Estado actual de la investigación y principales barreras para la práctica basada en evidencia en fisioterapeutas colombianos / Current status of research and barriers to evidence-based practice in Colombian physiotherapists

Introducción La práctica basada en la evidencia científica (PBE) se define como un proceso cuyo objetivo es la selección de los mejores argumentos científicos para la resolución de los problemas que se plantean en la práctica clínica. El propósito de este estudio fue evaluar el estado actual de la investigación y las principales barreras para la incorporación del uso de la PBE en fisioterapeutas colombianos. Materiales y métodos Estudio transversal, multicéntrico y descriptivo en 221 fisioterapeutas colombianos sin formación previa en PBE. Se aplicó una encuesta de 18 ítems divida en 3 apartados diferenciados: a) información de la titulación; b) aplicación de PBE, y c) áreas y líneas de desempeño profesional e investigativo. Adicionalmente, se reunieron datos de información sociodemográfica. Resultados El promedio de edad fue 26,6 ± 6,1 años; el 76% de los encuestados tenían titulación profesional y solo el 3,2% nivel de maestría. Un 43,4% de los encuestados buscan información en fuentes primarias y secundarias, mientras que el 28,5% respondió nunca hacerlo. El 55,7% usaban búsquedas mediante Altavista, Google, Hotbot y Lycos, y solo un 13% usaba Tesauros. El 48,9% respondía haber realizado estudios de tipo descriptivo, el 10,4% experimentales y el 3,2% de casos y controles. Un 10,9% de los encuestados desarrollaba proyectos en cuidado crítico, el 7,2% en enfermedad articular y el 4,5% en enfermedad neurológica. Conclusión El estudio confirma la escasa actividad científica y las barreras que limitan la inclusión de la PBE en profesionales de fisioterapia de Colombia. Múltiples estrategias de cambio serán necesarias para facilitar la inclusión de actividades encaminadas a la mejora de la competencia profesional en esta materia (AU)

Introduction Scientific evidence based practice (SEBP) is defined as a process whose objective is the selection of the best scientific arguments to solve the problems occurring in the clinical practice. This study has aimed to evaluate the current status of the investigation and the principal barriers existing for the Columbian physiotherapists to incorporate SEBP. Material and methods A cross-sectional, multicenter and descriptive study was performed in 221 Colombian physiotherapists with no previous training in SEBP. An 18-item survey divided into 3 differentiated sections was applied. These sections were: 1) degree information, 2) application of SEBP and 3) areas and lines of professional and investigational work. In addition, sociodemographic information data were collected. Results Average age was 26.6 ± 6.1 years; 76% of those surveyed had a professional degree and only 3.2% a master's degree. A total of 43.4% of those surveyed looked for information in primary and secondary sources while 28.5% stated they never did so. Searcy was performed in Altavista, Google, Hotbot, Lycos by 55.7% and only 13% used Tesauros. 48.9% stated they had carried out descriptive type studies, 10.4% experimental and 3.2% case-controls. Of those surveyed, 10.9% developed projected in critical care, 7.2% in articular disease and 4.5% in neurological disorder. Conclusion This study confirms the scarce scientific activity and barriers that limit including SEPB in physiotherapy professionals in Colombia. Multiple strategies of change will be necessary to facilitate the inclusion of activities aimed at the improvement of professional expertise in this material(AU)

[Effects of two methods of heat therapy on the acute vascular response and hemodynamics in healthy subjects]. / Efectos de dos métodos de termoterapia sobre la respuesta vascular aguda y parámetros hemodinámicos en un grupo de sujetos sanos.

OBJECTIVE: Recently, non-pharmacological resources to relieve pain like hot packs and ultrasound (US) have become common in clinical practice. However, little experimental evidence is available about the possible mechanisms through which these methods bring about pain relief. We aimed to determine the effects of hot packs and US on the acute vascular response and on hemodynamic parameters in healthy subjects. MATERIALS AND METHODS: We conducted an experimental study in 20 healthy subjects (10 men and 10 women; mean age, 22.54±1.70 years). The two interventions were randomly applied: a) hot packs (n=10): 15min at 60°C and b) US (n=10): 15min at 1Mhz. Before and after each intervention, the following vascular parameters were measured in the brachial artery using Doppler ultrasonography with a 7MHz probe: arterial compliance, elastic modulus, beta stiffness index, systolic and diastolic arterial diameters, systolic flow velocity and diastolic flow velocity, systolic/diastolic ratio, resistance index, and pulsatility index. The following hemodynamic parameters were monitored: heart rate and blood pressure (systolic, diastolic, and mean). RESULTS: After the application of hot packs, we observed changes in diastolic flow velocity and in the pulsatility index (P<05). After the application of US, we observed changes in diastolic flow velocity, systolic/diastolic ratio, resistance index, and arterial compliance (P<05). No changes in hemodynamic parameters were observed after either intervention. CONCLUSIONS: Applying hot packs or US modifies the physiology of the vascular system but does not affect hemodynamic parameters in healthy subjects.