Rehabilitation Evidence-Based Decision-Making: The READ Model

Abstract

Evidence-based practice is the foundation of rehabilitation for maximizing client outcomes. However, an unacceptably high number of ineffective or outdated interventions are still implemented, leading to sub-optimal outcomes for clients. This paper proposes the Rehabilitation Evidence bAsed Decision-Making (READ) Model, a decision-making algorithm for evidence-based decision-making in rehabilitation settings. The READ Model outlines a step-by-step layered process for healthcare professionals to collaboratively set goals, and to select appropriate interventions. The READ Model acknowledges the important multi-layered contributions of client's preferences and values, family supports available, and external environmental factors such as funding, availability of services and access. Healthcare professionals can apply the READ Model to choose interventions that are evidence-based, with an appropriate mode, dose, and with regular review, in order to achieve client's goals. Two case studies are used to demonstrate application of the READ Model: cerebral palsy and autism spectrum disorder. The READ Model applies the four central principles of evidence-based practice and can be applied across multiple rehabilitation settings.

Effectiveness of virtual reality interventions of the upper limb in children and young adults with cerebral palsy: A systematic review with meta-analysis

“…These results are important to health professionals that use evidence-based practice in their decision-making. 85,86 Clinical messages…”

Improving public health through the development of local scientific capacity and training in rehabilitation in LMICs: A proof-of-concept of collaborative efforts in Parakou, Benin

“…The rehabilitation workforce is made up of different health workers, including but not limited to physiotherapists, occupational therapists, speech/language therapists, audiologists, orthotists, and prosthetists, clinical psychologists, physical medicine and rehabilitation doctors, and rehabilitation nurses ( 5 ). Evidence-based practice (EBP) in rehabilitation has been defined by Novak et al as “the cornerstone of care to maximize client outcomes through the application of best available interventions” ( 6 ). It must be noted that interventions are not limited to care but also included promotion, prevention, and diagnosis ( 7 ).…”

Participant diversity in clinical trials of rehabilitation interventions for people with multiple sclerosis: A scoping review

“…6 In addition to context, rehabilitation providers must also consider the availability and generalizability of research evidence during the MS rehabilitation process. 7 Rehabilitation providers use research evidence to guide the selection, application, and evaluation of specific rehabilitation approaches for an individual client, given their functional problems and contextual situation. The extent to which evidence can be used confidently to guide clinical practice depends, in part, on the information provided in published studies.…”

“…8 If research participants lack the diversity of individuals seen in clinical practice or if their context is inadequately described in published studies, it is difficult for rehabilitation providers to determine whether interventions and their findings can be applied to their own clients. [7][8][9] One of the goals of a 2-day workshop hosted by the International Advisory Committee on Clinical Trials in MS in December 2022 was to discuss strategies to enhance diversity of clinical trial populations and review implications for study design, recruitment, and cultural safety. 10 This scoping review was conducted to inform these discussions.…”