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 steady increase in higher-quality

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
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).
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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 EVIDENCE-BASED
PHYSIOTHERAPY PRACTICE IN
ALGERIA
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 EVIDENCE-BASED
PHYSIOTHERAPY PRACTICE IN
EGYPT
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
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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 EVIDENCE-BASED
PHYSIOTHERAPY PRACTICE IN
MOROCCO
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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 non-
autonomous 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 EVIDENCE-BASED
PHYSIOTHERAPY PRACTICE IN
SUDAN
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
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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 south-
east. (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 EVIDENCE-BASED
PHYSIOTHERAPY PRACTICE IN
TUNISIA
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
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 evidence-
based practice and standardized
outcome measures and reported lack of
time as a barrier to adoption of
evidence-based-practice.
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Confederation for Physical Therapy.

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