Volume: 6, Issue: 1, Year: 2022
Scientific Research Journal of India Mini Review
Evidence of Barriers to Evidence-Based Physiotherapy Practice in Northern Africa Krishna Nand Sharma Submission: May 2022; Published: June 2022 * Managing Director, Virtued Academy International, Dr. L. Sharma Campus, Muhammadabad Gohna, Mau, U.P., India 276403; Email: me@drkrishna.co.in
ABSTRACT Physiotherapists are in charge of rehabilitative programme assessment, planning, and implementation. As members of a medical team, it is critical that they apply research findings to their therapy. The concept of Evidence-Based Physiotherapy is gaining popularity around the world. However, there are still obstacles in the way of its implementation. This mini-review looks at the evidence of impediments to evidence-based physiotherapy practice in the nations of northern Africa. KEYWORDS: Physiotherapy, Research, Barriers, Evidence-Based-Physiotherapy, Evidence-Based-Practice, Northern Africa
INTRODUCTION The International Standard Classification of Occupations (ISCO) defines physiotherapist as the ones who “… assess, plan, and implement rehabilitative programmes that improve or restore human motor functions, maximize movement ability, relieve pain syndromes, and treat or prevent physical challenges associated with injuries, diseases and other impairments.” (International Labor Office, 2012). Evidence-Based Medicine (EBM) is becoming more prevalent in healthcare, and physiotherapy is no exception. To find research trends in Evidence-Based Medicine, Hung et al. (2015) evaluated more than 50 years of publication data. They discovered a
steady increase in higher-quality research methodologies. EVIDENCE-BASED-PHYSIOTHERAPY PRACTICE According to the World Confederation for Physical Therapy (WCPT), the evidence-based-physiotherapy is “a commitment to use the best available evidence to inform decision-making about the care of individuals that involves integrating physiotherapist practitioners and individual professional judgement with evidence gained through systematic research.” (Evidence based physiotherapy, 2018). This definition by WCPT was inspired by the evidence-based medicine’s definition given by Sackett et al. (1996).
Scientific Research Journal of India (ScReJI) The World Confederation for Physical Therapy has made several recommendations to its member organizations (MO) to improve the evidence-based-physiotherapy practice. Hence, the active presence of physiotherapy organizations in countries and regions is crucial for better research participation by physiotherapists (Evidence based physiotherapy, 2018). BARRIERS TO PHYSIOTHERAPY ALGERIA
EVIDENCE-BASED PRACTICE IN
The Mediterranean Sea borders Algeria's northern border, making it the largest Maghreb state in North Africa. It shares borders with Niger in the southeast, Western Sahara, Mauritania, Mali, and Tunisia in the northeast, Libya in the east, Morocco in the west, and Niger in the southwest (Algeria – Country Profile, 2021). There is no known independent physiotherapy council or association in Algeria. Lack of research sensitization due to absence of organization might also be one of the reasons why there is no publication regarding the research participation of physiotherapists based in Algeria. BARRIERS TO PHYSIOTHERAPY EGYPT
EVIDENCE-BASED PRACTICE IN
The Arab Republic of Egypt is a transcontinental nation that spans the Sinai Peninsula in Western Asia and northeastern Africa (Middle East). To the north, the Mediterranean Sea, and to the east, the Red Sea and the Gulf of Suez, the country share borders. Its western border is with Libya, its northeastern and southern borders are with Israel and the Gaza Strip, and its southern border is with Sudan. In the Mediterranean Sea, Egypt has maritime ScReJI
boundaries with Cyprus, Turkey, and Greece; in the Red Sea, it has maritime borders with Jordan and Saudi Arabia (Egypt – Country Profile, 2021). They Egyptian physiotherapists have formed their independence organization named- the General Physical Therapy Syndicate of Egypt. However, the World Confederation of Physical Therapy terminated their membership on 4 September 2018 (World Confederation of Physical Therapy, 2018). Salwa and Akram (2012) in their study reported that the majority of physiotherapists in Egypt support evidence-based-practice and standardized outcome measures, and nearly half of them use them in clinical settings, particularly when treating patients with musculoskeletal issues and needing clear, objective means to monitor their progress. The main thing seen as a barrier to their adoption is a lack of time. BARRIERS TO EVIDENCE-BASED PHYSIOTHERAPY PRACTICE IN LIBYA The majority of Libya is covered by the Sahara desert, and there are only a few sparsely spaced oasis in the eastern Libyan desert and the southern Fazzan region where people can live. (Libya – Country Profile, 2021). There is no publication found that talks about the barriers to evidence-based physiotherapy practice in Libya. There is no known independent physiotherapy council or association in Libya. Lack of research sensitization due to absence of organization might also be one of the reasons why there is no publication regarding the research participation of physiotherapists based in Libya. BARRIERS TO PHYSIOTHERAPY MOROCCO
www.virtued.in/p/screji
EVIDENCE-BASED PRACTICE IN
84
