How do excellent physiotherapists use Evidence Based Practice for better results?
All physiotherapists want the best for their patients and we aim to provide the most effective treatment for each and every person on the Northern Beaches that walks through our doors. But how do we know that our physiotherapy is making a difference and that it is the best care for every individual’s circumstances?
Everybody and every body is different, which means there are going to be nearly an infinite number of ways to treat individuals suffering from chronic pain, musculoskeletal disorders and muscular or ligament injuries. It is up to physiotherapists to identify the best methods for each individual client and implement them in a broader strategy to meet their goals. This is where utilising evidence based practice techniques and taking a results based approach to treatment and injury management can shave weeks from your recovery period and result in less pain and a decreased risk of suffering a re-injury.
What is evidence based practice?
Evidence based practice (EBP for short) isn’t a new concept, it has been utilised in the medical world for a number of years now and has become a popular method of treatment for physiotherapists around the world over the last decade.
EBP utilises ‘the integration of best research evidence with clinical expertise and patient values’ in order to shape the treatment of patients and include them in the processes of treatment in order to prevent pain and injury in the future.
The goals of evidence based practice are:
- To improve the care for clients, resulting in more effective treatment and injury recurrence
- To use evidence from high quality sources to help shape physiotherapy practice
- To challenge treatment views based on anecdotal evidence
- To integrate patient preferences into the treatment and decision making processes
- To take the guess work out of treatments, using education to shape future activities
What are the 5 steps of evidence based practice?
Because evidence based practice relies on consistency and clinical fact in order to make diagnoses and frame the best treatment, a framework of steps has been outlined in order to help physiotherapists design and implement and evidence based approach to treating musculoskeletal conditions.
Step 1 – Ask an answerable and measurable question
One of the fundamental skills needed by musculoskeletal physiotherapists in designing an evidence based program is the asking of to the point clinical questions. By asking the right questions you can focus your efforts specifically on the areas needed, instead of non-important matters.
Step 2 – Acquire relevant research evidence
With the easy part out of the way, your physiotherapist will move onto extrapolating the answers to their questions in order to find relevant, recent and scientifically proven methods for treating your specific condition. Physiotherapists will use a combination of their own data collected over years of practicing in the field and scientific studies located in databases specifically designed to provide a workflow in order to come to the right conclusions.
Step 3 – Analyse the evidence
This is where the expertise and experience of your physiotherapist is really going to come in handy. For example, a Titled Musculoskeletal Physiotherapist has likely spent over a decade studying and practicing in the field and has gained an advanced insight into what evidence is important and what evidence may not be supported by clinical practice and other data. By critically analysing the scientific data your physio is already piecing together your treatment plan in their head and focusing on your goals in relation to the evidence for treatment techniques.
Step 4 – Implementation of the evidence
Now that your physio has conducted their full body assessment, questionnaire and compared data with high quality evidentiary sources, the real fun is ready to begin. Physiotherapists will implement their treatment plans usually by combining the best available evidence with their clinical expertise and their patient’s values and goals. During the implementation phase, your physio will be documenting and assessing your treatment and recovery in order to make any adjustments to your program and to ensure your recovery is progressing. Implementation isn’t a single process; it is the sum of all their experience and knowledge that can be altered and updated to suit your progress.
Step 5 – Evaluate the outcome
If your original treatment plan isn’t getting results, this is where your physio has the knowledge and flexibility to alter what’s required to get you back to 100% health. By documenting your progress and implementing evidence based methods, your physio is able to alter your treatment based on results and at the end of the day, that’s exactly why you see a physio in the first place. To get results. If it’s not working, fix it.
Evidence based practice in physiotherapy is a constantly evolving concept and allows for a flexible and science based approach to combating common musculoskeletal problems. Find yourself a Northern Beaches physio with the expertise and experience to create and implement an evidence based, patient-centred and results focussed program and you’ll be on the right track to a pain free future.
 Sackett DL, Rosenberg WMC, Gray JAM, Haynes RB, Richardson WS: Evidence based medicine: what it is and what it isn’t. BMJ 1996;312:71-2