Physical therapists' use of interventions with high evidence of effectiveness in the management of a hypothetical typical patient with acute low back pain.
OBJECTIVE
Evidence-based practice aims to improve patient care and service delivery, particularly in the management of individuals with low back pain (LBP), the largest client group seen by outpatient physical therapists. The purpose of this study was to determine the prevalence of use of interventions with evidence of effectiveness in the management of acute nonspecific LBP by physical therapists.


METHODS
A multicenter cross-sectional study was conducted on 100 physical therapists working with patients with LBP.


METHODS
Using a telephone-administered interview, therapists described their current and desired treatment practices for a typical case of LBP. Each intervention reported was coded according to its evidence of effectiveness (strong, moderate, limited, or none). Information on clinician, workplace, and client characteristics also was obtained.


RESULTS
The prevalence of use of interventions with strong or moderate evidence of effectiveness was 68%. However, 90% to 96% of therapists also used interventions for which research evidence was limited or absent. Users of interventions with high evidence of effectiveness, as compared with nonusers, had graduated more recently and had taken a higher number of postgraduate clinical courses.


CONCLUSIONS
Although most therapists use interventions with high evidence of effectiveness, much of their patient time is spent on interventions that are not well reported in the literature. The results indicate the need for improvement in the quality of clinical research as well as its dissemination and implementation in a way that is appealing to therapists, such as through practice-related courses.
Mikhail
Christine
C
Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, 3630 Promenade Sir William Osler, Montreal, Quebec, Canada H3G 1Y5. christine.mikhail@mail.mcgill.ca
Korner-Bitensky
Nicol
N
Rossignol
Michel
M
Dumas
Jean-Pierre
JP
D000208:Acute Disease; D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards; D003430:Cross-Sectional Studies; D019317:Evidence-Based Medicine / Q000193:education / Q000458:organization & administration* / Q000592:standards; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D017116:Low Back Pain / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020380:Needs Assessment; D026741:Physical Therapy Modalities / Q000193:education / Q000458:organization & administration*; D010818:Practice Patterns, Physicians' / Q000458:organization & administration*; D011792:Quebec; D012107:Research Design; D011795:Surveys and Questionnaires; D013996:Time and Motion Studies; D016896:Treatment Outcome; D016526:Workload / Q000706:statistics & numerical data