Adherence to evidence-based guidelines for ankle sprain care among physiotherapists in Peshawar Pakistan: a cross-sectional study

Abstract

Background: Ankle sprain is one of the most common sports injuries worldwide. Despite its high prevalence, the level of adherence to clinical practice guidelines (CPGs) for ankle sprain management among physical therapists (PTs) in Peshawar, Pakistan, has not been adequately explored. This survey aimed to evaluate physiotherapists’ knowledge and adherence to CPGs in managing ankle sprains.

Material & Methods: A cross-sectional survey was conducted using an online questionnaire distributed via an online platform. Inclusion criteria was limited to participants who have treated at least two ankle sprain patients in the past 12 months. PTs working in academic settings or those who provided incomplete responses were excluded. A total of 230 PTs were recruited using convenience sampling. The study duration was six months. Data were analysed using SPSS version 23.0.

Results: A total of 230 PTs (mean age: 28 ± 5 years; male: 57%, female: 43%) participated in the study. For the clinical scenario involving an acute ankle sprain with negative Ottawa Ankle Rules (OAR) findings, 0.2% of participants were classified as following CPGs, 31.4% as partially following, 19.6% as partially not following, and 48.5% as not following. In the scenario with positive OAR findings, 5.2% were following CPGs, 55.9% were partially not following, and 38.8% were not following. In the knowledge assessment section, participants demonstrated a 50% agreement rate across 11 CPG-related statements.

Conclusion: The majority of PTs revealed suboptimal adherence to CPGs for ankle sprain management, indicating a significant evidence-to-practice gap in physical therapist working in Peshawar, Pakistan.