ArticleBMC musculoskeletal disorders2007
Adherence to physiotherapy clinical guideline acute ankle injury and determinants of adherence: a cohort study.
Article in BMC musculoskeletal disorders, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- What is the quality of clinical practice guidelines for the treatment of acute lateral ankle ligament sprains in adults? A systematic review.BMC musculoskeletal disorders · 2019Pooled it
- Criteria-Based Return to Sport Decision-Making Following Lateral Ankle Sprain Injury: a Systematic Review and Narrative Synthesis.Sports medicine (Auckland, N.Z.) · 2019Pooled it
- Excellent adherence and no contamination by physiotherapists involved in a randomized controlled trial on reactivation of COPD patients: a qualitative process evaluation study.International journal of chronic obstructive pulmonary disease · 2012Trial
- Implementation of a Personalized, Cost-Effective Physical Therapy Approach (Coach2Move) for Older Adults: Barriers and Facilitators.Journal of geriatric physical therapy (2001)Trial
- Determinants and strategies for implementing guideline-adherent physiotherapy: a scoping review.BMJ open · 2026Article
- Measuring guideline adherence in physiotherapy: A scoping review of methodological approaches.Journal of evaluation in clinical practice · 2025Article
- The Use of Primary Care Physiotherapy for Persons With Bleeding Disorders in the Netherlands-A Retrospective Study of Health Records.Haemophilia : the official journal of the World Federation of Hemophilia · 2025Article
- Assessing Physiotherapists' Adherence to Clinical Practice Guidelines for Ankle Sprain Management in Saudi Arabia: A Cross-Sectional Study with National Online Survey.Journal of clinical medicine · 2025Article
- Assessing the importance of predictors of adherence to a digital self‑management intervention for osteoarthritis.Journal of orthopaedic surgery and research · 2023Article
- Physiotherapists' knowledge of and adherence to evidence-based practice guidelines and recommendations for ankle sprains management: a cross-sectional study.BMC musculoskeletal disorders · 2022Article
- Social psychological aspects of ACL injury prevention and rehabilitation: An integrated model for behavioral adherence.Asia-Pacific journal of sports medicine, arthroscopy, rehabilitation and technology · 2017Review
- Compliance with clinical guidelines for whiplash improved with a targeted implementation strategy: a prospective cohort study.BMC health services research · 2013Article
- Comparing patient characteristics and treatment processes in patients receiving physical therapy in the United States, Israel and the Netherlands: cross sectional analyses of data from three clinical databases.BMC health services research · 2008Article
- Manual physical therapy in the Netherlands: reflecting on the past and planning for the future in an international perspective.The Journal of manual & manipulative therapy · 2007Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundClinical guidelines are considered important instruments to improve quality in health care. In physiotherapy, insight in adherence to guidelines is limited. Knowledge of adherence is important to identify barriers and to enhance implementation. Purpose of this study is to investigate the ability to adherence to recommendations of the guideline Acute ankle injury, and to identify patient characteristics that determine adherence to the guideline.
methodsTwenty-two physiotherapists collected data of 174 patients in a prospective cohort study, in which the course of treatment was systematically registered. Indicators were used to investigate adherence to recommendations. Patient characteristics were used to identify prognostic factors that may determine adherence to the guideline. Correlation between patient characteristics and adherence to outcome-indicators (treatment sessions, functioning of patient, accomplished goals) was calculated using univariate logistic regression. To calculate explained variance of combined patient characteristics, multivariate analysis was performed.
resultsAdherence to individual recommendations varied from 71% to 100%. In 99 patients (57%) the physiotherapists showed adherence to all indicators. Adherence to preset maximum of six treatment sessions for patients with severe ankle injury was 81% (132 patients). The odds to receive more than six sessions were statistically significant for three patient characteristics: females (OR:3.89; 95%CI: 1.41-10.72), recurrent sprain (OR: 6.90; 95%CI: 2.34 - 20.37), co-morbidity (OR: 25.92; 95% CI: 6.79 - 98.93). All factors together explained 40% of the variance. Inclusion of physiotherapist characteristics in the regression model showed that work-experience reduced the odds to receive more than six sessions (OR: 0.2; 95%CI: 0.06 - 0.77), and increased explained variance to 45%.
conclusionAdherence to the clinical guideline Acute ankle sprain showed that the guideline is applicable in daily practice. Adherence to the guideline, even in a group of physiotherapists familiar with the guideline, showed possibilities for improvement. The necessity to exceed the expected number of treatment sessions may be explained by co-morbidity and recurrent sprains. It is not clear why female patients were treated with more sessions. Experience of the physiotherapist reduced the number of treatment sessions. Quality indicators may be used for audit and feedback as part of the implementation strategy.
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