From clinic to courtroom: the integration of physiotherapists into the forensic fieldAbstract
Introduction: The increasing judicialization of social, labor, and social security relations in Brazil has increased demand for specialized technical evaluations that support judicial decisions grounded in scientific evidence. In this context, forensic physical therapy has emerged as a professional field focused on functional assessment and the preparation of expert reports and technical opinions in different legal settings.
Objective: To analyze the insertion of physical therapists in the forensic field in Brazil, characterizing their professional profile, academic background, areas of practice, and aspects related to their professional activity.
Methods: This exploratory, cross-sectional, observational study was conducted in accordance with the STROBE guidelines with physical therapists working as expert witnesses, technical assistants, or legal consultants. Participants completed a structured, self-administered online questionnaire.
Results: The sample consisted of 36 physical therapists. Most participants were between 30 and 50 years old (83.33%), female (63.89%), and primarily working in the Southeast (44.44%) and South (36.11%) regions of Brazil. A high proportion reported having specific training in forensic physical therapy (91.67%). Only 11.11% reported working as court-appointed experts, while 61.11% worked as technical assistants and/or legal consultants. Most participants performed up to five forensic-related activities per month (86.11%), with an average completion time of one to three days (66.67%) and remuneration of up to two minimum wages per activity (88.89%). Additionally, 38.89% reported having experienced attempts to restrict their professional practice.
Conclusion: Although the forensic field shows potential for professional practice and income generation, the findings indicate the persistence of institutional barriers and challenges related to professional recognition and the full integration of physical therapists into forensic practice.
Keywords:
Forensic sciences; Physical therapy specialty; Job market; Expert testimony; Professional practice
Resumo
Introdução: A crescente judicialização das relações sociais, trabalhistas e previdenciárias no Brasil tem ampliado a demanda por avaliações técnicas especializadas capazes de subsidiar decisões judiciais. Nesse contexto, a fisioterapia forense surge como um campo de atuação voltado à análise funcional e à elaboração de laudos e pareceres técnicos em diferentes contextos jurídicos.
Objetivo: Investigar a inserção dos fisioterapeutas brasileiros na área forense, caracterizando o perfil profissional, a formação acadêmica, as áreas de atuação e aspectos relacionados à prática profissional.
Métodos: Trata-se de um estudo observacional transversal, de caráter exploratório, conduzido conforme as diretrizes STROBE, com fisioterapeutas atuantes como peritos, assistentes técnicos ou juris-consultores. Os participantes responderam a um questionário estruturado e autoaplicável disponibilizado online. A amostra foi composta por 36 fisioterapeutas. A maioria possuía entre 30 e 50 anos (83,33%), era do sexo feminino (63,89%) e atuava principalmente nas regiões Sudeste (44,44%) e Sul (36,11%). Observouse elevada proporção de profissionais com formação específica em fisioterapia forense (91,67%). Apenas 11,11% dos participantes relataram atuar como peritos judiciais, enquanto 61,11% atuavam como assistentes técnicos e/ou jurisconsultores. A maioria realizava até cinco atividades periciais mensais (86,11%), com tempo médio de elaboração entre um e três dias (66,67%) e remuneração de até dois salários-mínimos por trabalho (88,89%). Além disso, 38,89% relataram já ter enfrentado tentativas de impedimento do exercício profissional.
Conclusão: Os resultados indicam que, embora a área apresente potencial de atuação e geração de renda, ainda existem barreiras institucionais e desafios relacionados ao reconhecimento profissional e à inserção plena do fisioterapeuta no campo pericial.
Palavras-chave:
Especialidade de fisioterapia; Ciências forenses; Mercado de trabalho; Prova pericial; Prática profissional
Introduction
The increasing judicialization of social, labor, and social security relations in Brazil has broadened the demand for specialized technical assessments capable of supporting scientifically based judicial decisions. By offering an approach centered on the analysis of human movement and functionality, the forensic physiotherapist plays a central role in elucidating causal relationships between health problems and work activities performed, elements frequently neglected in exclusively biomedical assessments.1-3
The forensic physiotherapist is qualified to prepare reports and opinions based on kinesiological and functional diagnoses, which are applied in multiple judicial and administrative contexts. Social security and labor lawsuits, claims related to the right to use or acquire adapted vehicles with tax exemption, litigation arising from accidents on public roads, criminal proceedings, and audits of clinical conduct involving possible medical or physiotherapeutic iatrogenic effects are among the scopes of practice of the forensic physiotherapist. 4-7
Therefore, forensic physiotherapists can work in different roles, each with specific responsibilities. The expert physiotherapist is the professional appointed by the judge to conduct the judicial examination, acting with technical impartiality in evaluating the case and preparing the report that will support the judicial decision.
