Sibley Kathryn M, Salbach Nancy M
K.M. Sibley, PhD, Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada, and Physical Therapy, University of Toronto, Toronto, Ontario, Canada.
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.
Phys Ther. 2015 Apr;95(4):579-87. doi: 10.2522/ptj.20130486. Epub 2014 Jun 26.
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.
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.
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.
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.
知识转化（KT）是一门新兴学科，专注于在决策制定和临床实践中应用健康证据。知识转化理论提供了概念框架，可指导旨在优化最佳实践的研究。本病例报告的目的是描述一种著名的知识转化理论——知识到行动（KTA）框架，以及它如何应用于物理治疗实践中平衡和步态评估的研究。
推荐使用有效且可靠的评估工具来评估平衡和步态功能，但物理治疗实践中存在已知差距。KTA框架的双管齐下方法（知识创造阶段和行动循环）指导了研究问题，探索加拿大安大略省平衡和步态评估的当前实践以及影响实践的因素，目标是开发和评估有针对性的知识转化干预措施。
结果显示，治疗师使用标准化平衡和步态工具的比率不理想，并确定了知识到实践的差距以及实施最佳评估实践的个人和组织障碍。这些发现突出了在制定潜在干预策略之前，需要综合证据来弥补这些差距。
全面的KTA框架有助于指导这些正在进行的研究项目的方向。在这两个案例中，KTA各个步骤的顺序都进行了修改，以提高干预措施开发的效率，需要在KTA框架的两个阶段之间反复进行，并且还参考了其他行为改变和障碍评估理论。需要继续开展研究，以明确评估将知识转化理论应用于医疗保健最佳实践的效果。
