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 .
Evaluation of the theory-based Quality Improvement in Physical Therapy (QUIP) programme: a one-group, pre-test post-test pilot study
Background Guideline adherence in physical therapy is far from optimal , which has consequences for the effectiveness and efficiency of physical therapy care . Programmes to enhance guideline adherence have , so far , been relatively ineffective . We systematic ally developed a theory-based Quality Improvement in Physical Therapy ( QUIP ) programme aim ed at the individual performance level ( practicing physiotherapists ; PTs ) and the practice organization level ( practice quality manager ; PQM ) . The aim of the study was to pilot test the multilevel QUIP programme ’s effectiveness and the fidelity , acceptability and feasibility of its implementation . Methods A one-group , pre-test , post-test pilot study ( N = 8 practice s ; N = 32 PTs , 8 of whom were also PQMs ) done between September and December 2009 . Guideline adherence was measured using clinical vignettes that addressed 12 quality indicators reflecting the guidelines ’ main recommendations . Determinants of adherence were measured using quantitative methods ( question naires ) . Delivery of the programme and management changes were assessed using qualitative methods ( observations , group interviews , and document analyses ) . Changes in adherence and determinants were tested in the paired sample s T-tests and expressed in effect sizes ( Cohen ’s d ) . Results Overall adherence did not change ( 3.1 % ; p = .138 ) . Adherence to three quality indicators improved ( 8 % , 24 % , 43 % ; .000 ≤ p ≤ .023 ) . Adherence to one quality indicator decreased ( −15.7 % ; p = .004 ) . Scores on various determinants of individual performance improved and favourable changes at practice organizational level were observed . Improvements were associated with the programme ’s multilevel approach , collective goal setting , and the application of self-regulation ; unfavourable findings with programme deficits . The one-group pre-test post-test design limits the internal validity of the study , the self-selected sample its external validity . Conclusions The QUIP programme has the potential to change physical therapy practice but needs considerable revision to induce the ongoing quality improvement process that is required to optimize overall guideline adherence . To assess its value , the programme needs to be tested in a r and omized controlled trial
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 .