Physiotherapists' use of evidence based practice: a cross‐national study

Turner, Patricia A.; Whitfield, T. W. Allan

doi:10.1002/pri.76

Cited by 131 publications

(84 citation statements)

References 17 publications

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“…Reasons for non-use References Non-availability of equipment 17,30,44 Safety concerns / fear of safety 11,24,33,47 Lack of evidence for clinical effectiveness 11, 27, 28, 33, 35-37, 43, 50-52 Physiotherapist's choice 23,15 Lack of knowledge / training and unfamiliarity with the modality 23,35,52,53 Lack of research and information on EPAs 25,27 Nature of the clinical condition being treated 30 Supersession of modality e.g. MWD and H-wave 35 Level of ease of / difficulty in application 24 Area / nature of practice i.e.…”

Section: Discussionmentioning

confidence: 99%

Trends in the availability and usage of electrophysical agents in physiotherapy practices from 1990 to 2010: a review

Shah

Farrow²

2012

Physical Therapy Reviews

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Section: Discussionmentioning

confidence: 99%

Trends in the availability and usage of electrophysical agents in physiotherapy practices from 1990 to 2010: a review

Shah

Farrow²

2012

Physical Therapy Reviews

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“…2,21,22 The literature [2][3][4][5][22][23][24][25][26][27] suggests that the existing gaps between evidence and practice are indeed the result of a combination of barriers related to the individual, the practice environment, and the clarity of the messages about the effectiveness of a treatment.…”

Section: Background Barriers To Evidence-based Practice In Physical Tmentioning

confidence: 99%

“…7 These findings suggest that some physiotherapists may rely on colleagues, textbooks, and/or techniques learned from their initial training to inform their clinical practice, rather than reading scientific journals. 3,5,23,25,26 Another barrier to EBP is the lack of skills and resources to access current and relevant research. 2,5 In fact, skills in accessing online information, rather than the size and location of the workplace, are related to research use.…”

Section: Individual Factorsmentioning

confidence: 99%

“…For nearly two decades, clinicians have been encouraged to embrace EBP, in which treatment decisions are made by integrating the best available evidence with clinical expertise and patient preference. 1 Studies from Australia, 2,3 England, 3 Sweden, 4 the United States, 5,6 and Canada 7 have shown that physical therapists have a positive attitude toward EBP, but this attitude does not always translate into practice. For example, a variety of studies [8][9][10] have provided evidence supporting the use of inspiratory muscle training (IMT) for some people with chronic obstructive pulmonary disease (COPD), such as those who are unable to participate fully in whole-body exercise training because of comorbid conditions or those who have intractable dyspnea despite whole-body exercise.…”

Section: Introductionmentioning

confidence: 99%

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Development of a Theory-Based Intervention to Increase Prescription of Inspiratory Muscle Training by Health Professionals in the Management of People with Chronic Obstructive Pulmonary Disease

