Article

A divide is experienced between producers and users of evidence in
prosthetic rehabilitation. OBJECTIVE: To discuss the complexity inherent in
establishing evidence-based practice in a prosthetic rehabilitation team
illustrated by the case of prosthetic prescription for elderly dysvascular
transfemoral amputee patients. STUDY DESIGN: A qualitative research design was
used, in which data from multiple sources was triangulated to extract themes for
discussion. METHODS: This discussion paper draws on empirical material gathered
by individual and focus-group interviews with members of a prosthetic
rehabilitation team, information on technological advancements presented on
websites of orthopaedic industry, guidelines and literature study. RESULTS: A
prosthetic rehabilitation team needs to deal with lack of evidence, contradictory
results, various classification systems, diverging interests of different
stakeholders and many modifying factors, and all of this in a continuous
technological changing environment. Integrating research designs with different
strengths but not sharing the same biases may help researchers to deal with the
multimorbidity and multifaceted disability of the target group. Articulating
clinical knowledge, patients' needs and values in a systematic way provides
depth, detail, nuance and context for evidence-based practice issues in
prosthetic rehabilitation. CONCLUSIONS: Reconsidering the relationship between
evidence, technology and rehabilitation practice is an imperative shared
enterprise for clinicians and researchers. Scientific, clinical and
patient-related knowledge are seen as important knowledge practices that should
inform and strengthen each other. CLINICAL RELEVANCE: This discussion paper puts
the academic clinical debate on evidence-based practice in prosthetics and
orthotics in another light. By demonstrating the complexities surrounding
evidence-based practice, it is argued and illustrated how both researchers and
clinicians can contribute to optimal patient care in which evidence, technology
and rehabilitation practice are integrated.
- Médecine basée sur les faits

Langue : ANGLAIS