extracted and details were entered into an Access database. Results:152 Physiotherapy-related resources were identified, including seven which met appropriate quality standards (using Cochrane methodology). A meta-analysis was not performed due to the paucity of RCTs. ConclusionsDrivers for the roles in the 152 resources mainly included local or national service demands (34%). Most ESP roles reported included a form of non-invasive assessment (47%) or non-invasive treatment (37%) of patients that was more traditionally carried out by medical colleagues. None of the resources including data were a) unsupportive of ESP or b) mainly expressing concerns. This review has demonstrated overwhelming support 4 for ESP; the vast majority of resources were supportive of ESP despite being largely descriptive or discursive in nature (76%). There is an urgent need for robust research in order to evaluate the expansion of ESP roles, underpin further development of those roles and, strengthen the evidence base of ESP in physiotherapy.

In this study involving a subject with normal joints, goniometry is more reliable than CFF when only one measurer is involved. However, CFF may be a useful alternative where multiple joint measures are required, or when goniometry is impracticable.

Although both goniometry and wire tracing show limitations as reliable assessment tools, it is recommended that where possible goniometry should be used.

There is little evidence to address the hypothesis that the ingestion of baked hen's egg or cow's milk results in more patients outgrowing their hen's egg or cow's milk allergy respectively. Data are required from a trial comparing the resolution rates of baked-tolerant participants who are randomized to ingest or avoid baked products to assess the accuracy of this hypothesis.