Evidence-Based Practice in Rehabilitation

Rehabilitation Medicine encompasses the areas of rehabilitation sciences, such as speech therapy, physical therapy, occupational therapy, prosthetics & orthotics, psychology, and physical medicine & rehabilitation.

This guide introduces the basic principles of Evidence-Based Practice (EBP) as they apply to rehabilitation medicine.  Becoming an EBP practitioner is an iterative process, integrating evidence into your clinical reasoning. Use the tabs to find out more about practicing EBP in rehabilitation.

What is EBP?

Sacket defined evidence-based practice as “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research” (Sackett DL et al, 1996). EBP encourages the integration of these three of components, rather than using just one piece of evidence, to inform clinical decision-making.

What is meant by the “Best Available Research Evidence”?

The quality of evidence varies based on the way it was gathered and vetted. There are various hierarchies to aid clinicians rate the quality of evidence. The Quantitative Pyramid is used for evaluating evidence for cause and effect questions; whereas, the Qualitative Pyramid illustrates the relative usefulness of different types of evidence to answer meaning or experience questions.

The iterative process has 5 steps:

1. Develop a relevant, answerable clinical question
2. Plan, search & find the best available evidence
3. Criitcally appraise articles for validity & applicability
4. Integrate the evidence into practice
5. Evaluate your clinical decision