RESULTS Knowledge translation interventions appear to have result ed 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 .
AND IMPLICATION OF KEY FINDINGS The intensity and type of knowledge translation intervention seem to have an effect on practice change .
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 .
Pragmatic Implementation of a Stratified Primary Care Model for Low Back Pain Management in Outpatient Physical Therapy Settings: Two-Phase, Sequential Preliminary Study
Background The effectiveness of risk stratification for  low back pain ( LBP ) management has not been demonstrated in outpatient physical therapy setting s. Objective The purpose s of this study were : ( 1 ) to assess implementation of a stratified care approach for LBP management by evaluating short-term treatment effects and ( 2 ) to determine feasibility of conducting a larger-scale study . Design This was a 2-phase , preliminary study . Methods In phase 1 , clinicians were r and omly assigned to receive st and ard ( n=6 ) or stratified care ( n=6 ) training . Stratified care training included 8 hours of content focusing on psychologically informed practice . Changes in LBP attitudes and beliefs were assessed using the Pain Attitudes and Beliefs Scale for Physiotherapists ( PABS-PT ) and the Health Care Providers Pain and Impairment Relationship Scale ( HC-PAIRS ) . In phase 2 , clinicians receiving the stratified care training were instructed to incorporate those strategies in their practice and 4-week patient outcomes were collected using a numerical pain rating scale ( NPRS ) , and the Oswestry Disability Index ( ODI ) . Study feasibility was assessed to identify potential barriers for completion of a larger-scale study . Results In phase 1 , minimal changes were observed for PABS-PT and HC-PAIRS scores for st and ard care clinicians ( Cohen d=0.00–0.28 ) . Decreased biomedical ( −4.5±2.5 points , d=1.08 ) and increased biopsychosocial ( + 5.5±2.0 points , d=2.86 ) treatment orientations were observed for stratified care clinicians , with these changes sustained 6 months later on the PABS-PT . In phase 2 , patients receiving stratified care ( n=67 ) had greater between-group improvements in NPRS ( 0.8 points ; 95 % confidence interval=0.1 , 1.5 ; d=0.40 ) and ODI ( 8.9 % points ; 95 % confidence interval=4.1 , 13.6 ; d=0.76 ) scores compared with patients receiving st and ard physical therapy care ( n=33 ) . Limitations In phase 2 , treatment was not r and omly assigned , and therapist adherence to treatment recommendations was not monitored . This study was not adequately powered to conduct subgroup analyses . Conclusions In physical therapy setting s , biomedical orientation can be modified , and risk-stratified care for LBP can be effectively implemented . Findings from this study can be used for planning of larger studies
RESULTS Knowledge translation interventions appear to have result ed 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 .
AND IMPLICATION OF KEY FINDINGS The intensity and type of knowledge translation intervention seem to have an effect on practice change .
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 .