A newly accepted study in Frontiers in Rehabilitation Sciences, part of Volume 6 (2025), reveals alarming shortfalls in how physiotherapy services were integrated into health emergency planning during the COVID-19 pandemic. The research, led by Heidi Kosakowski, World Physiotherapy head of membership and policy, in collaboration with experts from the World Health Organization, was published on 18 August 2025.
The researchers analysed responses to World Physiotherapy’s annual membership census in 2022, which included questions about whether physiotherapy services were incorporated into emergency preparedness planning and what strategies were used to mitigate service disruptions. The results are stark: of the 125 member organisations surveyed, 116 responded. Nearly a quarter (24%) reported not having any of the mitigation strategies in place during the pandemic. Even more concerning, 64% said that physiotherapy services were entirely absent from any health emergency preparedness components in their country or territory.
Pete Skelton, WHO consultant for rehabilitation in emergencies and one of the researchers, said: “The 2023 World Health Assembly resolution on rehabilitation calls on all member states “to ensure timely integration of rehabilitation in emergency preparedness and response".
“We see great strides being taken in many emergency responses around the world where rehabilitation is increasingly being recognised as an essential component of patient care. From a preparedness perspective though we still have much work to do. This important work establishes a clear baseline for the global integration of physiotherapy into emergency preparedness, with 83% of countries not integrating physiotherapy services into national or subnational emergency plans.
“Together with World Physiotherapy and leading rehabilitation organisations, as part of the Rehabilitation 2030 agenda we are ready to support member states to integrate rehabilitation into their emergency preparedness planning, and we will soon be publishing a practical toolkit to support this.”
The findings shed light on a major global vulnerability in healthcare systems: the marginalisation of rehabilitation and physiotherapy in planning for health crises. The study also notes that this lack of integration is widespread and did not appear to depend on a nation’s income level.
These conclusions echo calls for reform heard elsewhere in the rehabilitation sector, for example from the Chartered Society of Physiotherapy (CSP) in the UK. In 2025, CSP's global health network ADAPT secured a motion at the annual representatives conference (ARC) urging endorsement of WHO’s Resolution 76.6 and its policy brief on rehabilitation in health emergency preparedness and response. The CSP council has now committed to pushing UK authorities to assess and enhance the integration of rehabilitation into emergency planning, leveraging parliamentary advocacy and engagement with resilience agencies. The CSP approach illustrates how global guidance can be translated into concrete national action plans.
Heidi Kosakowski said: “By taking a global resolution and turning it into a concrete national ask, the CSP has created a pathway for advocacy: anchoring in global commitments, securing formal endorsement, and defining a clear national action. The CSP is helping ensure that global advocacy commitments are translated into practical national measures that strengthen preparedness, response, and recovery.”
As the world remains vigilant about future pandemics or disasters, this research underscores an urgent need: emergency planners must embed rehabilitation services into preparedness frameworks - or risk repeating critical gaps that emerged during the COVID-19 pandemic.
