Neurospast -
In reference to your previous post:
You should have read on and you would have understood what I am trying to say. Tinetti was a real example of how things can go wrong and we are just at the beginning of evidence based
No, I understood what you were getting at, but I think you, as well as some of the other posters on this thread, actually are taking issue with how clinicians misunderstand EBP, rather than EBP itself. The practitioners you mention who are using the Tenetti as a falls predictor are NOT practicing EBP. I am not that familiar with the Tenetti, but from a precursory literature review I performed, it seems like it is only a valid predictor of falls in patients who have Wikipedia reference-linkparkinson's disease. Those physios who use the test for other patient populations need more education on how to impliment EBP. In fact, most of your arguments seem to indicate that you have seen numerous practitioners misuse the term EBP due to poor understanding of 1) what EBP is, and 2) how to impliment it.

EBP is not blindly following the results of one research article. It is familiarity with a body of evidence that has good external validty to your patient population (or in essence, good clinical utility), and applying that evidence to drive your examination and/or intervention. When there is a lack of evidence, EBP requires the EBP practitioner to fall back onto sound scientific theory to drive ther exam and intervention, or essentially to use clinical reasoning.

EBP is not abandoning clinical reasoning. It is combining clinical reasoning with the appllication of a body of current best evidence.

You state that implimentation of progressive rehabilitation research was already occuring prior to the current push for EBP. I agree that it was happening as well, but not nearly to a large enough extent. For example, passive management of patients with modalities still occurs to a large extent within our profession, despite the large amount of evidence that suggests that this is not only not helpful to achieving a positive outcome, it is in fact detrimental to the patient. How do we change this, without getting our profession to accept the changes that widespread EBP will bring.

In short, our profession needs to better understand what EBP is. From better understanding will come acceptance of its principles.