# Assessing Physiotherapists’ Adherence to Clinical Practice Guidelines for Ankle Sprain Management in Saudi Arabia: A Cross-Sectional Study with National Online Survey

## TL;DR

This study finds that physiotherapists in Saudi Arabia often don't follow guidelines for treating ankle sprains, showing a gap between evidence and practice.

## Contribution

The study is the first to assess physiotherapists' adherence to ankle sprain guidelines in Saudi Arabia using a national online survey.

## Key findings

- Only 0.2% of physiotherapists followed guidelines for ankle sprains with negative Ottawa Ankle Rules.
- Most participants showed suboptimal adherence to clinical practice guidelines for ankle sprain management.
- Participants agreed with only 50% of the clinical guideline statements assessed.

## Abstract

Background/Objectives: Ankle sprain is one of the most common sports injuries globally. Despite its prevalence, the adequacy of knowledge in managing ankle sprain among physiotherapists in Saudi Arabia has not been assessed. This study aimed to assess the knowledge and degree of adherence to clinical practice guidelines (CPG) for the management of ankle sprains among physiotherapists. Methods: This study was a cross-sectional with national online questionnaire administered to participants through an online platform. It comprised three sections. The first section collected demographic data. The second section presented two clinical cases as the basis for the participants’ management decisions (the first with negative Ottawa Ankle Rules (OAR) and the second with positive OAR); participants were classified as “following”, “partially following”, “not following”, and “partially not following” the CPGs. In the third section, on a Likert scale (1–5), participants indicated how much they agreed with various CPGs statements. Results: A total of 381 physiotherapists (mean age: 28 ± 5; male: 57.1%) completed the questionnaire. In the case of acute ankle sprain with negative OAR, 0.2% of the participants were considered as “following” CPGs, 31.4% as “partially following”, 19.6% as “partially not following”, and 48.5% as “not-following”. In the case of acute ankle sprain with positive OAR, 5.2% were considered as “following” CPGs, 55.9% as “partially not following”, and 38.8% as “not following”. The knowledge assessment section elicited a 50% agreement among the participants on the 11 provided statements. Conclusions: Most physiotherapists have suboptimal adherence to CPG for managing ankle sprains, thus highlighting an evidence-to-practice gap.