Evidence Based Physical Therapy PDF
Preview Evidence Based Physical Therapy
1716_FM_i-xviii 01/05/12 1:51 PM Page ii 1716_FM_i-xviii 01/05/12 1:51 PM Page i Evidence Based Physical Therapy 1716_FM_i-xviii 01/05/12 1:51 PM Page ii 1716_FM_i-xviii 01/05/12 1:51 PM Page iii Evidence Based Physical Therapy Linda Fetters, PhD, PT, FAPTA Julie Tilson, PT, DPT, MS, NCS Professor Assistant Professor of Clinical Physical Therapy Skyes Family Chair in Pediatric Physical Therapy, Division of Biokinesiology and Physical Therapy Health & Development University of Southern California Division of Biokinesiology & Physical Therapy Los Angeles, California Department of Pediatrics, Keck School of Medicine University of Southern California Los Angeles, California 1716_FM_i-xviii 01/05/12 1:51 PM Page iv 1915 Arch Street Philadelphia, PA 19103 www.fadavis.com Copyright © 2012 by F. A. Davis Company All rights reserved. This product is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America Last digit indicates print number: 10 9 8 7 6 5 4 3 2 1 Acquisitions Editor:Margaret M. Biblis Manager of Content Development: George W. Lang Developmental Editor: Peg Waltner Manager of Art and Design: Carolyn O’Brien Cover Image:Avian/Shutterstock.com As new scientific information becomes available through basic and clinical research, recommended treatments and drug therapies undergo changes. The author(s) and publisher have done everything possible to make this book accurate, up to date, and in accord with accepted standards at the time of publication. The author(s), editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of the book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised always to check product information (package inserts) for changes and new information regarding dose and contraindications before administering any drug. Caution is especially urged when using new or infrequently ordered drugs. Library of Congress Cataloging-in-Publication Data Fetters, Linda, 1948- Evidence-based physical therapy / Linda Fetters, Julie Tilson. p. ; cm. Includes bibliographical references and index. ISBN 978-0-8036-1716-2 (pbk. : alk. paper) I. Tilson, Julie. II. Title. [DNLM: 1. Physical Therapy Modalities. 2. Evidence-Based Medicine. WB 460] 615.8'2—dc23 2012002237 Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by F. A. Davis Company for users registered with the Copyright Clearance Center (CCC) Transactional Reporting Service, provided that the fee of $.25 per copy is paid directly to CCC, 222 Rosewood Drive, Danvers, MA 01923. For those organizations that have been granted a photocopy license by CCC, a separate system of payment has been arranged. The fee code for users of the Trans- actional Reporting Service is: 8036-1716-2/+ $.25. 1716_FM_i-xviii 01/05/12 1:51 PM Page v Teaching and learning is a constant dynamic. My dedication is to the world’s most dynamic teacher both in the classroom and in life, my husband Mike Fetters; to all the students and colleagues who continue to give me feedback about best teaching, including my co-author Julie Tilson, and to my sons Seth and Zachary, who taught me how to learn. LF Life is neither in the wick, nor in the wax, but in the burning. My dedication is to those who light my way in life: my parents, Mike and Jennifer, who taught me to believe in myself; the many students and colleagues who inspire me, particularly my co-author Linda Fetters, who generously invited me on this journey; and most important, my ever supportive and loving husband Donovan Steutel, truly the light of my life. JT 1716_FM_i-xviii 01/05/12 1:51 PM Page vi 1716_FM_i-xviii 01/05/12 1:52 PM Page vii Foreword As someone interested in action, I rarely read forewords. So revolution. Whereas some educational programs still debate I will keep this one short and cut to the chase. The last few the need to include EBP, for many others it has become the decades have seen a revolution in medical care, particularly in norm. The three pillars of EBP are seen as essential skills in physiotherapy. Research is shedding light on many old and new the lifelong learning now needed in the fast-moving world of practices. Harnessing this research for the benefits of patients clinical care. means that modern practitioners will need new skills—evidence Physiotherapy has undergone its own revolution in the past based practice (EBP)—that are complementary to the clinical few decades, emerging from its apprenticeship craft to become skills and patient orientation needed for good care. Good clin- a more scientifically focused discipline. The growth in research ical practice now requires the three pillars shown in Chapter 1, has been astonishing. The Physiotherapy Evidence Database Figure 1.1, of this book: (1) clinical expertise (gained by good (PEDro) (www.pedro.org.au) now contains over 19,000 ran- training plus years of experience with feedback), (2) under- domized trials, systematic reviews, and clinical practice guide- standing of patient values (requiring good history-taking skills lines in physiotherapy, and it continues to grow rapidly. and shared decision-making skills), and (3) skills in locating Currently, the number of randomized trials in physiotherapy and appraising research literature: all three the subjects of doubles about every 7 years (see Chapter 7, Figure 7.2). That this book. implies that the last 7 years has seen as many trials as in all the The ideas behind EBP—the empirical testing of theories previous history of physiotherapy. Whereas some trials merely about treatment and diagnosis by careful study in groups of confirm current practice as correct, some will overturn ideas, patients—date back many centuries to at least the 10th century and others will introduce new methods and practices. This and Al Rhazi in Persia (for those interested in learning more growth and change is potentially a great blessing for patients. about Al Rhazi, Lind, Bradford-Hill, and the whole history of However, for that blessing to reach the bedside, clinicians must clinical trials, an excellent resource is www.jameslindlibrary.org). be highly skilled in accessing, interpreting, and applying this The 20th century saw a rapid development in the methods for wealth of research evidence. both clinical research and connecting this research directly to The goal of this book is to support the learning of those clinical practice. A pivotal moment in this long development skills. However, EBP must be adapted to be adopted. Although was the coining of the term “evidence-based medicine” for a the fundamental principles are the same, the needs and contents series of articles — the “user guides” — published in the Jour- of each health-care discipline require the principles of EBP to nal of the American Medical Association (JAMA) in the 1990s. be framed and applied in ways that suit its special issues and The new term and the JAMA series helped spark worldwide research base. EBP looks somewhat different in medicine, interest of clinicians across countries and disciplines. Profes- psychiatry, nursing, and physiotherapy. This book, then, is an sional curricula have been slowly catching up with this essential bridge to assist the application of EBP to physiotherapy. vii 1716_FM_i-xviii 01/05/12 1:52 PM Page viii viii Foreword Dr. Fetters and Dr. Tilson have done an excellent job in real benefits to patients to be seen. I wish you well with that describing the fundamentals of EBP and expertly adapting vital task. them to the needs of physiotherapists using everyday clinical examples to illustrate the processes. Using this book will help Paul Glasziou in learning these vital skills for 21st century practice. But that Professor, Centre for Research in Evidence-Based Practice Bond University is not enough. The methods of EBP must also be practiced and integrated into your professional life and clinical care for the
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