Kathryn M Sibley1, Nancy M Salbach2. 1. K.M. Sibley, PhD, Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada, and Physical Therapy, University of Toronto, Toronto, Ontario, Canada. 2. N.M. Salbach, PT, PhD, Department of Physical Therapy, University of Toronto, 500 University Ave, Room 160, Toronto, Ontario, Canada M5G 1V7, and Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada. nancy.salbach@utoronto.ca.
Abstract
BACKGROUND AND PURPOSE: Knowledge translation (KT) is an emerging discipline with a focus on implementing health evidence in decision making and clinical practice. Knowledge translation theories provide conceptual frameworks that can direct research focused on optimizing best practice. The objective of this case report is to describe one prominent KT theory--the knowledge-to-action (KTA) framework--and how it was applied to research on balance and gait assessment in physical therapist practice. CASE DESCRIPTION: Valid and reliable assessment tools are recommended to evaluate balance and gait function, but gaps in physical therapy practices are known. The KTA framework's 2-pronged approach (knowledge creation phase and action cycle) guided research questions exploring current practices in balance and gait assessment and factors influencing practice in Ontario, Canada, with the goal of developing and evaluating targeted KT interventions. OUTCOMES: Results showed the rate at which therapists use standardized balance and gait tools was less than optimal and identified both knowledge-to-practice gaps and individual and organizational barriers to implementing best assessment practices. These findings highlighted the need for synthesis of evidence to address those gaps prior to the development of potential intervention strategies. DISCUSSION: The comprehensive KTA framework was useful in guiding the direction of these ongoing research programs. In both cases, the sequence of the individual KTA steps was modified to improve the efficiency of intervention development, there was a need to go back and forth between the 2 phases of the KTA framework, and additional behavior change and barrier assessment theories were consulted. Continued research is needed to explicitly evaluate the efficacy of applying KT theory to best practice in health care.
BACKGROUND AND PURPOSE: Knowledge translation (KT) is an emerging discipline with a focus on implementing health evidence in decision making and clinical practice. Knowledge translation theories provide conceptual frameworks that can direct research focused on optimizing best practice. The objective of this case report is to describe one prominent KT theory--the knowledge-to-action (KTA) framework--and how it was applied to research on balance and gait assessment in physical therapist practice. CASE DESCRIPTION: Valid and reliable assessment tools are recommended to evaluate balance and gait function, but gaps in physical therapy practices are known. The KTA framework's 2-pronged approach (knowledge creation phase and action cycle) guided research questions exploring current practices in balance and gait assessment and factors influencing practice in Ontario, Canada, with the goal of developing and evaluating targeted KT interventions. OUTCOMES: Results showed the rate at which therapists use standardized balance and gait tools was less than optimal and identified both knowledge-to-practice gaps and individual and organizational barriers to implementing best assessment practices. These findings highlighted the need for synthesis of evidence to address those gaps prior to the development of potential intervention strategies. DISCUSSION: The comprehensive KTA framework was useful in guiding the direction of these ongoing research programs. In both cases, the sequence of the individual KTA steps was modified to improve the efficiency of intervention development, there was a need to go back and forth between the 2 phases of the KTA framework, and additional behavior change and barrier assessment theories were consulted. Continued research is needed to explicitly evaluate the efficacy of applying KT theory to best practice in health care.
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