An Australian and New Zealand clinical practice guideline for the physiotherapy management of people with spinal cord injuries.

STUDY

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 .