The ‘#PEDroTacklesBarriers to evidence-based physiotherapy’ campaign will help you to tackle the four biggest barriers to evidence-based physiotherapy – lack of time, language, lack of access, and lack of statistical skills.

If you are new to the campaign, we suggest that you start at the beginning by looking at earlier posts on strategies to tackle the barriers of lack of time and language. These are available on the campaign webpage, blog, Twitter or Facebook.

Evidence-based physiotherapy cannot be implemented if there are barriers to accessing research. Below are two videos on strategies to tackle the barrier of lack of access. The first focuses on accessing full text using the links in PEDro. The second will outline strategies that use other non-PEDro methods.

Access to full-text articles is crucial for all health professionals trying to provide evidenced-based care. Full-text articles are needed to appraise the quality and applicability of research to address a clinical question. They are also needed for a detailed description of the intervention.

When a PEDro search locates an article of interest, clicking on the title hyperlink brings up its “Detailed Search Results” page. In 2022 we have recently estimated the percentage of articles in PEDro that have free full-text access via these links. Access to free full text was available for 60% (95% confidence interval 53% to 67%) of the articles sampled. This is higher than the free full-text access that was available via PubMed (47%, 95% confidence interval 40% to 54%).

PEDro provides up to 5 links to full text for each article. The number of links will depend on whether the article is indexed in PubMed or PubMed Central, if the article has a DOI number, and if the journal has a website. These links may be to free full text, or you may need a subscription to the journal or to pay to view the article. Access to free full text is determined by the journal publishers. The links to full text in PEDro are listed in order of likelihood for accessing free full text. With links at the top of the list being more likely to link to free full text than the links at the end of the list.

The links are:

1. PubMed Central
PubMed Central is a free full-text archive of biomedical journal literature produced by the United States National Institutes of Health’s National Library of Medicine. In January 2022 it contained over 7.6 million full-text articles that have been published in journals that have an agreement with PubMed Central to archive their content. Clicking on the “PubMed Central” link on the PEDro “Detailed Search Results” page will take you directly to the article in PubMed Central. You may be able to view the full-text article on this website or open the article in Portable Document Format (PDF) by clicking on a link.

2. DOI
This is the acronym for Digital Object Identifier, a unique alphanumeric string assigned by the International DOI Foundation to identify content and provide a persistent link to its location on the internet. Clicking on the “DOI” link on the PEDro “Detailed Search Results” page will take you directly to the article on the journal’s website. Not all journals will allow you to access full text free of charge. In this case you may be asked to login or to pay to access the article. If a subscription is required, you may be able to access the article via the library provided by your university or health service your local medical library.

3. PubMed
Produced by the United States National Institutes of Health’s National Library of Medicine, PubMed is a free database containing over 34 million citations and abstracts of biomedical literature. The “PubMed” link on the PEDro “Detailed Search Results” page will take you to the PubMed entry for the article. This PubMed entry may contain links to full text from other sources.

4. PDF locator
Some search engines on the internet are designed to find free PDF documents. In PEDro we have created a link that uses PDFSearchEngine.net to search for PDF copies of the article. Clicking on the “PDF locator” link on the PEDro “Detailed Search Results” page will take you to the search results generated by PDFSearchEngine. These results are ranked for relevance using a built-in algorithm. You will need to scan down the list of search results to see if a link to full text is available for your article of interest. We suggest that you look at the first two pages of search results.

5. Publisher
The last option for accessing full text is via the website of the journal using the “publisher” hyperlink on the PEDro “Detailed Search Results” page. Accessing full text will require additional navigation through the journal website in order to locate the issue that your target article is published in. Not all journals will allow you to access full text free of charge. In this case you may be asked to login or to pay to access the article.

Saurab Sharma, University of New South Wales, Australia

As a physiotherapist, researcher, and educator in Nepal, Saurab Sharma often faced barriers to accessing full-text research articles that are behind a “paywall”. Saurab provides some innovative solutions on how to access full-text articles freely in low and middle-income countries where resources are scarce. For example, digital archives like PubMed Central or Hinari provide options to search for articles in specific languages and can provide free access to full-text articles. Other good resources for accessing free full-text articles are journals or publishers that publish ‘open-access’ articles such as Journal of Physiotherapy, PLoS and BMC. The Physiotherapy Evidence Database also provides links to accessing full-text articles, some of which are freely available. Research published in 2022 showed that PEDro provides access to 60 % of the articles sampled from the PEDro database, compared to PubMed which provides access to 47% of full-text articles. In this video, Saurab explores these resources and other strategies to address the barrier of access.