Evidence-based practice (EBP) is an emerging and increasing theme in rehabilitation [1], which means the conscientious and judicious use of current best evidence in conjunction with clinical expertise and patient values to guide health care decisions [2-5]. Thus, in other words, EBP “is a process whereby clinicians integrate best research evidence with clinical expertise and client preferences, producing the most appropriate and effective service” [6,7].

Despite the clear benefits of EBP, its uptake within physiotherapy has been irregular and inconsistent in quality [8]. Actually, professionals report many barriers to the EBP implementation, making it difficult this process. Recent systematic reviews investigated the findings of research into EBP barriers, facilitators and interventions in physiotherapy and identify methods of enhancing adoption and implementation [9]. As result, the authors reported that, although the physiotherapists hold positive attitudes towards EBP, this does not translate into consistent, high-quality EBP [9]. Many barriers to EBP implementation are apparent, including: lack of time and skills, and misperceptions of EBP [9]. In fact, the increase in the number of published studies and the lack of skills in finding and understanding the researches, associated with the lack of time for reading and synthesizing the available evidence represents a challenge.

In order to facilitate the EBP implementation, multiple models are available and have been used in a variety of clinical settings [10-12]. However, there is no a “magic formula” for translating research into practice, since several strategies may be needed [13]. What works in one context of care may or may not work in another setting, thereby suggesting that context variables matter in implementation [13]. Thus, studies emphasize which there is no “one-size fits all” approach to enhancing EBP implementation, although assessing organizational culture prior to designing interventions is decisive [9].

Another way that may help professionals in the EBP implementation is the production of summarized information, such as clinical guidelines and reviews. As advantage, the clinical guidelines are developed by experts, which summarize in only one publication, all the information on a certain topic. However, since the development of a clinical guideline is a long process, the information provided by them does not represent the most updated evidence [14]. On the other hand, systematic reviews of randomized clinical trials are the most robust source of information of the literature [15,16]. As advantage, the systematic reviews are updated more frequently and, thus, provide current information. However, since they require a systematic and judicious process, their questions are more specific, which makes it impossible to summarize all the information about a certain topic. Furthermore, they are dependent on the publication of clinical trials with good methodological quality [15,16].

Thus, nowadays, the challenge of the EBP implementation is not only the professionals, but also the researches. Unfortunately, the large number of articles of low quality submitted to scientific journals, associated with suspects artifices used for publishing is resulting from an “academic evaluation policy based on the number of published papers” [17]. Since the high number of publications and the lack of ability to distinguish its quality are barriers to the EBP implementation, this uncontrolled “productivism” further distance the professionals to apply a practice based only on strong evidence. Thus, producing highquality clinical evidences or summarizing content when there is sufficient information derived on a particular topic, researches are facilitating the access of professionals to this information and, consequently, ensuring an effective therapeutic implementation.

In summary, it’s necessary to approach research and clinical practice. While this task is often attributed to clinical professionals, researchers must also contribute to this process. Producing high quality research and summarizing this information in clear and accessible publications is crucial to the EBP implementation, properly and definitively.

References

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