Simms

Li²,

Reid³

2011

Physiotherapy Canada

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Purpose: The purpose of this paper is twofold: (1) to provide an overview of the literature on barriers to evidence-based practice (EBP) and the effectiveness of implementation interventions in health care; and (2) to outline the development of an implementation intervention for improving the prescription of inspiratory muscle training (IMT) by physical therapists and other health professionals for people with chronic obstructive pulmonary disease (COPD). Summary of Key Points: Individuals, organizations, and the research itself present barriers to EBP in physical therapy. Despite the evidence supporting the use of IMT, this treatment continues to be under-used in managing COPD. Current health services research shows that traditional information-based approaches to implementation, such as didactic lectures, do not adequately address the challenges health professionals face when trying to make changes in practice. We propose the development of a theory-based intervention to improve health professionals' use of IMT in the management of COPD. It is postulated that a behavioural intervention, based on the theory of planned behaviour (TPB), may be more effective than an information-based strategy in increasing the prescription of IMT by health professionals. Conclusion: TPB may be used to understand the antecedents of health professionals' behaviour and to guide the development of implementation interventions. Further research is needed to evaluate the effectiveness of this proposed intervention in the management of people with COPD.Key Words: evidence-based practice, inspiratory muscle training, knowledge translation, physical therapist, theory of planned behaviour RÉ SUMÉObjectif : L'objectif de cet article comporte deux volets : 1) offrir un survol de la documentation relative aux obstacles à la pratique fondé e sur les faits scientifiques et qui traite de l'efficacité des interventions de mise en oeuvre dans les soins de santé ; et 2) donner un aperc¸u de l'é laboration d'une intervention de mise en oeuvre pour amé liorer la prescription d'entraînement des muscles inspiratoires (IMT) par les physiothé rapeutes et autres professionnels de la santé pour les patients aux prises avec une maladie pulmonaire obstructive chronique (MPOC). Ré sumé des principaux points : Les individus, les organismes et la recherche elle-mê me comportent des obstacles à la pratique fondé e sur les preuves scientifiques en physiothé rapie. Malgré des preuves qui appuient le recours à l'IMT, cette forme de traitement continue d'ê tre sous-utilisé e dans la gestion des MPOC. Les recherches actuelles en services de santé dé montrent que les approches traditionnelles de mise en oeuvre, fondé es sur l'information, telles que les exposé s didactiques, ne parviennent pas à relever adé quatement les dé fis auxquels font face les professionnels de la santé lorsqu'ils tentent d'apporter des changements à la pratique. Nous proposons l'é laboration d'une intervention fondé e sur la thé orie en vue d'accroître le recours à l'IMT par les profe...

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“…The most common reasons given by respondents were that they were taught the intervention in their initial training and had used the intervention in their prior experience. 36 The optimal time to influence clinical decision making may, therefore, be during the physical therapist professional degree program. Because of the influence first professional education has on future clinical decision making, the Manipulation Education Manual for Physical Therapists Professional Degree Programs (MEM) was developed to support the ongoing efforts in physical therapist education programs to provide appropriate, evidence-based instruction in thrust manipulation.…”

mentioning

confidence: 99%

Spinal Manipulation in Physical Therapist Professional Degree Education: A Model for Teaching and Integration Into Clinical Practice

Flynn

Wainner²,

Fritz

2006

J Orthop Sports Phys Ther

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Spinal manipulation for low back complaints is an intervention supported by randomized clinical trials and its use recommended by clinical practice guidelines. Physical therapists in this country and internationally have used thrust spinal manipulation at much lower-than-expected rates, despite evidence supporting its efficacy for the treatment of acute low back pain (LBP). The purpose of this clinical commentary is to describe a physical therapist professional degree curriculum in thrust spinal manipulation and outline a method of monitoring ongoing student performance during the clinical education experience. Increased emphasis on evidence-based decision making and on the psychomotor skills of thrust spinal manipulation was introduced into a physical therapist professional degree curriculum. As part of ongoing student performance monitoring, physical therapy students on their first full-time (8-week) clinical education experience, collected practice pattern and outcome data on individuals with low back complaints. Eight of 18 first-year students were in outpatient musculoskeletal clinical settings and managed 61 individuals with low back complaints. Patients were seen for an average (±SD) of 6.2 ± 4.0 visits. Upon initial visit the student therapists employed spinal manipulation at a rate of 36.2% and spinal mobilization at 58.6%. At the final visit, utilization of manipulation and mobilization decreased (13% and 37.8%, respectively), while the utilization of exercise interventions increased, with 75% of patients receiving some form of lumbar stabilization training. Physical therapist students used thrust spinal manipulation at rates that are more consistent with clinical practice guidelines and substantially higher then previously reported by practicing physical therapists. Education within an evidence-based framework is thought to contribute to practice behaviors and outcomes that are more consistent with best practice guidelines.

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Physiotherapists' use of evidence based practice: a cross‐national study

Cited by 131 publications

References 17 publications

Trends in the availability and usage of electrophysical agents in physiotherapy practices from 1990 to 2010: a review

Trends in the availability and usage of electrophysical agents in physiotherapy practices from 1990 to 2010: a review

Development of a Theory-Based Intervention to Increase Prescription of Inspiratory Muscle Training by Health Professionals in the Management of People with Chronic Obstructive Pulmonary Disease

Spinal Manipulation in Physical Therapist Professional Degree Education: A Model for Teaching and Integration Into Clinical Practice

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