title: Incorporating self-management in prosthetic rehabilitation: case report of an integrated knowledge-to-action process.
abstract: BACKGROUND
  In improvement of clinical practice, unidirectional approaches of translating evidence into clinical practice have been pinpointed as main obstacles. The concept of engaged scholarship has been introduced to guide knowledge-to-action (KTA) processes, in which research knowledge and practical knowledge derived from therapists, patients, and organizational structures mutually inform each other. Accordingly, KTA experts should engage end-users earlier in knowledge translation and work in concert with them on both knowledge creation and knowledge implementation.
  
  
  OBJECTIVE
  The purposes of this case report are: (1) to provide an illustrative example of an evidence-informed improvement process in prosthetic rehabilitation in a local setting and (2) to articulate the bidirectional translation work incorporated into an integrated KTA process.
  
  
  METHODS
  A KTA expert translated research knowledge on self-management and task- and context-specific training into a functional prosthetic training program for patients with a lower limb amputation. Therapists contributed as co-creators to the translation process with practical knowledge of the specificities of the target group and local organizational context. The KTA expert moved the co-created knowledge into action in iterative and interactive steps with local therapists, patients, and managers.
  
  
  RESULTS
  This bidirectional KTA translation process led to shared ownership of the functional prosthetic training program, in which self-management and task- and context-specific training principles and practices were integrated.
  
  
  CONCLUSIONS
  Bidirectional knowledge translation builds on explicating and integrating the different knowledge practices of researchers, therapists, and their patients. Knowledge-to-action experts and end-users have their own roles and activities in such knowledge translation processes. Appreciating these different roles in genuine partnerships and acknowledging the distinct but equally valued knowledge practices can help in effectively translating evidence into action.
authors: S. van Twillert, PT, MSc, University Medical Center Groningen, Center for Rehabilitation, University of Groningen, Haren, the Netherlands. s.van.twillert@umcg.nl.
authors: Sacha
authors: S
authors: van Twillert
authors: K. Postema, MD, PhD, University Medical Center Groningen, Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, Groningen, the Netherlands.
authors: Klaas
authors: K
authors: Postema
authors: J.H.B. Geertzen, MD, PhD, University Medical Center Groningen, Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, Groningen, the Netherlands.
authors: Jan H B
authors: JH
authors: Geertzen
authors: A.T. Lettinga, PT, PhD, University Medical Center Groningen, Center for Rehabilitation, University of Groningen, Haren, the Netherlands.
authors: Ant T
authors: AT
authors: Lettinga
mesh_terms: D000671:Amputation, Surgical / Q000534:rehabilitation; D001186:Artificial Limbs; D055812:Community-Based Participatory Research; D006801:Humans; D007869:Leg Injuries / Q000534:rehabilitation / Q000601:surgery; D009048:Motor Skills; D019982:Organizational Case Studies; D010348:Patient Care Team; D012046:Rehabilitation / Q000458:organization & administration*; D012648:Self Care; D057170:Translational Research, Biomedical