An Australian and New Zealand Clinical Practice Guideline for the Physiotherapy Management of People With Spinal Cord Injuries

Abstract

Study design: Development of a Clinical Practice Guidelines (CPG) Objective: To develop a CPG on the physiotherapy management of people with Spinal Cord Injuries (SCI). Setting: Australia and New Zealand Methods: Systematic reviews of randomised controlled trials (RCTs) of physiotherapy interventions for adults with SCI were conducted to address over 100 clinical questions. Questions were decided a priori and written in PICO format (Participant, Intervention, Comparison and Outcome). Meta-analyses were conducted across trials that made similar comparisons. A Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess evidence certainty and formulate recommendations. A Guideline panel made evidence recommendations and consensus-based opinion statements based on a standardised process that included voting. Results: Seventy-six RCTs met the inclusion criteria for the systematic reviews. These RCTs informed 20 meta-analyses that were used in the development of the CPG. More than one hundred evidence recommendations and consensus-based opinion statements across 13 categories of physiotherapy interventions were made by the panel. Conclusion: The Australian and New Zealand CPG on the Physiotherapy Management of people with SCI provide clear and readily accessible guidance to physiotherapists based on evidence and consensus of clinical experts. The Guideline is available at www.sciptguide.com.