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Ankle scientific knowledge is not translated into physiotherapy practice: a thematic analysis of French-speaking physiotherapists clinical behaviors.

CONTEXT: Chronic ankle instability (CAI) is prevalent amongst individuals who sustain a lateral ankle sprain (LAS) injury. The persistent of the characteristic long-standing clinical symptoms of CAI maybe attributable to the lack of adoption of evidence-informed clinical guidelines.

OBJECTIVE: To investigate to what extent French-speaking physiotherapists implement the International Ankle Consortium Rehabilitation-Oriented-ASsessmenT (ROAST) framework when providing clinical care for individuals with an acute LAS injury.

DESIGN: Cross-sectional study.

SETTING: We created an online survey informed by a Delphi process of foot-ankle experts, and disseminated it to French-speaking physiotherapists in France, Switzerland, Quebec-Canada, Belgium, and Luxembourg.

PATIENTS OR OTHER PARTICIPANTS: In total, 426 physiotherapists completed the online survey.

MAIN OUTCOME MEASURE(S): The online survey comprised closed and open-ended questions organized in 5 sections: (1) participants' demographics, (2) participants' self-assessment expertise, (3) clinical diagnostic assessment (bones and ligaments), (4) clinical evaluation after an acute LAS injury (ROAST framework), and (5) CAI. The qualitative data from the open-ended questions was analyzed using best practice thematic analysis guidelines.

RESULTS: Only 6% of the respondents could name all Ottawa Ankle Rules criteria. Only 25% of the respondents cited or described "gold standard" tests from the literature to assess the integrity of the ankle lateral ligaments. Less than 25% of the respondents used some of the International Ankle Consortium ROAST recommended clinical evaluation outcome metrics to inform their clinical care for individuals with an acute LAS injury. In general, the respondents had a greater knowledge of the functional insufficiencies that associated with CAI when compared to the mechanical insufficiencies.

CONCLUSION: A minority of French-speaking physiotherapists use the International Ankle Consortium ROAST recommended clinical evaluation outcome metrics to inform their clinical care for individuals with an acute LAS injury. This highlights the responsibility of the scientific community to better disseminate evidence-informed research to clinicians.

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