Strategies to translate knowledge related to common musculoskeletal conditions into physiotherapy practice: a systematic review

Abstract

Background: Many physiotherapists underuse evidence-based practice guidelines or recommendations when treating patients with musculoskeletal disorders, yet synthesis of knowledge translation interventions used within the field of physiotherapy fails to offer clear conclusions to guide the implementation of clinical practice guidelines.

Objectives: To evaluate the effectiveness of various knowledge translation interventions used to implement changes in the practice of current physiotherapists treating common musculoskeletal issues.

Data sources: A computerized literature search of MEDLINE, CINHAL and ProQuest of systematic reviews (from inception until May 2016) and primary research studies (from January 2010 until June 2016).

Study selection and eligibility criteria: Eligibility criteria specified articles evaluating interventions for translating knowledge into physiotherapy practice.

Data extraction and data synthesis: Two reviewers independently screened the titles and abstracts, reviewed full-text articles, performed data extraction, and performed quality assessment. Of a total of 13014 articles located and titles and abstracts screened, 34 studies met the inclusion criteria, including three overlapping publications, resulting in 31 individual studies.

Results: Knowledge translation interventions appear to have resulted in a positive change in physiotherapist beliefs, attitudes, skills and guideline awareness. However, no consistent improvement in clinical practice, patient and economic outcomes were observed.

Limitations: The studies included had small sample sizes and low methodological quality. The heterogeneity of the studies was not conducive to pooling the data.

Conclusions and implication of key findings: The intensity and type of knowledge translation intervention seem to have an effect on practice change. More research targeting financial, organizational and regulatory knowledge translation interventions is needed.

Keywords: Back pain; Knowledge; Neck pain; Occupational injuries; Physical therapists.