I provided this lecture on Coach2Move, Evidence-based practice and Shared-decision making at the mini-symposium Movement & Health: towards an active society at the HAN univerisity of applied sciences.

1. Coach2Move:
Moving evidence-based physiotherapy forward
Thomas Hoogeboom, PT, PhD
Radboud Institute for Health Sciences
IQ healthcare
Movement & Health: towards an active society
8 feb 2019

2. Statements:
Physiotherapy fails when therapists try
to tell patients what to do...
Paternalistic care
Implementation of scientific
knowledge fails when researchers try
to tell physiotherapists what to do…
Evidence-biased practice

3. Easy fix!

4. Statements:
Physiotherapy fails when therapists try
to tell patients what to do...
Paternalistic care
Implementation of scientific
knowledge fails when researchers try
to tell physiotherapists what to do…
Evidence-biased practice
Shared decision making
Evidence-based practice

5. EBP – SDM = Evidence tyranny
SDM – EBP = Misinformation
EBP + SDM = <3
EBP
SDM

6. Castrop-Rauxel, Germany
So don’t build useless bridges…

7. the Flevopolder in the Netherlands
… reclame the land!

8. Hoffman, JAMA, 2014.
11
seconds
Ospina, JGIM, 2019
36
percent

9. But physiotherapist do a way better
job right? Right…? Do I really want to
know? I am getting a bit scared now..
They at least do better than that 36%
right? Right.. Dude.. Just tell us..

10. 36
percent
Hoffman, JAMA, 2014.
de Vries, JoCSM, 2016; Bosma, In Prep

11. But interviewing not our only issue…
de Vries, JoCSM, 2016; Bosma, In Prep
*A percentage >70% was deemed sufficient
Quality indicator Percentage met*
Interviewing 36%
Diagnostics 56%
Analysis 12%
Treatment plan 51%
Treatment 60%
Evaluation 31%

12. With Coach2Move,
we wanted to change this..

13. Wish list:
- Focus on physical activity and self-management
- Physiotherapist is autonomous
- Prolonged intake for diagnostics & clinical reasoning

15. Hoffman, JAMA, 2014.

16. Fried (2001); Faber (2001); Morley (2013); Hubbard (2009); de Vries (2012); Glasziou (2005); de Vries
(2011); Fisher (2005); Schenkman (2006); Jensen (2003); Bastian (2009); Knight (2006)
Intake: 1.5 hours

17. This all seems to make sense.. But
does it really? Convince me even
more, Thomas! With pleasure..

18. Jensen (2003)
Coach2Move

19. So in other words.. from good to expert

20. “[Implementation is] to make the right
thing to do.. the easy thing to do.”
Carolyn Clancy
(Agency for Healthcare Research and Quality)

21. Implementation strategies:

22. Did it work?
de Vries, JoCSM, 2016; Bosma, In Prep
*A percentage >70% was deemed sufficient
Quality indicator Regular PT Coach2Move PT
Interviewing 36% 79%
Diagnostics 56% 85%
Analysis 12% 71%
Treatment plan 51% 78%
Treatment 60% 85%
Evaluation 31% 70%

23. Moderate physical activity increased
0
10
20
30
40
50
60
70
Coach2Move PT (n=64) Regular PT (n=65)
Baseline
3 months
6 months
de Vries, JoCSM, 2016

24. Physical frailty decreased
0
0.05
0.1
0.15
0.2
0.25
0.3
0.35
0.4
Coach2Move PT (n=64) Regular PT (n=65)
Baseline
3 months
6 months
de Vries, JoCSM, 2016

25. Coach2Move saved..
850 euro per patient in 6 months
de Vries, JoCSM, 2016; Bosma, In Prep

26. Statements:
Physiotherapy excels when therapists
really work together with patients...
Shared decision making
Implementation of scientific
knowledge works when researchers aid
PTs in shared-decision making and
clinical reasoning…
Evidence-based practice
Thank you for your attention.
thomas.hoogeboom@radboudumc.nl