title: Supporting clinical practice behavior change among neurologic physical therapists: a case study in knowledge translation.
abstract: OBJECTIVE
  Physical therapists tend to underuse research evidence in clinical practice. Emerging research on knowledge translation activities (KTAs) provides guidance to address this problem. We describe a yearlong effort to promote clinical practice behavior change in neurologic physical therapists.
  
  
  METHODS
  Physical therapy stroke and brain injury teams in an inpatient rehabilitation setting implemented a quality improvement project to encourage use of a novel, evidence-supported gait training method (nonsupported gait training [NSGT]) for patients with hemiparesis.
  
  
  METHODS
  The project consisted of multidimensional KTAs, including (1) quarterly staff meetings at which NSGT was introduced, reviewed, and discussed; (2) group and individual dialogue regarding successes, challenges, solutions, and clinical decision-making; (3) ongoing monitoring of and aggregate feedback about appropriate NSGT attempts via chart audit; and (4) ongoing reminders, role modeling, and clinical consultation. Specific staff perceptions about the approach, captured by a mid-year survey, further informed targeted problem-solving and clinical case presentations.
  
  
  RESULTS
  In the first, second, and fourth quarter, 50%, 60%, and 73% of eligible patients were trained with NSGT, respectively. A mid-year survey showed that 19% of therapists were very/moderately familiar with NSGT before the quality improvement project, versus 78% at the 6-month point. Thirty-three percent stated that they used NSGT almost always/often before the project, versus 66% at the 6-month point.
  
  
  CONCLUSIONS
  Extensive multidimensional KTAs were feasible in inpatient rehabilitation and were accompanied by a moderate increase in documented and self-reported frequency of NSGT attempts. Clinical teams may benefit from adopting KTAs that best support clinical practice change.
authors.affiliation: Physical Therapy Program, Chatham University, Pittsburgh, Pennsylvania (S.B.P.); and Outpatient Neuro/Vestibular Program (H.Z.) and Stroke Rehabilitation Program, UPMC Centers for Rehab Services, Pittsburgh, Pennsylvania (T.B.).
authors.forename: Susan B
authors.initials: SB
authors.lastname: Perry
authors.forename: Hallie
authors.initials: H
authors.lastname: Zeleznik
authors.forename: Terry
authors.initials: T
authors.lastname: Breisinger
mesh_terms: D055317:Evidence-Based Practice; D006801:Humans; D059825:Physical Therapists; D026741:Physical Therapy Modalities; D010818:Practice Patterns, Physicians'; D000071939:Stroke Rehabilitation; D057170:Translational Research, Biomedical