Evidence-based practice: Methods to evaluate individual patient improvement

The expectations and demands associated with evidence-based practice in medical rehabilitation require the use of research procedures that are practice based and practitioner oriented. Traditional research methods, including randomized clinical trials, are powerful techniques for determining the efficacy of rehabilitation interventions; however, randomized clinical trials have some practical and ethical limitations when applied to many research questions important to the field of medical rehabilitation, and alternative methods are needed to fully examine the effectiveness of treatment techniques for individual patients and to document clinical accountability. This paper examines the use of single-system designs and N of 1 research strategies. The advantages and limitations of single-system methods are described, and examples relevant to the documentation of clinical outcomes in medical rehabilitation are presented.