The technical assistant is the professional appointed by one of the parties, responsible for monitoring the expert procedures and issuing a technical opinion on the report produced. In turn, the legal consultant performs a predominantly advisory function, offering opinions and technical clarifications on issues related to kinesiological and functional diagnosis, without necessarily participating directly in the expert act.8
Although forensic physiotherapy has normative and institutional recognition in Brazil,6,8 there is heterogeneity in professional training, a scarcity of systematized research, and uncertainty regarding the job market.
Given this context, the present study aimed to investigate, in an exploratory manner, the insertion of physiotherapists in the forensic field in the Brazilian context, seeking to characterize the professional profile, academic training, areas of practice, and aspects related to the professional practice of these individuals.
Methods
This cross-sectional exploratory observational study was reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.9 Ethical approval was obtained from the Research Ethics Committee of the Federal University of Pampa (CAAE: 53731221.5.0000.5323). All participants read and electronically signed an informed consent form before participating.
Participants
The study sample consisted of 36 physiotherapists working as experts, technical assistants, or legal consultants, based on self-declaration at the time of completing the questionnaire. Participants were recruited through convenience sampling. In total, 236 physiotherapists were invited to participate in the study, of whom 45 responded to the questionnaire, and 36 were included in the analysis. The participant recruitment and inclusion process is presented in Figure 1. The inclusion criteria adopted were: bachelor's degree in physiotherapy; working as an expert physiotherapist, legal consultant, or technical assistant; residing in Brazil; internet access to answer the online questionnaire; ability to understand and consent to the study procedures. Participants who did not fully complete the questionnaire, as well as duplicate responses, were excluded and not included in the analysis.
Procedures
Participant recruitment was conducted exclusively via email. Email addresses were obtained from associations and organizations comprised of expert physiotherapists, as well as from Regional Councils of Physiotherapy and Occupational Therapy (CREFITO) and the Federal Council of Physiotherapy and Occupational Therapy (COFFITO), between July and December 2025.
In the invitation email, the questionnaire was distributed via an open link using the Google Forms platform, which initially presented an informed consent form. Only participants who agreed to the terms could proceed to the questionnaire. The instrument is available for consultation at: https://tinyurl.com/2zyyhx34.
The structured, self-administered questionnaire was developed by the researchers themselves and evaluated by a specialist specifically for this population. The questionnaire consisted of four sections: professional practice; workplace; role of the occupational physiotherapist in forensic investigations; and professional recognition. The average time to complete the questionnaire was approximately 20 minutes. All data was collected and stored on the Google Forms platform, which has security mechanisms to protect the information. Access to the responses was restricted to the responsible researchers through authentication with an institutional account, minimizing the risk of unauthorized access.
Sample and statistical analysis
Considering the exploratory and descriptive nature of the study, physiotherapists who voluntarily answered the questionnaire during the data collection period were included. Categorical variables were presented as absolute (n) and relative (%) frequencies, and analyses were performed using descriptive statistics.
Results
Most physiotherapists were between 30 and 50 years old (83.33%), female (63.89%), and worked in the Southeast region (44.44%). Regarding their area of practice, 11.11% of physiotherapists worked as judicial experts, and 61.11% worked as technical assistants and/or legal consultants (Table 1).
Regarding the professional performance in the forensic field, the majority of physiotherapists performed up to five expert assessments, technical assistance, and/or legal consulting services monthly (86.11%), with an average value received per job of less than two minimum wages (88.89%), and had never experienced attempts to impede their professional practice due to being physiotherapists (61.11%), as presented in Table 2.
Figure 2 shows the equipment most commonly used by physiotherapists for conducting expert reports, technical assistance, and/or legal consulting. The most frequently used materials were smartphones (72.22%), notebooks (69.44%), and cameras (30.56%).
Frequency distribution of equipment used by physiotherapists for conducting judicial assessments, technical assistance, and/or legal consulting.
Discussion
To the best of our knowledge, this is the first study to investigate the characteristics of the professional insertions of physiotherapists in the forensic field, considering national and international contexts.
The findings indicate the presence of barriers to professional insertion, including the requirement for specific training, resistance from judges to the appointment of physiotherapists to positions with greater decision-making power, such as expert work, and attempts to impede professional practice.
On the other hand, the results suggest that forensic physiotherapy can be an economically attractive area, considering the average monthly number of activities performed (expert reports, technical assistance, and legal consulting), as well as the average amounts received and the time required to perform these activities.