Scientific Research Journal of India (ScReJI) Officially known as the Kingdom of Morocco, Morocco is a member of the Arab world and is located in the western Maghreb region of North Africa. The nation shares maritime boundaries with Portugal and Spain and is bordered by the Atlantic Ocean to the west and the Mediterranean Sea to the north. Morocco shares borders with Western Sahara to the south and Algeria to the east. In the region of Western Sahara that Morocco controls, there is a nonautonomous territory that borders Mauritania. The Spanish exclaves of Ceuta and Melilla, the two populous Spanish possessions on the African continent, form Morocco's land boundary with Spain (Morocco – Country Profile, 2021). The physiotherapists in Morocco formed National Fédération of Physiothérapeute in Morocco (National Federation of Physiotherapists in Morocco) in 2008. The association has estimated that there are over 4,000 practicing physiotherapists in Morocco (National Federation of Physiotherapists in Morocco, 2021). However, there is no publication found that talks about the barriers to evidence-based physiotherapy practice in Morocco. BARRIERS TO PHYSIOTHERAPY SUDAN
EVIDENCE-BASED PRACTICE IN
east. Additionally, it shares maritime borders with Saudi Arabia and is bordered by Libya in the north-west, Chad in the west, the Central African Republic in the south-west, South Sudan in the south, and Ethiopia in the southeast. (Sudan – Country Profile, 2021). The physiotherapists in Sudan formed Sudanese Physiotherapy Association and became member of the World Confederation of Physical Therapy in 2019 (Sudanese Physiotherapy Association, 2019). However, there is no publication found that talks about the barriers to evidence-based physiotherapy practice in Sudan. BARRIERS TO PHYSIOTHERAPY TUNISIA
EVIDENCE-BASED PRACTICE IN
The smallest nation in both North Africa and the Maghreb is Tunisia. Tunisia is a Mediterranean Sea country that borders both Algeria and Libya. Italy and the nation are separated by water on both sides (Tunisia - Country Profile, 2021). There is no known independent physiotherapy council or association in Tunisia. Lack of research sensitization due to absence of organization might also be one of the reasons why there is no publication regarding the research participation of physiotherapists based in Tunisia. CONCLUSION
Formerly, Sudan was the biggest nation in Africa. In 2011, Sudan was divided into South Sudan, formerly the southern portion of Sudan, now officially the Republic of South Sudan, with a majority population of people of Black African origin, and Northern Sudan, officially the Republic of the Sudan, with a predominately Arab population. The nation is located in northeastern Africa, bordering the Red Sea in the northeast and Egypt to the north and Eritrea to the ScReJI
Except for Egypt, Morocco, and Sudan, the physiotherapy profession in the northern African region is unorganized. Only publication has reported the egyptian physical therapists' beliefs, perceptions and adoption of evidencebased practice and standardized outcome measures and reported lack of time as a barrier to adoption of evidence-based-practice.
www.virtued.in/p/screji
85
Scientific Research Journal of India (ScReJI)
REFERENCES
https://www.nationsonline.org/onewor ld/morocco.htm
Algeria – Country Profile. (n.d.). Nations Online. Retrieved August 18, 2021, from https://www.nationsonline.org/onewor ld/algeria.htm#Countryprofile Egypt – Country Profile. (n.d.). Nations Online. Retrieved August 18, 2021, from https://www.nationsonline.org/onewor ld/egypt.htm Evidence based physiotherapy (2018). World Confederation for Physical Therapy—European Region. Brussels: The Confederation. Retrieved August 18, 2021, from http://www.erwcpt.eu/education/evid ence_based_physiotherapy_evidence_an d_research Hung, B. T., Long, N. P., Hung, L. P., Luan, N. T., Anh, N. H., Nghi, T. D., van Hieu, M., Trang, N. T. H., Rafidinarivo, H. F., Anh, N. K., Hawkes, D., Huy, N. T., & Hirayama, K. (2015). Research Trends in EvidenceBased Medicine: A Joinpoint Regression Analysis of More than 50 Years of Publication Data. PLOS ONE, 10(4), e0121054. https://doi.org/10.1371/journal.pone.0 121054 International Labor Office. (2012). International Standard Classification of Occupations (ISCO–08). International Labor Office. Libya – Country Profile. (n.d.). Nations Online. Retrieved August 18, 2021, from https://www.nationsonline.org/onewor ld/libya.htm Morocco – Country Profile. (n.d.). Nations Online. Retrieved August 18, 2021, from ScReJI
National Federation of Physiotherapists in Morocco (2021). World Confederation for Physical Therapy. Retrieved August 18, 2021, from https://world.physio/membership/mor occo Sackett, D. L., Rosenberg, W. M. C., Gray, J. A. M., Haynes, R. B., & Richardson, W. S. (1996). Evidence based medicine: what it is and what it isn’t. BMJ, 312(7023), 71–72. https://doi.org/10.1136/bmj.312.7023. 71 Salwa B. El-Sobkey and Akram M. Helmy (2012). Evidence-Based Practice and Standardized Outcome Measures: Egyptian Physical Therapists' Beliefs, Perceptions and Adoption. World Applied Sciences Journal, 16(9), 12821291 Sudan – Country Profile. (n.d.). Nations Online. Retrieved August 18, 2021, from https://www.nationsonline.org/onewor ld/sudan.htm Sudanese Physiotherapy Association (2019). World Confederation for Physical Therapy. Retrieved August 18, 2021, from https://world.physio/membership/sud an Tunisia – Country Profile. (n.d.). Nations Online. Retrieved August 18, 2021, from https://www.nationsonline.org/onewor ld/tunisia.htm WCPT terminates membership of two associations (2018). World
www.virtued.in/p/screji
86
Scientific Research Journal of India (ScReJI) Confederation for Physical Therapy. Retrieved August 18, 2021, from https://world.physio/news/WCPTterminates-membership-of-twoassociations
ScReJI
www.virtued.in/p/screji
87