Evidence-based practice among physiotherapists in India: a nationwide survey of knowledge, attitude, and implementation behavior

Background Physiotherapy services are often integrated within the broader healthcare system in India. Unlike in developed countries, physiotherapy is still limited to indirect access and needs a referral from other healthcare providers, which potentially limits physiotherapists. The purpose of this study was to explore the knowledge or skill, attitude, and behavior towards the implementation of evidence-based practice (EBP) in physiotherapy care. In addition, the physiotherapist’s perception of barriers in the implementation of EBP was inquired. Methods A cross-sectional study was conducted through an online survey involving two thousand nine hundred and ninety-six physiotherapists from 22 states/union territories in India. A 24-item EBP questionnaire (EBPQ) investigating knowledge, attitude, and behavior domains with a 1 to 7 Likert scale response for each item, with a higher score indicating a favorable response. A linear regression model was used to analyze the relationship between factors and evidence-based practice behavior among physiotherapists. Results The mean age of the participants was 35.8 ± 6.2 years, with a work experience of 13.25 ± 6.38 years. The overall EBPQ mean score of Indian physiotherapists was 3.6 ± 0.38, and the mean scores of the domains—knowledge, attitude, and implementation of EBP—were 3.59 ± 0.53, 4.29 ± 0.79, and 3.20 ± 0.62, respectively. The EBP domains were mainly determined by the educational attainment and workplace, which explained 46.1% of the variance. Lack of time and skills was identified as the top barrier influencing EBP among physiotherapists in India. The behavior dimension score of EBPQ is determined by 8 knowledge items and 2 attitude items, which explain 61.2% of the variance. Conclusions The Indian physiotherapists reported a positive attitude toward evidence-based practice; however, their knowledge and behavior were observed to be insufficient. Lack of time, limited skills, a shortage of resources, and limitations in applying EBP were reported as the main barriers.