Use of Knowledge Translation Action Framework to Improve Physical Therapy Rehabilitation Outcomes in Concussion Management

Abstract

Context: Translating new evidence into clinical practice is a dynamic and iterative process. Research is ever evolving specific to concussion rehabilitation and requires a systematic approach rooted in science for translation into clinical practice. The knowledge-to-action (KTA) cycle framework is an effective strategy to ensure optimal outcomes and sustainability. The objective of this study was to investigate changes in clinical outcomes and clinician self-efficacy specific to concussion management in a suburban health care system utilizing the KTA framework. Design: Pretraining and posttraining intervention study. Methods: Rehabilitation professionals were electronically surveyed pre–post targeted concussion educational intervention. Questions were adapted from the General Self-Efficacy scale and tailored specifically to confidence in current concussion management. Retrospective chart reviews were also completed pre–post knowledge translation educational intervention to examine practice patterns. Data from the presurvey and retrospective chart review were utilized to identify the know–do gap and design intentional educational interventions. Statistical analysis was performed utilizing SPSS (version 28). Results: Within-group differences revealed an increase in confidence with evaluation (P = .01), intervention (P = .01), and consultation (P = .01) in concussion management. When comparing physical therapists who participated in the intervention with those who did not, there was significantly higher self-confidence in all areas (P ≤ .001) for those who engaged in the educational intervention. Pre–post chart reviews revealed improvement in clinical practice patterns in the following constructs: use of patient-reported outcome measures (P ≤ .001), objective outcome measures (P = .002), exertional testing (P ≤ .001), completion of comprehensive evaluation (P ≤ .001), and use of evidence-based practice (P ≤ .001). Conclusions: Utilizing the KTA framework resulted in improved self-efficacy of clinicians as well as improved clinical practice patterns in concussion management in an outpatient hospital-based practice. The KTA framework is a potential tool for translating current evidence related to concussion management for improved clinical outcomes.