Organizational model and process for clinical best practice in rehabilitation and complex continuing care.

Toronto Rehabilitation Institute developed its Clinical Best Practice Model and Process (TR-CBPMP) to facilitate a systematic and consistent approach to best practice with the goal of shortening the path between best knowledge and clinical care and linking this process to patient needs and outcomes. The TR-CBPMP guides clinicians, inter-professional teams, administrators and leaders in identifying patient needs, reviewing present practice, determining best practice priorities, analyzing gaps, preparing for and implementing best practice, evaluating patient-based outcomes and sustaining the best practice. The TR-CBPMP has been used successfully to develop program-specific, profession-specific and organization-wide best practices.

Using SBAR to communicate falls risk and management in inter-professional rehabilitation teams.

This study implemented and evaluated the adapted Situation-Background-Assessment-Recommendation (SBAR) tool for use on two inter-professional rehabilitation teams for the specific priority issue of falls prevention and management. SBAR has been widely studied in the literature, but rarely in the context of rehabilitation and beyond nurse-physician communication. In phase one, the adapted SBAR tool was implemented on two teams with a high falls incidence over a six-month period.

Skill development and capacity building program for best practices in rehabilitation.

There is a growing body of literature on evidence-based decision-making and best practice development and the skills required for these approaches to influence decisions. A skill development and capacity building (SDCB) program was implemented in 2004 to facilitate the application of clinical best practices in a hospital specializing in adult rehabilitation and complex continuing care. This article describes the pilot program and its evaluation and provides a five-year review of initiatives developed as a result of this program.

Comparison of the psychometric properties of four at-work disability measures in workers with shoulder or elbow disorders.

Introduction: To better capture the extent of work disability following an occupational injury, clinical researchers are beginning to recognize the importance of considering not only levels of absenteeism, but also disabilities experienced while "at-work". Although at-work disability measures are available in the literature, currently there is little insight on the selection of specific measures that may be best suited for a given population or situation. The objective of this study is to assess and compare the measurement properties of four self-report at-work disability measures in workers with shoulder or elbow disorders.

Reliability and validity of the AGREE instrument used by physical therapists in assessment of clinical practice guidelines.

Background: The AGREE instrument has been validated for evaluating Clinical Practice Guidelines (CPG) pertaining to medical care. This study evaluated the reliability and validity of physical therapists using the AGREE to assess quality of CPGs relevant to physical therapy practice.

Methods: A total of 69 physical therapists participated and were classified as generalists, specialist or researchers.

Muscle relaxants for nonspecific low back pain: a systematic review within the framework of the cochrane collaboration.

Study Design: A systematic review of randomized and/or double-blinded controlled trials.

Summary Of Background Data: The use of muscle relaxants in the management of nonspecific low back pain is controversial. It is not clear if they are effective, and concerns have been raised about the potential adverse effects involved.

Comparison between an indoor and an outdoor 6-minute walk test among individuals with chronic obstructive pulmonary disease.

Objectives: To investigate the feasibility of an outdoor 6-minute walk test (6MWT) as a measure of functional status among individuals with chronic obstructive pulmonary disease (COPD), and to examine the relationship between performance on an indoor and an outdoor 6MWT.

Design: An experimental, repeated-measures crossover design. Subjects were studied on 2 separate days in the same week.

The short-term effect of a rollator on functional exercise capacity among individuals with severe COPD.

Study Objectives: This study was conducted to examine the short-term effects of using a rollator on functional exercise capacity among individuals with COPD and to characterize which individuals benefit most from its use.

Design: Repeated-measures randomized crossover design using the 6-min walk test (6MWT) as the primary outcome measure.

Setting: Respiratory rehabilitation center.