OT vs Physiotherapy – What’s the Difference and When Does My Participant Need Each?

Reading time: 9 minutes  |  Audience: Support Coordinators, Participants & Families  |  Updated: April 2026

Occupational therapy and physiotherapy are both allied health disciplines, both funded through Capacity Building — Improved Daily Living in an NDIS plan, and both work with people with disabilities to improve function. So what is the difference — and how do you know which one your participant actually needs?

The confusion is understandable. The two disciplines overlap significantly in some areas, particularly neurological and musculoskeletal conditions, and a participant may genuinely need both. But they have distinct scopes of practice, different core frameworks, and different primary contributions to NDIS outcomes. Getting the distinction right matters because it affects which referrals you make, in what order, and how you use limited IDL budget most effectively.

This guide explains the practical difference between OT and physiotherapy for NDIS support coordinators — when each is indicated, where they overlap, and how to determine which should take the lead for a given participant and situation.

The Core Conceptual Difference

The clearest way to understand the difference between OT and physiotherapy is through their primary questions:

Put another way: physiotherapy addresses the physical capacity to perform movement. OT addresses the participation in daily activities — using physical capacity, along with cognitive, sensory, and environmental factors, to achieve functional outcomes that matter to the person.

In practice, this means that physiotherapy and OT often address related problems from different angles — and for many participants, the most effective approach involves both disciplines working in coordination.

What Occupational Therapy Focuses On

Occupational therapists address the full spectrum of factors that affect a person’s participation in daily life — physical, cognitive, sensory, emotional, and environmental. OT’s scope includes:

• Daily living skills — showering, dressing, meal preparation, medication management, household tasks, money management
• Cognitive function — memory aids, organisational systems, executive function strategies, safety assessment
• Sensory processing — sensory diets, sensory integration, environmental modification for sensory needs
• Assistive technology — assessment, prescription, and training for wheelchairs, communication devices, daily living aids, environmental control
• Home modification — assessment and clinical justification for accessibility modifications
• School and workplace participation — assessment and strategies for participation in education and employment
• NDIS report writing — Functional Capacity Assessments, SIL assessments, AT prescriptions, home modification reports that underpin NDIS plan funding
• Upper limb rehabilitation — hand therapy, splinting, fine motor retraining after injury or neurological event
• Fatigue management — energy conservation programs and pacing strategies for neurological and chronic conditions
• Social participation and community access — building the skills and environmental supports for meaningful community engagement

What Physiotherapy Focuses On

Physiotherapists address physical function — the body’s capacity to move safely, strongly, and with endurance. Physiotherapy’s scope includes:

• Mobility and gait — walking ability, balance, and safe movement in the community
• Strength and endurance — exercise programs to build the physical capacity for daily activities and community participation
• Pain management — assessment and treatment of pain related to musculoskeletal conditions, neurological conditions, or post-injury
• Neurological rehabilitation — motor retraining after stroke, spinal cord injury, or traumatic brain injury, focusing on movement recovery and compensation
• Respiratory physiotherapy — breathing exercises, airway clearance, and respiratory management for conditions affecting the lungs
• Hydrotherapy — therapeutic exercise in water, particularly for conditions where land-based exercise is limited by pain or weakness
• Post-surgical rehabilitation — recovery programs after orthopaedic surgery, joint replacement, or spinal surgery
• Falls prevention — balance assessment, vestibular rehabilitation, and exercise programs targeting falls risk
• Manual therapy — joint mobilisation, massage, and hands-on techniques for musculoskeletal conditions
• Sports and exercise rehabilitation — conditioning programs for participants with disability who want to maintain physical fitness

OT vs Physio — Side-by-Side Comparison

Where OT and Physio Overlap — and How to Manage It

The areas of genuine overlap between OT and physiotherapy are worth understanding precisely, because overlap creates the risk of duplication — two providers billing from the same IDL budget for work that could be done by one — as well as the risk of gaps, where each discipline assumes the other has addressed something and neither does.

Upper limb function after stroke or neurological injury

This is the most common area of genuine clinical overlap. Both OTs and physiotherapists can deliver upper limb rehabilitation after stroke or brain injury — physiotherapy through motor retraining and strengthening, OT through functional task practice and splinting. In practice, the physiotherapist typically focuses on restoring movement capacity while the OT focuses on using that movement for functional daily tasks. Both contribute; the OT typically takes the lead in translating motor gains into daily activity participation.

Mobility aid prescription

For simple mobility aids (walking frames, crutches, basic manual wheelchairs), physiotherapists frequently assess and prescribe. For complex mobility aids — particularly powered wheelchairs, tilt-in-space systems, and specialised seating — an OT with AT experience typically leads the prescription, with physiotherapy input on positioning and postural needs. For the NDIA’s purposes, complex AT prescriptions for wheelchairs are expected to come from an OT.

Falls prevention

Falls prevention involves both disciplines but from different angles. Physiotherapy addresses the physical determinants of fall risk — balance, strength, vestibular function. OT addresses the environmental and cognitive contributors — home hazards, medication effects on balance, unsafe footwear, cognitive changes affecting judgment. A comprehensive falls prevention program for a high-risk participant should involve both.

Functional capacity in musculoskeletal conditions

For participants whose primary disability is a musculoskeletal condition — significant arthritis, chronic back pain, or post-amputation — both OT and physiotherapy may contribute to an FCA. Physiotherapy assesses physical capacity and pain; OT assesses how that physical capacity translates to (or is limited in) daily activities. The FCA itself is produced by the OT.

When Your Participant Needs OT

Refer to an OT when the primary concern is:

When Your Participant Needs Physiotherapy

Refer to a physiotherapist when the primary concern is:

When Your Participant Needs Both

Many participants with complex or progressive disabilities genuinely benefit from both OT and physiotherapy — not duplicating each other but working in a complementary, coordinated way. Here are the most common scenarios where both are clearly indicated:

NDIS Reports — Which Discipline Produces What

One of the most practically important distinctions for support coordinators is understanding which reports and clinical documents each discipline produces — because this directly affects who you need to refer to when specific NDIS funding applications are being prepared.

Frequently Asked Questions

Summary

OT and physiotherapy are complementary disciplines that address different — though related — aspects of disability and daily function. Physiotherapy focuses on the body’s physical capacity to move. OT focuses on how that capacity (combined with cognitive, sensory, and environmental factors) translates into participation in the activities of daily life.

For NDIS purposes, the distinction matters practically: OT produces the FCA, AT prescription, home modification, and SIL reports that drive plan funding decisions. Physiotherapy contributes valuable functional information but does not produce these documents. When both are needed, coordinate them — a physiotherapist and OT working in parallel without communication is less effective than the same pair working from a shared understanding of the participant’s goals.

TEAH provides both OT and physiotherapy across Darwin, Perth, Brisbane, and Victoria — making coordinated multidisciplinary referrals straightforward.