Evidence-based Physiotherapy By B.Nelson

Outline of Presentation What is Evidence –Based Healthcare and its importance Labels used across health care professions What is evidence based practice ? What is evidence based physiotherapy practice What evidence is needed? Steps in EBPT

What is needed ? Reliable, objective, high-quality information Tools for critical evaluation of evidence

Evidence-based across professions Use of evidence in the clinical decision making is used extensively across health care professions APTA states that by 2020 PTs will be utilising evidence based clinical decisions APTA created “ Hooked on evidence” a database for research articles on physiotherapy interventions

Evidence in health care referred to by a variety of labels Evidence based medicine Evidence based practice Evidence based healthcare

What is evidence-based practice Integrating the clinical expertise with the best clinical evidence from systematic research Clinical decision making is moving away from reliance on knowledge gained from authority or tradition

Evidence based physiotherapy practice (EBPT) Is a thoughtful clinical decision making about physiotherapy management of a patient/client that integrates the “best available evidence with clinical judgment” and the patient /client preferences and values and that further considers the larger social context in which physiotherapy services are provided,to optimise patient outcomes and quality of life.

What evidence is needed Best technique Prognosis Choice of intervention outcome

Best technique Evidence may assist in selecting the best technique to correctly identify, quantify and classify the patient’s problems,a result that will enhance the efficiency and effectiveness of service delivery

Prognosis Evidence may identify the salient factors which may produce the most accurate prediction

Choice of intervention Do good (beneficence) Do no harm (non- maleficence) Evidence may assist in the therapist and patient by providing information about effectiveness and harm

Outcome Evidence may assist the therapist in determining the possible outcomes and which measurement tool can detect change in a consistent manner

Process of EBPT practice Depends on some factors: PT requires sufficient knowledge about the patient/client’s condition in order to recognise what is unknown PTs need access to evidence PTs need time to search for,appraise and integrate the evidence into practice

EBPT practice requires practice like any other skill PTs should use evidence to inform their decision making during the patient management process

What constitutes evidence? Published research articles Clinical guidelines Patient records Recall of prior patient Best available clinical evidence

Suggested readings Guide to Evidence based Physical Therapy Practice by Dianne A.Jewell Understanding Evidence-Based Healthcare: A Foundation for Action by Musa Mayer, MS, MFA (Johns Hopkins Bloomberg School of Public Health) www. wcpt.org