Evidence Based-Practice (EBP) aggregates results of scientific research, physiotherapist's clinical experience and patients' expectations regarding treatment into a single procedure [1]. The aim of the present original study was to analyze the opinion, knowledge, skills and barriers related to EPB for female urinary incontinence (UI) treatment, according to Brazilian physiotherapists perspectives.

This is an original cross-sectional study conducted from January 2021 to March 2021. Participants were included if they were Brazilian physiotherapists that worked in Women’s Health area, specific with women with UI; and if they had a valid certification emitted by the Brazilian Physical Therapy Registration board of their region. A self-administered structured questionnaire, available from Google Forms Platform, was applied to assess the sociodemographic characteristics and the professional qualification of the professionals. They also filled an adapted questionnaire about the opinion, knowledge, skills and barriers on daily use of EBP during UI treatment [2]. Participants should answer the questionnaire according to a 5-point Likert Scale (1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree, 5 = strongly agree). An answer option “I don’t know how to answer” was added to the questions. Preliminary data analysis was performed using statistical software SPSS (Statistical Package for the Social Sciences) version 21.0. Categorical variables were expressed as frequencies and percentages, and continuous variables were expressed as mean ± SD.

Forty-three Brazilian physiotherapists were included in this study. The majority of the subjects was female (97.7%) and was from the age group of 20-29 years (53.5%). The average of graduation time was 6.12 years (± 5.02 SD; range of minimum-maximum 0.5-24 years). Only 23.3% and 4.7% of the physiotherapists concluded the Master and Ph.D. studies, respectively. The majority of respondent declared to work in private clinics (93%) while a 7% of the subjects declared to work with education research. Table 1 presented the physiotherapists’ answers according their opinion, knowledge and skills related to EBP during clinic routine. Figure 1 showed the barriers related to the EBP application.

The results from the present study demonstrate that EBP is often applied during Brazilian physiotherapeutic treatment of women with UI. Most part of the Brazilian physiotherapists strongly agree (67.4%) that their decision making is based on EBP during their Physiotherapy sessions in Women's Health area. There was also a strong agreement that EBP can assists the making decisions about the patient care (81.4%).
Another relevant information is that 76.7% of the physiotherapists included in the present study are interested about learning or improving the skills to incorporate the EBP into clinical practice. This result may be related to the fact that most part of the participants included in the present study were not specialist on Women’s Health and performed clinic assistance to women with UI. In addition, more than a half of the physiotherapists included in the present study strongly agree that they were instructed to evaluate (60.6%) and to treat women with urinary disorders (58.1%) during graduation. 
Although none of the participants reported a lack of scientific basis to implement EBP, barriers related to the EBP often reported by the subjects were the difficulty to understand scientific research statistical analysis (48.8%), insufficient time to study and incorporate EBP (44.2%) and the language of the papers published in the area (39.5%). The less frequently cited barriers were lack of interest in research (4.7%) and lack of incentive in research (4.7%), equally. Graduate and postgraduate institutions, as well as scientific researchers, should be aware to the barriers related to the implantation of EBP, as it may contribute to the physiotherapeutic clinical practice.

This original study raised the main opinion, knowledge, skills and barriers related to EPB according the Brazilian physiotherapists’ perceptions during UI treatment. It seems that Brazilian management of UI treat is based on EPB during decision-making and patient care. However, Brazilian physiotherapists are interest to learn or improve skills to apply EBP on UI treatment routine, even though they have learned to assess and treat women with UI during graduation. Therefore, there are some barriers related to EBP implementation on clinic practice in Brazil.

Nilsagård Y, Westerdahl E, Forsberg A. Engagement in performing clinical physiotherapy research: Perspectives from leaders and physiotherapists. Physiother Res Int. 2019;24(2):e1767. doi:10.1002/pri.1767
Jette Diane U et al. Evidence-Based Practice: Beliefs, Attitudes, Knowledge, and Behaviors of Physical Therapists. Phys Ther. 2003 Sep;83(9):786-805.