• Susanne Bernhardsson and LarssonMaria E HMEHhttp://orcid.org/0000-0002-1225-9736Närhälsan Research and Development Primary Health Care, Region Västra Götaland, Gothenburg, Sweden.Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, Unit of Physiother.
• Närhälsan Research and Development Primary Health Care, Region Västra Götaland, Gothenburg, Sweden.
• J Eval Clin Pract. 2019 Aug 1; 25 (4): 575-584.

Rationale, Aims, And ObjectivesClinical practice guidelines are a common strategy for implementing research findings into practice and facilitating evidence-based practice in health care settings. There is a paucity of knowledge about the impact of different guideline implementation strategies on clinical practice in a physiotherapy context. The study aimed to assess the impact of a guideline implementation intervention on clinical physiotherapy practice.MethodsA tailored, multicomponent guideline implementation was compared with usual practice. Clinical practice was evaluated in physiotherapy treatment methods used for 3 common musculoskeletal disorders. Data were collected with a validated web-based questionnaire.ResultsPostimplementation data were collected from 168 physiotherapists in the intervention group and 88 in the control group. The most frequently reported treatment methods for low back pain were advice on posture (reported by 95% in the intervention group vs 90% in the control group), advice to stay active (93% vs 90%), and stabilization exercise (88% vs 80%). Differences between groups were not significant. Reported use of body awareness training (23% vs 6%, P = .023) and spinal manipulation (9% vs 23%, P = .044) differed between the groups. The most frequently used treatment methods for neck pain were advice on posture (95% vs 92%), advice to stay active (89% vs 87%), and ROM exercise (85% vs 71%) (no significant differences between groups). Reported use of body awareness training (24% vs 7%, P = .023) differed between the groups. The most frequently used treatment methods for subacromial pain were range of motion exercises (reported by 93% in both groups), advice on posture (90% vs 87%), home exercise (77% vs 74%), and stabilization exercise (69% vs 66%) (no significant difference between groups).ConclusionsTreatment methods used were largely in line with evidence already before the guideline implementation, which may explain why the guideline implementation had only little impact on clinical practice.© 2018 John Wiley & Sons, Ltd.

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