Recent studies on the physiotherapy job market have indicated wide variability in remuneration between countries and work contexts.10-12 In Brazil, a national survey of physiotherapists identified that approximately one-third of professionals receive between R$1,500 and R$3,000 per month and another third between R$3,000 and R$ 6,000, with the need for multiple employment relation-ships being frequent.10
In the present study, 88.89% of participants reported receiving up to two minimum wages for each expert assessment, technical assistance, and/or legal consulting service provided, corresponding to values between R$ 1,518 and R$3,036. Considering that 86.11% stated that they perform, on average, up to five of these activities per month, there is a potential for income generation higher than that observed in most traditional physiotherapy practice modalities. Furthermore, two-thirds of the participants reported needing up to three days to complete each task, which may suggest a potentially favorable relationship between remuneration and time spent performing the activities.
Our findings also highlight a high qualification requirement for physiotherapists to work in the forensic field. In the present study, 91.67% of participants had postgraduate training, a percentage significantly higher than that observed in other areas of physiotherapy. Although the contexts of practice are different, comparison with other professional fields allows us to measure the level of qualification required. In this regard, Russo et al.13 identified that 70.37% of physiotherapists working in intensive care units had postgraduate degrees, while Resende et al.14 observed that, in the traumaorthopedic area, only 24.5% had specific training.
This contrast suggests that working in a forensic context may require higher levels of formal qualification, possibly due to the technical and scientific complexity involved in producing reports and opinions, as well as the need to demonstrate professional credibility before the justice system and other healthcare professionals.
Similarly, resistance was observed on the part of magistrates to the appointment of physiotherapists to positions with greater decision-making power, since only 11.11% of participants reported having been appointed to the position of judicial expert. In contrast, most participants stated that they work in legal consulting and technical assistance activities, both mentioned by 61.11% of respondents. This scenario can be partially explained by the recent inclusion of physiotherapists in the field of expert work, which is still not widely known among legal professionals and other professionals involved in the judicial process.
Furthermore, the historical tradition of the predominance of medical expertise in cases involving the assessment of disability or bodily injury may contribute to the maintenance of this pattern of appointment by magistrates. Thus, acting as a judicial expert is still frequently, and mistakenly, associated exclusively with other professional categories, which can generate doubts about the technical competencies of physiotherapists as auxiliaries of justice.
However, physiotherapy expertise is configured as a complementary approach in the context of expert assessments, not aiming to occupy the space of other traditionally involved areas, but rather to contribute from its own framework, centered on the analysis of human movement and functionality. In this way, the physiotherapist's role integrates with the other areas involved in the expert process, adding specific technical information that broadens the understanding of the evaluated conditions and favors a more comprehensive and qualified analysis, with a view to better elucidating the facts in the judicial context.6,15
More than a third of respondents reported having experienced attempts to prevent them from practicing their profession because of their training in physiotherapy. Similarly, a study conducted by Rodrigues et al.16 found that 21.65% of the rulings of the Regional Labor Court of the 6th Region (TRT-6) were unfavorable to the admissibility of expert reports prepared by physiotherapists. These findings reinforce the existence of institutional barriers to the full inclusion of physiotherapists in the field of expert analysis.
It is worth noting that the work of forensic physiotherapists is supported by Article 466 of the Code of Civil Procedure, which establishes rules for the appointment and participation of professionals in judicial proceedings.8 This provision, together with COFFITO Resolutions 381 and 465, provides a legal basis for physiotherapists to officially act in proceedings involving functional issues, work incapacity, and physical sequelae, among other aspects related to human functionality.6,17 Any impediments to professional practice constitute undue restrictions, and it is possible to present the legal prerogatives of the profession to the competent courts, as well as request the suspension of proceedings until the regular exercise of professional activity is ensured.
This study has limitations that should be considered. The convenience sample and the small number of participants limit the generalizability of the findings, while the use of a self-administered questionnaire may introduce response biases. Even so, the results provide a relevant initial overview of the physiotherapist's role in the forensic field. Future studies with larger samples and multicenter designs are needed to deepen the understanding of training, the job market, and existing institutional barriers.
Conclusion
The results indicate that the inclusion of physiotherapists in the forensic field still faces significant challenges, such as high professional qualification requirements, institutional resistance to expert work, and attempts to impede professional practice. Despite these barriers, the area presents potential for activity and income generation, especially through activities such as technical assistance and legal consulting. Taken together, the findings contribute to a broader understanding of the profile and working conditions of physiotherapists in this emerging field, as well as reinforcing the need for greater institutional recognition and strengthening of the professional category through the consolidation of its technical prerogatives in the legal context.
Data availability statement
Data are available from upon reasonable request.
Acknowledgments
The authors thank the Coordination for the Improvement of Higher Education Personnel (CAPES), Brazil, for the scholarship grant, and the Federal University of Pampa (UNIPAMPA), Uruguaiana campus, for supporting the stages of conducting the research.
References
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Edited by
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Associate editor:
Ana Paula Cunha Loureiro
