Article

OBJECTIVE: To contribute to the discussion on the research-practice gap by
illustrating obstacles and opportunities that arise in an evidence-informed
improvement process of prosthetic rehabilitation in a local setting. SETTING:
Dutch rehabilitation centre. The improvement process was
considered as a two-way translation process rather than a unidirectional process
of knowledge transfer between science and practice. METHOD: Case study and
participatory research methods comprising documentary analysis, treatment
observations, individual and focus groups interviews, and literature studies. A
qualitative software program (Atlas-ti) was used to triangulate the collected
data. RESULTS: The main concern of local practitioners was identified to be the
post-discharge decline in functional capacity in elderly amputees. This was
related to a predominantly biomedical and biomechanical approach, and
accompanying traditional therapist-patient interactions. The content and
underpinnings of prosthetic treatments were scarcely specified in either the
scientific literature or the local setting. Generic principles and practices from
other fields were useful for treatment innovation for post-discharge problems,
such as task- and context-specific training and self-management education. A
circuit training focused on motor learning and a problem-solving training focused
on social learning were developed by integrating amputation-specific knowledge.
CONCLUSION: Improving rehabilitation practice with the use of available evidence
is a heterogeneous and multifaceted scientific enterprise. Such an enterprise
requires as much self-reflexivity from researchers as from practitioners.

Langue : ANGLAIS