Physical therapists' experiences updating the clinical management of walking rehabilitation after stroke: a qualitative study.
BACKGROUND
Little is known about physical therapists' experiences using research evidence to improve the delivery of stroke rehabilitation.


OBJECTIVE
The purpose of this study was to explore how physical therapists use research evidence to update the clinical management of walking rehabilitation after stroke. Specific objectives were to identify physical therapists' clinical questions related to walking rehabilitation, sources of information sought to address these questions, and factors influencing the incorporation of research evidence into practice.


METHODS
Two authors conducted in-depth telephone interviews with 23 physical therapists who treat people with stroke and who had participated in a previous survey on evidence-based practice. Data were analyzed with a constant comparative approach to identify emerging themes.


RESULTS
Therapists commonly raised questions about the selection of treatments or outcome measures. Therapists relied foremost on peers for information because of their availability, ease of access, and minimal cost. Participants sought information from research literature themselves or with the help of librarians or students. Research syntheses (eg, systematic reviews) enabled access to a body of research. Older therapists described insufficient computer and search skills. Most participants considered appraisal and application of research findings challenging and identified insufficient time and peer isolation as organizational barriers to the use of research.


CONCLUSIONS
Physical therapists require efficient access to research syntheses primarily to inform the measurement and treatment of walking limitation after stroke. Continuing education is needed to enhance skills in appraising research findings and applying them to practice. Older therapists require additional training to develop computer and search skills. Peer networks and student internships may optimize the exchange of new knowledge for therapists working in isolation.
Department of Physical Therapy, Faculty of Medicine, University of Toronto, 160-500 University Ave, Toronto, Ontario M5G1V7, Canada. nancy.salbach@utoronto.ca
Nancy M
NM
Salbach
Paula
P
Veinot
Susan
S
Rappolt
Mark
M
Bayley
Dawn
D
Burnett
Maria
M
Judd
Susan B
SB
Jaglal
D000328:Adult; D019317:Evidence-Based Medicine; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000193:education*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D026741:Physical Therapy Modalities / Q000639:trends*; D026761:Physical Therapy Specialty / Q000592:standards*; D011361:Professional Competence; D036301:Qualitative Research; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016138:Walking / Q000502:physiology*