Cultural Adaptation in Physical Therapy: A Scoping Review of Empirical Evidence and Practices.

Background and Purpose: The cultural adaptation of physical therapy interventions has been widely recommended, yet the literature remains limited, heterogeneous, and unevenly reported. This scoping review maps the literature on culturally adapted physical therapy and identifies adaptation strategies, key characteristics of the evidence base, and gaps relevant to education and practice. Methods: A scoping review of PubMed, Google Scholar, and Elicit (2000-2026) identified 37 peer-reviewed articles on the cultural adaptation of physical therapy. Searches were supplemented by backward and forward citation tracking. Guided by PRISMA-ScR reporting standards, data were charted on study design, article type, populations, outcomes, and reported cultural adaptation approaches. Results: Thirty-seven articles were identified, including experimental, non-experimental quantitative, qualitative, and non-empirical sources. The literature was published primarily after 2017 and reflected substantial heterogeneity in populations, intervention types, and outcomes. Five experimental studies were identified, which assessed patient activation, attendance, adherence, pain-related suffering, pain severity, physical function, and health literacy. Reported findings were mixed, with some studies noting improvements in implementation-related or patient-reported outcomes and others reporting no significant differences across clinical outcomes. Additional evidence came from eight non-experimental quantitative studies and twelve qualitative studies. Adaptation strategies included language, content, and intervention adaptation; addressing norms, values, and context considerations; reconciling explanatory models of health and illness; engaging cultural experts; and training for providers. Discussion and Conclusions: This scoping review found that the literature on culturally adapted physical therapy is limited, methodologically heterogeneous, and uneven across intervention types and populations. There is a need for methodologically robust and systematically reported research to clarify adaptation approaches, inform education and practice, and support the development of adaptation frameworks. Strengthening this evidence base may help inform future education policy, clinical guidance, and culturally adapted physical therapy care.