Determinants and strategies for implementing guideline-adherent physiotherapy: a scoping review

Objectives Clinical practice guidelines support evidence-based care and aim to reduce unwarranted variation in healthcare. Despite evidence that guideline-adherent physiotherapy is associated with reduced healthcare utilisation, adherence among physiotherapists remains inconsistent.

This scoping review aimed to synthesise evidence on determinants of guideline adherence and implementation strategies in physiotherapy and to identify research gaps relevant to guideline implementation. Data sources MEDLINE (PubMed), EMBASE, the Cochrane Library, PEDro and CINAHL were searched from database inception to July 2023 and updated in July 2025.

Grey literature sources, including Grey Literature Report, OpenGrey and Web of Science Conference Proceedings, were also searched. Reference lists of included studies were screened.

Eligibility criteria Studies were eligible if they examined determinants of guideline adherence and/or implementation strategies in physiotherapy. Studies involving physiotherapists across all clinical fields and settings were included.

Only studies published in English or German were considered. Data extraction and synthesis Determinants were analysed using qualitative content analysis and mapped to the Consolidated Framework for Implementation Research (CFIR).

Implementation strategies were summarised using Proctor’s reporting recommendations.