The Physio2Future-Model as an Orientation for Responsible Physiotherapy of the Future – a Delphi Study

Background The challenges of physiotherapy led to the development of the Physio2Future-Model. These challenges include a lack of autonomy, e.g., direct access; internal conflicts of interest within best practice, e.g., biological vs. psychosocial approaches; the adherence of physiotherapists to clinical practice guidelines; the knowledge of professionals about clinical, medical, and social relevance; the support of professionals, e.g., investments in education and health; the patient-centered practice, e.g., high-value therapy, and questions about the long-term effectiveness of resource-efficient strategies. The Physio2Future-Model comprises six dimensions: Autonomy, Evidence, Relevance, Human-centeredness, Effectiveness, and Sustainability. However, more specific data is needed to assess its suitability as an orientation for the future of physiotherapy.

This Delphi survey aimed to identify a consensus among experts in management positions at physiotherapy centers on the future of physiotherapy based on the Physio2Future-Model.

Methods For this study, the DELPHISTAR recommendations served as a guide. The survey was conducted in three rounds and contained 45 items (22 original and 23 suggested by experts). The first two rounds were mainly quantitative items about the future of responsible physiotherapy, rated on 5-point Likert scales. The third round was to clarify the accuracy of data extraction and the sufficiency of information. The consensus level was defined as 80% and included all ratings between 'absolutely correct' and 'correct'.

Results Of 26 invited experts, 17 participated in all three rounds. A consensus was reached on 92% of the 45 proposed items. All experts rated the need for a qualitative change in physiotherapy as 'very important' (100% consensus). The highest consensus was achieved in the domains Autonomy (97%), Sustainability (94%), and Evidence (94%). Followed by Effectiveness (92%), Human-centeredness (92%), and Relevance (82%). The suitability of the Physio2Future-Model as an orientation for responsible physiotherapy achieved 90% consensus.

Conclusion The dimensions Autonomy, Sustainability, Evidence, and Human-centeredness should be considered mainly as an orientation for the responsible physiotherapy of the future. Further consensus studies with expert groups of other relevant sections, e.g., education and/or politics, are needed to more comprehensively evaluate the suitability of the Physio2Future-Model as an orientation for the future of physiotherapy.

Publication History

Article published online:
23 October 2025