Clinical Implications

A recommendation that can be made from the findings of a study in relation to real world applications, or potential ramifications of the findings. These implications may be from the perspective of; - A patient/individual - A physiotherapist or other health care professional - The government, society/community, DHB, support group

Clinician - Recommend Tai Chi to older adults with falls risks - Find out what Tai Chi classes are run locally - Learn Tai Chi and run classes Older Adults - Look for a Tai Chi class - Improved balance and reduced falls may increase self-efficacy, independence, quality of life and participation Government/Society - Reduced falls = reduced healthcare costs for fall-related injuries - Train more Tai Chi instructors - Fund more Tai Chi resources, classes facilities - Make Tai Chi classes compulsory in all retirement villages/rest homes

Office Workers - May start a resistance training programme - Less headaches may lead to a better QOL and productivity Physio's - May recommend resistance training Society - Managers of a big company may implement compulsory breaks for workers = more productivity and better company results

Patients - May change their exercise programme to a combination of both or whichever they enjoy more/is more accessible Physio's - Can educate patients on both options, especially if one option isn't working/applicable Society - May fund whichever option is more cost efficient, yet as land based is already more common, may make pools readily available and provide aqua aerobics classes for people with arthritis

- What was the study design? - Who was the population study? - What were the outcome measures? - What were the specific findings? Specific clinical implications that can be made will be influenced by the population studied, the interventions given, the outcome measures used, and the study findings

Observational studies cannot determine cause. However they can still provide useful information one relationships - this evidence suggests an association between... clinical implications may be...

Homogenous vs Heterogenous population Homogenous - Similar characteristics - More likely to see a similar response to an intervention - Cannot be generalised to general population Heterogenous - Broad sample characteristics - More variable outcomes - Results are more generalisable

- Was there a control group and if so was it applicable? i.e. usual care, another intervention, a placebo? - The better controlled the study is, the more specific the conclusions can be

- Are the results statistically and clinically significant? i.e. small sample size = large statistic difference yet small in actuality and thus maybe not clinically significant - How confident are you in the findings? (CI, Reliability, Validity etc)