Barriers and Facilitators to Evidence-Based Practice among Physiotherapists Practicing in Sub-Saharan Africa

Background: Evidence-based practice (EBP) is vital for high-quality patient care, yet its implementation among physiotherapists in sub-Saharan Africa (SSA) faces significant challenges. This scoping review explores the barriers and facilitators of EBP in this region. Objectives: To identify barriers and facilitators of EBP at individual, organisational, and extra organisational levels among physiotherapists in SSA. Methods: A comprehensive literature search was conducted across PubMed, Sabinet, BioMed Central, and Google Scholar. Seven studies from Ghana, Nigeria, Cameroon, Benin, Kenya, Zimbabwe and South Africa met the inclusion criteria. Results: Key barriers at the practitioner level included lack of time, insufficient knowledge of EBP, limited access to information resources, and inadequate research skills. Facilitators comprised positive attitudes toward EBP and a desire for further knowledge. At the organisational level, resource unavailability emerged as a major barrier. Notably, no studies addressed extra organisational factors. Conclusion: This review highlights critical barriers and facilitators of EBP among SSA physiotherapists and emphasises the need for further research on extra organisational influences. Addressing systemic challenges is essential for enhancing physiotherapist engagement in EBP, ultimately improving patient care and outcomes in sub-Saharan Africa.

Attitudes and diagnostic practice in low back pain:A qualitative study amongst Greek and British physiotherapists

AIM To explore current diagnostic practice and attitudes of Greek and United Kingdom physiotherapists(PTs)on assessing low back pain(LBP)patients.METHODS Three focus groups were undertaken,followed by a structured questionnaire-type survey comprising 23 health professionals and a random stratified sample of 150 PTs,respectively.Twenty-nine themes relating to LBP diagnostic practice emerged.These were then given to 30 British PTs assessing their level of agreement with their Greek counterparts.Analysis was performed by percentage agreements andχ2 tests.RESULTS The survey was divided into three subsections;PTs’attitudes on LBP assessment,patients’attitudes and diagnostic/healthcare issues,each constituting 14,7 and 8 statements,respectively.Over half of the statements fell within the 30%-80%agreement between Greece and United Kingdom whereas,5 statements reported low(<10%)and 8 statements demonstrated high(>90%)PT percentage agreement.Similarities across British and Greek PTs were detected in history taking methods and in the way PTs feel patients perceive physiotherapy practice whereas,re-assessment was undertaken less frequently in Greece.Diagnosis according to 91%of the Greek PTs is considered a“privilege”which is exclusive for doctors in Greece(only 17%British PTs agreed)and is accompanied with a great overuse of medical investigations.Forty percent of Greek PTs(compared to 0%of British)consider themselves as“executers”,being unable to interfere with treatment plan,possibly implying lack of autonomy.CONCLUSION Although similarities on history taking methods and on patients’attitudes were detected across both groups,gross differences were found in re-assessment procedures and diagnostic issues between Greek and British physiotherapists,highlighting differences in service delivery and professional autonomy.

Factors Influencing the Use of Outcome Measures for Patients with Low Back Pain: A Survey of Nigerian Physiotherapists

Background: Low back pain is one of the important patients’ presenting complain that requires expert management from the physiotherapists. Yet no work was available for reference on the use of outcome measures for its evaluation by Nigeria physiotherapists. Objective: This study, therefore, investigated the outcome measures used by Nigerian physiotherapists to evaluate patients with Low Back Pain and the factors that influenced their use. Methods: A survey questionnaire was posted to 306 randomly selected mem- bers of the Nigeria Society of Physiotherapy (NSP). Data were analyzed using frequency, percentages, mean, ANOVA, and Pearson’s Chi-square. P-value was placed at 0.05. Results: 52.9% of the respondents (221) used a pain visual analog scale. Only 36.1% used LBP-specific clinical outcome measures. The factors that influenced their use were belief, attitude, knowledge, and choice. There was no significant difference between the majority of the factors and the use of clinical outcome measures. The P-values were 0.960, 0.648, 0.760 for belief, attitude and knowledge respectively. The only factor that had a significant difference (P = 0.029) with the use of clinical outcome measures was choice. Gender and postgraduate qualification had no significant influ- ence on the use of clinical outcome measures at the P-value of 0.117 and 0.510 respectively. Conclusion: Pain visual analog scale is the outcome measure frequently used by Nigeria Physiotherapists to evaluate patients with Low Back Pain. Belief, attitude, knowledge, and choice are the factors that influ- enced the use. There is a need to incorporate the use of LBP-specific outcome measures by Nigerian physiotherapists while treating patients with LBP.