El acceso a la literatura y el tiempo son dos limitaciones esenciales que dificultan la práctica de la fisioterapia basada en la evidencia, muy a menudo debido a las restricciones de la organización como la falta de recursos o de tiempo. Una encuesta realizada en el Reino Unido y Australia muestra que entre un 20% y un 44% de fisioterapeutas piensan que tienen dificultad para acceder a la literatura científica, y entre un 31% y un 61% declara que no tiene tiempo para leer investigaciones. Un primer paso para vencer estas barreras es tener acceso a las bases de datos en el sitio de trabajo, tanto por parte de instituciones públicas como privadas, y luego hacer un uso eficiente.
Otros aspectos que dificultan la aplicación de los hallazgos en la práctica clínica tienen relación con la dificultad para discriminar estudios de alta o baja calidad, o para interpretar correctamente los resultados obtenidos de una investigación (muy a menudo debido a una baja comprensión de los datos estadísticos). La presentación de resultados contradictorios en la literatura o la dificultad para recopilarla en un solo lugar, también son un problema. Igualmente, la poca claridad en las implicaciones de la evidencia para la práctica clínica o la falta de evidencia de alta calidad conllevan otras barreras para los fisioterapeutas.
Finalmente, las resistencias al cambio por parte de otros profesionales implicados en el proceso de rehabilitación o sencillamente la presencia de una apatía en general, suponen dificultades importantes para que el fisioterapeuta incorpore en su la práctica clínica habitual las mejores evidencias disponibles. A pesar del interés y el crecimiento de la fisioterapia basada en la evidencia, al nuestro país aún tiene mucho camino por recorrer respecto de otras disciplinas de la salud. Es fundamental que los futuros fisioterapeutas no tengan limitaciones para la aplicación de la práctica clínica basada en la evidencia y puedan fundamentar así sus intervenciones.
Autor: Manuel Rozalen
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