October 2017 Issue: Evidence-Based Practice for Kinesiologists - D. Santa Mina, RKin PhD

Posted Oct 4th, 2017 in Professional, Public, General, KineKT

On a daily basis, registered kinesiologists (RKins) make decisions about how to best support the health of their clients to improve their clinical outcomes and maximize safety. Care decisions are highly individualized to ensure that the right client (or patient) receives the right treatment (or assessment or program) at the right time. With the ubiquity of ‘snake oils’, trendy diets, gizmos, gadgets, and fitness fads, it can be challenging to sift through the noise to discern the real from the fake, the good from the bad, and the helpful and the harmful. The foundational training of RKins establishes a critical eye for the essential evidence on which to accept or refute health claims. However, scientific research requires critical appraisal, consideration, and contextualization before it can be appropriately applied.

Evidence-based practice (EBP) is at the heart of contemporary health care, and is defined as:

 “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research.”1

EBPs origin is in medicine, but its value has extended to drive EBP considerations in nursing2,3, allied health4,5, and exercise sciences6.  The ‘conscientious, explicit and judicious’ use of research to guide responses to practice-level queries is supported through a rigorous, systematic process described as the “5 As”.  

The 5 As in Evidence Based Practice are:

  • ASSESS the client and context from which a practice or programmatic decision is required. In other words, what is the rationale for your need for more information?
  • ASK the question for which you need an answer. This is a tricky yet crucial element of the process because it needs to be appropriately focused to direct you towards the desired information.
  • ACQUIRE the relevant research to answer your question. Finding the evidence to answer your question requires a skilful search of the scientific literature. Databases such as PubMed, SportDiscus, Google Scholar, and CINAHL are likely to be the best place to find the evidence you need to make an evidence-based decision in kinesiology. Consider connecting with a librarian to assist with this step.
  • APPRAISE the research you find to be sure of its quality and applicability. Concepts like internal and external validity are important so that you don’t misapply good evidence or apply bad evidence.
  • APPLY your newfound evidence via your practice. This is where the rubber meets the road – your decision to do or not to do based on the evidence (and your expertise and client values/preferences) is what EBP is all about.
  • ASSESS the impact of your decision. This step requires monitoring your decision to ascertain its safety and effectiveness, as well as the satisfaction for your client. It also contributes to your overall experience and expertise that will support your decision process the next time you face a similar circumstance. 

EBP is best practice and although it hasn’t been conventionally oriented towards athletic performance outcomes (versus clinical outcomes that more closely approximate the medical origins of EBP), decisions to maximize power, strength, and endurance for athletes should be grounded in research to avoid injuries and setbacks and to maximize outcomes.

For more information on EBP consider these resources:

McMaster Evidence Based Clinical Practice Workshops: http://ebm.mcmaster.ca 

Centre for Evidence Based Medicine: http://www.cebm.net

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