Background: To review and meta-analyse the evidence about the prevalence of barriers to evidence-based practice (EBP) reported in physiotherapy.Methods: Two independent investigators conducted an extensive electronic search in EMBASE, PubMed, Scopus, Web of Science and CINAHL databases from their inception to July 2020 and included the retrieved articles if they investigated barriers to EBP among physiotherapy professionals. Subsequently, they extracted data and assessed the methodological quality using a scale described in a similar previous study. The outcome for meta-analysis was frequency of each reported barrier. Sub-analyses were performed grouping studies based on countries where surveys were performed, classified as either developed or developing countries.Results: Twenty-nine articles were included in the systematic reviews and meta-analysis. Risk of bias assessment of included studies showed a median score: 4 points (interquartile range: 3–4). The findings of meta-analysis revealed that lack of time was the most frequently reported barrier (53.0% [95% confidence interval, 95%CI, 44.0–62.0]), followed by language (36.0% [95%CI 16.0–62.0]), lack of access (34.0% [95%CI 23.0.27]) and lack of statistical skills (31.0% [95%CI 20.0–44.0]). Lack of skills and lack of generalizability were declared as barriers by 27.0% [95%CI 18.0–38.0] and 23.0% [95%CI 15.0–33.0] of responders, respectively. Lack of support and lack of interest are less frequent, with 16.0% [95%CI 11.0–24.0] and 9.0% [95%CI 6.0–15.0] of responses, respectively. Barriers reported in investigations performed in developed countries were less frequent when compared to those performed in developing countries.Conclusion: Organizational issues and methodological skills seem key issues to allow the implementation of EBP, suggesting the need to adopt or enhance organizational and training strategies to facilitate the implementation of the EBP. Quantitative synthesis showed high heterogeneity for all analyses, and therefore, pooled data should be interpreted with caution.

The Bobath concept, also known as neurodevelopmental treatment, is a widely used approach in the reh...

This review summarizes the recent advances inglenohumeral subluxation (GHS) in hemiplegic patients andanalyzes the reliability and validity of clinical evaluation andthe effectiveness of different treatment approaches.

Purpose: Depression is very common following stroke. Correlation between post-stroke depression (PSD) and functional outcome has been shown, but differential impact both on functional and motor recovery has not been deeply investigated. This study evaluates the influence of PSD on motor and functional outcome. Method: One hundred and seventeen acute stroke patients were selected in an intensive rehabilitation department, and divided into two groups according to the presence of PSD (PSD + and PSD −). Screening measures were DSM-IV criteria, the Geriatric Depression Scale and the Cornell Scale. Outcomes were evaluated on the basis of the Barthel Index (BI) and the Fugl – Meyer Assessment Scale (FMA). Measurements were performed at admission to the department (T1), discharge (T2) and follow up (T3) in a whole period of 3 months from stroke. Results: Both groups showed a significant improvement in all outcome measures. Improvement differences were not significant on FMA scores in either group at each assessment; the PSD group had a significant higher improvement on BI score at follow-up. According to the logistic model, from T1 to T2 and from T1 to T3, only motor recovery shows a significant relation with functional recovery; from T2 to T3 PSD is the only significant factor related to functional recovery. Conclusions: PSD is not an influencing factor for motor recovery. Results show a negative impact of PSD on the functional recovery process after discharge and not during hospitalisation. Discharge appears to be a critical step for management of PSD.

Background and Purpose: Considerable disagreement exists among researchers with regard to the prevalence, pathophysiology, and treatment of “pusher behavior” (PB), partly because of different testing procedures. This study was primarily aimed at establishing cutoff scores for and the construct validity of the Scale for Contraversive Pushing (SCP). The prevalence of PB in people with right- and left-brain lesions also was investigated.Subjects and Methods: The study subjects were 105 consecutive patients with recent stroke. Two methods were used to diagnose PB: clinical examination and SCP score with 3 different cutoff points—an SCP total score of greater than 0 (Crit_1), subscores in each section of the scale of greater than 0 (Crit_2), and subscores in each section of the scale of ≥1 (Crit_3). Clinical and SCP diagnoses were independently made by different examiners. The Cohen κ coefficient was used to determine the agreement between clinical and SCP diagnoses. The construct validity of the SCP was estimated by calculation of Spearman rank correlation coefficients for SCP and balance, mobility, and functional scores.Results: The agreement between clinical and SCP diagnoses was low (κ=.212) when Crit_1 was used. Crit_2 led to the highest agreement with the clinical diagnosis (κ=.933). However, only Crit_3, although globally less accurate (κ=.754), ensured no false-positive results. The construct validity of the SCP was demonstrated by significant (P<.001) moderate to high correlations with mobility (rho=.595), functional (rho=.632), and balance (rho=.666) scores. The prevalence of PB was not influenced by the side of the lesion. A limitation of the study was that the reliability of the clinical examination method was not investigated.Discussion and Conclusion: The results support the validity of the SCP and suggest the need to choose different SCP cutoff criteria (Crit_2 or Crit_3) according to the aim of the evaluation.