Evidence-Based Practice in Physiotherapy

You might have heard your seniors and faculty mention "Evidence-based practice" often. Things like "Is your management evidence-based?" or "On what evidence are you basing your statement?"

But what does it really mean?

What is Evidence-Based Practice?

Evidence-based practice (EBP) is an approach in healthcare that involves the integration of 3 aspects :

1. The best available research (Evidence)

2. Your clinical expertise and

3. Patient values

It is an approach that has gained widespread acceptance in many healthcare fields, including physiotherapy.

Why use this approach?

Physiotherapy aims to improve individuals' mobility, function, and quality of life through the assessment, diagnosis, and treatment of musculoskeletal, neurological, cardiorespiratory, gynaecological and industrial conditions. Since physiotherapy is part of healthcare, it is essential that physiotherapists use the best available evidence to guide their clinical decision-making and treatment approaches.

Evidence-based practice in physiotherapy helps ensure that physiotherapists stay updated and their patients receive the most effective and appropriate treatment for their specific conditions. It also helps to reduce the risk of harm and can improve patient outcomes.

How to be an evidence-based physiotherapist?

1. Look for "good-quality" research.

(Emphasis on the "good quality". Finding any random article will not do)

• Access recent articles through search engines (Google Scholar, Pubmed, Cochrane Library, etc.)

• Read updated books in that field.

• Follow evidence-based PTs and researchers across different social media to be updated (This especially helps if you're new to research).

Know the hierarchy of good quality research. Pay attention to those research and biostats lectures. Find a better teacher if you need help understanding the topic because these lectures will help you lifelong.

Give the highest preference to systematic reviews and meta-analyses, which are rigorous analyses of multiple studies conducted on a particular topic. These reviews provide a synthesis of the current evidence and can help physiotherapists to make informed decisions about treatment approaches.

Lowest preference for someone's own opinion, even if they're considered an expert with decades of experience.

2. Study well. Know your stuff

Just knowing the recent research articles is not enough! You should know the basics of anatomy, pathology, assessment, management guidelines.. basically everything you learned in college to improve your clinical expertise.

Manage as many patients as you comfortably can during your postings. Even if research says something works, it may need to be modified for your patient, requiring you to take a clinical decision based on your skills.

3. Take your patient's expectations into consideration.

It is an essential aspect of evidence-based physiotherapy practice. Incorporate your patient's values and preferences into treatment planning. This involves considering the patient's goals, values, and preferences and working with them to develop a treatment plan tailored to their needs and preferences.

For e.g., in a higher-level Spinal Cord Injury, hand spasticity actually helps the patient to hold spoons and eat. But if research and you feel that maintaining optimal muscle is important, you stretch and reduce spasticity. But now, the patient has a reduced capacity to eat independently. So was the management worth it? No. Because even though spasticity is detrimental, for this patient, it was helping.

This approach is a continuous process involving staying up-to-date on the latest research, critically evaluating the evidence, and integrating it into clinical practice.

Take out some time in a week to read, watch, or listen to recent evidence. Of course, as you get better at it, you'll require lesser time.

Overall, using evidence-based practice in physiotherapy is an important aspect of providing high-quality care to patients. By using the best available evidence to guide treatment decisions, physiotherapists can vastly improve patient outcomes, help individuals to achieve their goals and improve their quality of life.

If you have any doubts or require further assistance understanding this topic, do reach out to us at (info@physiosimplified.com/@_physiosimplified_) and share it with your friends so that they can learn as well!