Glinsky, JoanneHarvey, LisaRalston, KeiraChu, JackieMcDonald, MarkGollan, EmilieWadsworth, BrookeWilson, DeanneBen, MarshaWhite, JacquiByak, AdrianTang, JonathonRainey, DonnaRedhead, JasonHaber, AmandaBye, LizDi Natal, FernandaFornusek, CheChen, LydiaDenis, SophiaPeach, JaiQuel De Oliveira, CamilaDonahoe, SheelaghDunn, JenniferNunnerley, JoStavric, VernaWalters, MareeMcCorkell, JennieNakhle, AnthonyMaughan, LucyRees, LeanneMcCarthy, JanetKotze, Mel2025-09-032025-09-032023-04-041362-43931476-5624http://hdl.handle.net/10292/19753STUDY DESIGN: Development of a Clinical Practice Guideline (CPG). OBJECTIVE: To develop a CPG for 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 for 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 .Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. © The Author(s) 20254201 Allied Health and Rehabilitation Science32 Biomedical and Clinical Sciences3202 Clinical Sciences42 Health SciencesClinical Trials and Supportive ActivitiesNeurosciencesTraumatic Head and Spine InjurySpinal Cord InjuryPhysical Injury - Accidents and Adverse EffectsClinical Research1103 Clinical Sciences1106 Human Movement and Sports Sciences1109 NeurosciencesRehabilitation3209 Neurosciences4201 Allied health and rehabilitation scienceJournal ArticleOpenAccess10.1038/s41393-025-01088-8