Evidence Based Physiotherapy

Definition of Evidence Based Physiotherapy (EBP)
Evidence-based physiotherapy: can be described as a commitment to use the best available evidence to inform decision-making about the care of individuals that involves:
·        integrating physiotherapist practitioners
·        individual professional judgement with evidence gained through systematic research.
Evidence includes:
·       systematic reviews of randomised controlled trials,
·       individual randomised controlled trials,
·       systematic review of cohort studies,
·       individual cohort studies,
·       outcomes research,
·       systematic review of case-control studies,
·       individual case-control studies,
·       case-series and expert opinion.
It is the use of evidence to inform practice and to ensure that the services delivered to patients/clients, their carers, and communities are based on the best available evidence.
Why Evidence Based Physiotherapy?
Evidence-based physiotherapy is an important mechanism to ensure health care quality and to make sure that the best available treatment is given to the individual patient according to the latest knowledge within the field. Member Organisations within the WCPT have agreed to be committed to the goal of developing EBP in all countries. One crucial issue to achieve this is the concept of life long learning implying various ways for physiotherapists to continue to update their professional knowledge throughout their career.
How to find the current best evidence in physiotherapy practice?
Often there are systematic reviews published on specific topics related to physiotherapy and which present the current state of evidence for certain treatments and/or recommendations for clinical conditions. These are available in scientific journals or through electronic data bases like for instance:
Centre for Evidence Based Physiotherapy, The Netherlands
An electronic centre with the purpose to search, collect and disseminate available scientific evidence in the physiotherapy domain for physiotherapists, health care workers, patients and financiers of health care.
Pedro: Physiotherapy Evidence Database
A physiotherapy specific database based in Australia developed to give fast access to bibliographic details and abstracts of randomised controlled trials, systematic reviews and evidence-based clinical practice guidelines in physiotherapy. Most trials on the database have been rated for quality to help you quickly discriminate between trials which are likely to be valid and interpretable and those which are not.
General database on health issues
For a more detailed overview, please see WCPT’s website on databases related to EBP
Clinical guidelines
Clinical guidelines are emerging tools essential for treatment of specific clinical condition. There is no single data base for clinical guidelines but WCPT has collected some useful international resources on the topic related to physiotherapy.
In The Netherlands a particular emphasis has been put on developing clinical guidelines which are also available in English
Clinical measurement instruments
Today there are many established clinical measurements and tools to quantify a patients’ status and ability and often according to structure and function, activity and participation in line with the suggested model of WHO: the International Classification of Function
Some Member Organisations of the ER-WCPT present databases or lists of clinical instruments like Sweden and the United Kingdom Chartered Society of Physiotherapy Outcome Measures Database
Database of international physiotherapy EBP projects led by Member Organisations of the ER-WCPT
This issue will be further developed in collaboration with the Member Organisations.
EBP in relation to education and life long learning
It has been agreed in the General Assembly of ER-WCPT Sibenik in Croatia 2006 that Evidence Based Physiotherapy is an important concept for the MO’s to encourage to be taught and implemented at all educational levels in physiotherapy all across Europe. It is further discussed, and promoted as necessary in documents such as the European Physiotherapy Benchmark Statement  and in the “The competence chart of the European Network of Physiotherapy in Higher Education”
WCPT Declaration of Principle – Evidence Based Practice
Symposia in the 2nd Education Congress on Evidence Based Physiotherapy in Stockholm Sept 25-26 2008
Promoting, delivering and implementing Evidence Based Physiotherapy in the 21st century – roles of MOs, educational institutions, employers and clinicians. (Page 77)