Factors influencing evidence-based practice in prosthetics and orthotics

Andrysek, Jan; Christensen, James R.; Dupuis, Annie

doi:10.1177/0309364610389353

Cited by 13 publications

(32 citation statements)

References 21 publications

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“…This is confirmed by a recent survey with prosthetists and orthotists, who also felt that research studies presented too many contradictory results, and what is more, the research findings were considered out of date. 1 Contradictory research findings and various opinions about prescription of MKMs are among other things attributed to a lack of knowledge on the exact target group for MKMs. Are the most technologically advanced prosthetic components only suitable for the young athletic amputees or can patients with a lower level of functioning also profit from this technology?…”

Section: Impact Of Technological Advancements On Evidence-based Prescmentioning

confidence: 99%

“…9 In line with Sackett et al's 10 definition of evidencebased medicine (EBM), EBP in prosthetic rehabilitation is characterized as the process of integrating individual clinical expertise and patient values with the best available evidence from systematic research, in order to provide the best clinical care. [1][2][3][4] This definition comes across as attractive. It gives the impression that it is the 'simple' task of (rehabilitation) clinicians to combine original evidence produced in different research settings with their own individual clinical expertise including the individual needs of patients to whom they wish to give the best treatment.…”

mentioning

confidence: 99%

“…A number of practical barriers in performing EBP are to be dealt with, such as lack of high-level evidence in P&O, time constraints and workload demands experienced by clinicians and finally limited skills, knowledge and resources required to perform EBP. [1][2][3][4] Researchers interested in P&O point variously to limitations in both research and practice hindering the evidence-based integration process. A culture change is plead for, in which clinicians in P&O are to be educated as lifelong, self-directed learners and are encouraged to pursue relevant clinical research themselves.…”

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confidence: 99%

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Reconsidering evidence-based practice in prosthetic rehabilitation

Twillert

Geertzen

Hemminga

et al. 2013

Prosthetics &Amp; Orthotics International

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Background: A divide is experienced between producers and users of evidence in prosthetic rehabilitation. Objective: To discuss the complexity inherent in establishing evidence-based practice in a prosthetic rehabilitation team illustrated by the case of prosthetic prescription for elderly dysvascular transfemoral amputee patients. Study Design: A qualitative research design was used, in which data from multiple sources was triangulated to extract themes for discussion. Methods: This discussion paper draws on empirical material gathered by individual and focus-group interviews with members of a prosthetic rehabilitation team, information on technological advancements presented on websites of orthopaedic industry, guidelines and literature study. Results: A prosthetic rehabilitation team needs to deal with lack of evidence, contradictory results, various classification systems, diverging interests of different stakeholders and many modifying factors, and all of this in a continuous technological changing environment. Integrating research designs with different strengths but not sharing the same biases may help researchers to deal with the multimorbidity and multifaceted disability of the target group. Articulating clinical knowledge, patients’ needs and values in a systematic way provides depth, detail, nuance and context for evidence-based practice issues in prosthetic rehabilitation. Conclusions: Reconsidering the relationship between evidence, technology and rehabilitation practice is an imperative shared enterprise for clinicians and researchers. Scientific, clinical and patient-related knowledge are seen as important knowledge practices that should inform and strengthen each other. Clinical relevance This discussion paper puts the academic clinical debate on evidence-based practice in prosthetics and orthotics in another light. By demonstrating the complexities surrounding evidence-based practice, it is argued and illustrated how both researchers and clinicians can contribute to optimal patient care in which evidence, technology and rehabilitation practice are integrated.

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Section: Impact Of Technological Advancements On Evidence-based Prescmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Reconsidering evidence-based practice in prosthetic rehabilitation

Twillert

Geertzen

Hemminga

et al. 2013

Prosthetics &Amp; Orthotics International

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“…[1][2][3][4][5] To date, articles related to EBP in prosthetics and orthotics (P&O) have focused on defining terminology, 3 reviewing the state of EBP in P&O clinical practice and on identifying factors that influence the use of EBP in P&O clinical practice. [1][2][3]5 To date, no discussion or research has been dedicated to the practical process of introducing and sustaining EBP as part of clinicians' everyday routine. Christensen and Andrysek 5 suggest that strategic implementation may facilitate the use of EBP but highlight that little research is available from within the field of P&O.…”

Section: Introductionmentioning

confidence: 99%

“…[13][14][15][16][17] In P&O, barriers to adopting EBP have been specifically identified as follows: time constraints, workload demands, limited relevant evidence, gaps in the skills and knowledge to perform EBP, demographics, and level of involvement in research. 1,5 Implementation science, sometimes cited as translation science, is the scientific study of methods that promote the adoption of research into practice. 18 A number of models have been proposed to elucidate variables that may influence adoption of EBPs and to facilitate the TRIP.…”

Section: Introductionmentioning

confidence: 99%

Translating research into prosthetic and orthotic practice

Ramstrand

2013

Prosthetics &Amp; Orthotics International

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Background: Evidence-based practice is commonly accepted as a means of improving patient outcomes; however, there is little understanding of the processes required to successfully implement it into prosthetic and orthotic practice. Objectives: To discuss factors affecting adoption of evidence-based practice and present a theoretical framework for its implementation into prosthetic and orthotic practice. Discussion: Numerous factors that affect adoption of evidence-based practice are discussed, ranging from individual factors to those that can be attributed to administrative and environmental issues. Specific factors are likely to be context specific and are influenced by the manner in which evidence-based practice is introduced into the working environment. It is argued that successful implementation of evidence-based practice requires consideration of numerous interrelated factors. A formal translating research into practice model is presented as a means of developing a strategic plan that considers all relevant factors and maximizes acceptance of evidence-based practice into prosthetics and orthotics clinical practice. Conclusions: The use of a theoretical model for implementation of evidence-based practice is likely to improve its adoption by prosthetic and orthotic clinicians. Clinical relevanceThe demand for prosthetists/orthotists to utilize evidence-based practice is increasing. Lack of strategic planning throughout the implementation phase is likely to compromise adoption of evidence-based practices by clinicians.

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