Objective

Australian and New Zealand Guidelines for the Physiotherapy Management of People with Spinal Cord Injury recommend the use of inspiratory muscle training for people with spinal cord injury and respiratory muscle weakness. The aim of this study was to evaluate if tailored implementation strategies increased provision of inspiratory muscle training by physiotherapists.

Design

A pre–post implementation study with baseline, post and follow-up measures.

Setting

Three spinal units in Sydney, Australia.

Participants

Twenty-one physiotherapist-participants and 68 patient-participants across three spinal units.

Intervention

Tailored, evidence-based, multi-faceted implementation strategies to improve physiotherapists’ provision of inspiratory muscle training, delivered over a 6-week period (the implementation phase).

Main measures

Physiotherapists’ provision of inspiratory muscle training was measured via a standardised audit tool. Medical records were audited at baseline, immediately after the implementation phase and then two months later to determine whether patients had been provided inspiratory muscle training.

Results

Ninety-four medical records were audited of 68 patient-participants over the study period. Data at baseline indicated that inspiratory muscle training was only provided to 20% of eligible patient-participants. This improved to 91% immediately post the 6-week implementation phase but reduced to 72% two months later.

Conclusions

Tailored, evidence-based implementation strategies increased the provision of inspiratory muscle training by physiotherapists. These strategies can be adapted to different health care settings to improve physiotherapists’ provision of inspiratory muscle training for the respiratory management of people with spinal cord injury.

The study was prospectively registered with the Australian New Zealand Clinical Trials Registry (https://www.anzctr.org.au/. ACTRN: 12623001106628).